The use of fresh whole blood transfusions by the SOF medic for hemostatic resuscitation in the austere environment.

The leading cause of death on the battlefield is uncontrolled hemorrhage. Non-compressible (truncal) hemorrhage is the cause over two thirds of these deaths. This makes truncal hemorrhage the leading cause of potentially survivable death on the battlefield. Over one third of the casualties who arrive at the emergency department (ED) or combat surgical hospital (CSH) in need of a blood transfusion are already suffering from acute traumatic coagulopathy which is associated with an 80% mortality. Early aggressive treatment and prevention of this coagulopathy through hemostatic resuscitation has been shown to increase survival. Hemostatic resuscitation involves the very early use of blood and blood products as primary resuscitation fluids to both treat intrinsic acute traumatic coagulopathy and prevent the development of dilutional coagulopathy. Few, if any, of the products used in hemostatic resuscitation are currently available to the Special Operations Forces (SOF) medic. Warm fresh whole blood transfusions could be a powerful tool for the SOF medic to use in order to begin hemostatic resuscitation in the field.