The Tägerwilen II report: Recommendations from the NATO Prehospital Care Improvement Initiative Task Force.

Background: The Committee of the Chiefs of Military Medical Services (COMEDS) initiated the Prehospital Care Improvement Initiative Task Force (PHCII TF) to advise on how to improve prehospital care within NATO nations. The Task Force consisted of the NATO Military Health Care Working Group and its subordinated expert panels, including the Blood Panel, the Emergency Medicine Panel and the Special Operations Forces Medicine Panel.

Method: The PHCII TF identified four key prehospital care themes for exploration: 1) Tactical Casualty Care, 2) Blood Far Forward), 3) Forward Surgical Capabilities), and 4) Prolonged Casualty Care.

Transfusion practice in Central Norway - a regional cohort study in patients suffering from major haemorrhage.

Background: In patients with major hemorrhage, balanced transfusions and limited crystalloid use is recommended in both civilian and military guidelines. This transfusion strategy is often applied in the non-trauma patient despite lack of supporting data. The aim of this study was to describe the current transfusion practice in patients with major hemorrhage of both traumatic and non-traumatic etiology in Central Norway, and discuss if transfusions are in accordance with appropriate massive transfusion protocols.

Management of COVID-19 in a Deployed Setting.

Introduction: Hamid Karzai International Airport is a NATO military base connected to the international airport in Kabul, Afghanistan. It is one of the larger NATO installations in Afghanistan, and with its location being one of the main hubs for international transit, the base has been at the frontline since the beginning of the COVID-19 pandemic. Hamid Karzai International Airport base commanders and medical staff have been at the forefront, continually developing policies and procedures to mitigate the pandemic in a deployed setting.

Is there a place for crystalloids and colloids in remote damage control resuscitation?

Crystalloids and colloids are used in prehospital fluid resuscitation to replace blood loss and preserve tissue perfusion until definite surgical control of bleeding can be achieved. However, large volumes of fluids will increase bleeding by elevating blood pressure, dislodging blood clots, and diluting coagulation factors and platelets. Hypotensive fluid resuscitation strategies are used to avoid worsening of uncontrolled bleeding.

Heat shock increases survival in rats exposed to hyperbaric pressure.

It has been shown that a single bout of exercise performed 20 hours prior to hyperbaric exposure reduces bubble formation and increases survival in rats. Heat shock proteins (HSPs) are stress proteins expressed in cells that are exposed to different stressors. HSPs are known to protect cells, by binding to proteins and stabilizing them.