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This project reviewed various published methods to extend the shelf-life durations of whole blood and packed red blood cells and their possible effectiveness and implementations within an austere environment setting to not only increase blood bank capabilities but also reduce waste, providing a strategic advantage during anticipated future conflicts with higher estimated demands for casualties and a corresponding increase in the quantity of transfusions. Examined methods included usage of anticoagulants, additive solutions, deoxygenated/anaerobic storage, cryopreservation, and variable temperature cycling/thermal holding to understand if their benefits would be applicable to the challenges often experienced in a resource limited setting. Several studies revealed promising combinations of methods/techniques that would allow for shelf-life extension during the storage of blood products, introducing new possibilities to enhance the logistical infrastructure for supporting an extended blood supply duration if needed.

This discussion will provide the most up-to-date literature on whole blood use in military and civilian settings.

This event highlights the importance of adaptability in extended care environments throughout multiple echelons of care. Advanced Ranger First Responder (ARFR) and other non-medical attendants provided invaluable support at the POI and CCP. SOF medics became primary providers and were able to control the chaos despite the surgical team being seriously wounded. Interestingly, two patients experienced Ketamine ?emergence reactions? during PCC transport despite sub-dissociative dosing schedules. This unique event exemplifies the ability of SOF Medics to perform as highly capable independent medical providers in even the worst situations.

To describe the development of a Joint Austere Resuscitative & Surgical Care team curriculum. The Joint Trauma System led chartered Curriculum Development Work Group process of analyzing current Service (Army, Air Force, Navy, Marine Corps)? surgical team training and identifying common elements, best practices and curricular gaps will be described.?

Our team of trauma and critical care clinicians will summarize the available evidence as it relates to: albumin, ALM, vasopressors, and synthetic blood. Since the publication of the SAFE study, there has been hesitancy in the trauma community for use of albumin, however there has been increased interest recently in such fields as burn resuscitation to use albumin. Colloids in general, such as hextend, have equally fallen out of favor for their association with kidney injuries. Attempts at finding optimal dosing of ALM formulations have led to mixed results in multiple recent studies. Vasopressor use in trauma patients has recently experienced a resurgence at several academic centers and the underlying pathophysiology supporting their use, as well as recent studies, will be reviewed. Options for synthetic blood and future use cases will also be discussed.

This curriculum aims to maximize SOCM performance and augment surgical team capabilities ranging from Point of Injury (POI) through Damage Control Surgery (DCS) and Critical Care (CC). The SOCM curriculum includes standardized rotations through emergency medicine, trauma surgery, critical care, as well as intra-facility air and ground transport. Each rotation tracked performance and preparation for correlated skills - prehospital care, assisting in the operating room, and prolonged casualty care. Success was evaluated through objective measures of Individual Critical Task Lists and subjective SOCM self-assessment. Initial pilot data suggests successful integration of SOCMs into advanced medical care and increased preparation for combat casualty care.

Presentation: current ?uid/blood warming capabilities in austere environments; with a focus on weight/cube vs. logistics, and how that a?ects decision making when DCR/DCS is necessary for a patient.?

Environmental injuries are a frequently debilitating hazard for units operating in the Arctic or extreme cold environments (AoECE). Early treatment of cold weather injuries (CWIs) improves the preservation of combat power and reduces the morbidity and reduction in combat power associated with injury. The gold standard treatment of frostbite is a circulating warm water bath at 100.4øF ? 107.6øF. This has historically been difficult to accomplish for units in austere environments due to equipment constraints. However, recent publications by Fiutko et al., and Daniel et al. have raised awareness of a safe and effective means of rewarming extremities affected by cold weather which can be implemented in austere environments.

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