Strandenes Geir, Hervig Tor A, Bjerkvig Christopher K, Williams Steve, Eliassen Håkon S, Fosse Theodor K, Torvanger Hans, Cap Andrew P
1Norwegian Naval Special Operations Commando, Bergen, Norway; 2Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway; 3Department of Anesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway; 4Medical Operations Royal Caribbean Cruises Ltd., Miami, FL; and 5U.S. Army Institute of Surgical Research, Joint Base San Antonio-Fort Sam Houston, TX.
Curr Sports Med Rep. 2015 Mar-Apr;14(2):129-34. doi: 10.1249/JSR.0000000000000130.
The optimal resuscitation fluid for uncontrolled bleeding and hemorrhagic shock in both pre- and in-hospital settings has been an ongoing controversy for decades. Hemorrhage continues to be a major cause of death in both the civilian and military trauma population, and survival depends on adequacy of hemorrhage control and resuscitation between onset of bleeding and arrival at a medical treatment facility. The terms far-forward and austere are defined, respectively, as the environment where professional health care providers normally do not operate and a setting in which basic equipment and capabilities necessary for resuscitation are often not available. The relative austerity of a treatment setting may be a function of timing rather than just location, as life-saving interventions must be performed quickly before hemorrhagic shock becomes irreversible. Fresh whole blood transfusions in the field may be a feasible life-saving procedure when facing significant hemorrhage.
几十年来，在院前和院内环境中，用于控制出血和失血性休克的最佳复苏液体一直存在争议。出血仍然是 civilian 和 military 创伤人群死亡的主要原因，而生存取决于出血控制的充分性以及从出血开始到抵达医疗机构期间的复苏情况。“前沿”和“简易”这两个术语分别定义为专业医护人员通常不开展工作的环境以及通常不具备复苏所需基本设备和能力的场所。治疗环境的相对简易可能是时间的函数，而非仅仅取决于地点，因为必须在失血性休克变得不可逆之前迅速进行挽救生命的干预措施。在面对大量出血时，现场输注新鲜全血可能是一种可行的挽救生命的程序。
