Emergency Bleeding Management in High-Risk Scenarios
In a groundbreaking 2-part webinar series, Scott King, a renowned expert in hostile environment medicine, delves into the latest techniques, technologies, and human factors shaping trauma care in complex and challenging settings. The webinar series, available to watch here, serves as a valuable complement to the upcoming Hostile Environment Medicine Course in Namibia this June.
The second part of the webinar series focuses on massive hemorrhage control, an issue of critical importance in austere and high-threat environments where uncontrolled bleeding remains the leading cause of preventable death.
Key Techniques and Technologies
Rapid bleeding control methods are at the forefront of this revolution. Extremity tourniquets and junctional hemorrhage control devices are essential tools for swiftly stopping bleeding in trauma patients, prioritizing circulation before airway management in critical cases. Direct pressure and wound packing, especially with hemostatic gauze, remain indispensable and are widely taught through programs like the American College of Surgeons’ Stop the Bleed.
The introduction of prehospital focused assessment with sonography in trauma (FAST) and predictive scoring systems, such as the phTASH score, plays a significant role. FAST rapidly identifies internal bleeding sources, guiding timely intervention, while predictive scores provide high accuracy in predicting the need for any or massive transfusion even before hospital arrival.
Massive Transfusion Protocols (MTPs) and blood product use are central to managing extensive hemorrhage. Protocol-driven massive transfusion using balanced blood products is crucial, although indication must be precise to avoid risks associated with unnecessary transfusions. Advances include better logistical coordination to ensure timely availability of blood products and evidence-based protocols to standardize care in hostile or resource-limited settings.
Surgical interventions and interventional radiology methods, such as embolization, are increasingly used when rapid hemorrhage control is necessary and transport to advanced care is delayed.
Influence on Trauma Care
Improved early identification and tailored intervention, empowerment of non-medical responders, streamlined hospital protocols, and integrated multidisciplinary approaches are some of the ways these advancements impact trauma care in hostile environments. The combination of prehospital ultrasound, predictive scoring systems, and advanced hemorrhage control devices enables targeted, rapid decision-making that improves survival chances.
Scott King, the instructor for the webinar series, discusses various aspects of massive hemorrhage control, including the use of hemostatic agents, proper placement of tourniquets, tactical triage, and decision-making in mass casualty incidents. He brings over 22 years of experience in ambulance services, military instruction, and hostile environment training to the table.
For those interested in learning more, the first session of the webinar series explores hostile medicine in depth, while the second session delves into massive hemorrhage control. Scott King can be contacted directly via [email protected].
- The second part of Scott King's webinar series, focusing on massive hemorrhage control, emphasizes the importance of medical-conditions like uncontrolled bleeding, a leading cause of preventable death in disaster situations, and explores techniques such as the use of extremity tourniquets and junctional hemorrhage control devices.
- In addition to rapid bleeding control methods, key technologies like prehospital focused assessment with sonography in trauma (FAST) and predictive scoring systems, such as the phTASH score, are essential for identifying internal bleeding sources swiftly and guiding timely intervention.
- To manage extensive hemorrhage, courses like the American College of Surgeons’ Stop the Bleed teach direct pressure and wound packing methods, while Massive Transfusion Protocols (MTPs) and blood product use are central to providing care in resource-limited settings.
