Remote Damage Control Resuscitation: A Case Report of Hemorrhagic Shock Secondary to Multiple Gunshot Wounds

Author:

Puris Gal12,Gelikas Shaul1,Pikman Regina1,Shapira Shachar1,Talmy Tomer1,Almog Ofer12,Yazer Mark H34,Benov Avi15,Gendler Sami1ORCID

Affiliation:

1. The Trauma and Combat Medicine Branch, Surgeon General’s Headquarters, Israel Defense Forces , Ramat Gan 5262000, Israel

2. Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem , Jerusalem 9112102, Israel

3. Department of Pathology, University of Pittsburgh , Pittsburgh, PA 15213, USA

4. Department of Pathology, Tel Aviv University , Tel Aviv 69978, Israel

5. The Azrieli Faculty of Medicine, Bar-Ilan University , Safed 1311502, Israel

Abstract

ABSTRACT Hypovolemic shock is the leading cause of preventable death on the battlefield. Remote damage control resuscitation has evolved dramatically in the past decade by introducing novel treatments and approaches to bleeding in the prehospital setting. This report presents a case of a casualty who sustained multiple gunshot wounds to the chest and gluteal regions and suffered from hemorrhagic shock with an Injury Severity Score of 34. The casualty was treated at the point of injury and during evacuation according to the IDF’s remote damage control resuscitation algorithm utilizing the range of blood products available in the IDF. Prompt identification of the mechanism of injury, clinical and tactical decision-making, and immediate advanced medical care through several prehospital medical evacuation platforms culminated in this casualty’s survival. This case emphasizes the importance of medical advancements in prehospital field care and guideline-directed treatment to improve casualty survival.

Publisher

Oxford University Press (OUP)

Subject

Public Health, Environmental and Occupational Health,General Medicine

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