Major scientific lessons learned in the trauma field over the last two decades

John B Holcomb

doi:10.1371/journal.pmed.1002339

Abstract

John B Holcomb summarizes recent conceptual and practical advances in trauma care, in both military and civilian settings, and presents directions for future research.

Highlights

Major scientific lessons learned in the trauma field over the last two decades John B
Through the conflicts of the last 20 years, we have developed the current treatment for traumatic hemorrhagic shock; simultaneous mechanical hemorrhage control coupled with damage control resuscitation (DCR), with an emphasis on using plasma as the primary resuscitative fluid [6]
The current paradigm is changing with the Tactical Combat Casualty Care (TCCC) guidelines recommending a move from balanced component transfusion in favor of whole blood (WB) [8]. This important transition has been led by the military with more than 10,300 units of WB transfused in the war, with favorable clinical outcomes

Summary

OPEN ACCESS

A focus on current trauma experience has become accepted as critical for optimal patient outcomes in both the short and long term [2] These concepts have transitioned variably into clinical practice in the civilian world, where mass. 5, 2017 casualty and terrorist events are increasing, and the huge numbers of everyday trauma cases could benefit from hard-won military lessons Uniform translation of these concepts into both the military and civilian sectors is incomplete

Systems of care

Stopping bleeding is important

Neurosurgery and orthopedics

Research funding

The future