Triage in major incidents: development and external validation of novel machine learning-derived primary and secondary triage tools.

Background: Major incidents (MIs) are an important cause of death and disability. Triage tools are crucial to identifying priority 1 (P1) patients-those needing time-critical, life-saving interventions. Existing expert opinion-derived tools have limited evidence supporting their use.

Paediatric major incident triage: UK military tool offers best performance in predicting the need for time-critical major surgical and resuscitative intervention.

Background: Children are frequently injured during major incidents (MI), including terrorist attacks, conflict and natural disasters. Triage facilitates healthcare resource allocation in order to maximise overall survival. A critical function of MI triage tools is to identify patients needing time-critical major resuscitative and surgical intervention (Priority 1 (P1) status).

Comparative analysis of major incident triage tools in children: a UK population-based analysis.

Introduction: Triage is a key principle in the effective management of major incidents. There is currently a paucity of evidence to guide the triage of children. The aim of this study was to perform a comparative analysis of nine adult and paediatric triage tools, including the novel 'Sheffield Paediatric Triage Tool' (SPTT), assessing their ability in identifying patients needing life-saving interventions (LSIs).

The BCD Triage Sieve outperforms all existing major incident triage tools: Comparative analysis using the UK national trauma registry population.

Background: Natural disasters, conflict, and terrorism are major global causes of death and disability. Central to the healthcare response is triage, vital to ensure the right care is provided to the right patient at the right time. The ideal triage tool has high sensitivity for the highest priority (P1) patients with acceptably low over-triage.

Pre-hospital blood transfusion - an ESA survey of European practice.

Background: Blood products are a lifesaving commodity in the treatment of major trauma. Although there is little evidence for use of pre-hospital blood products (PHBP) in seriously injured patients, an increasing number of emergency medical services have started using PHBP for treatment of major haemorrhage. The primary aim of this survey was to establish the degree of prehospital blood product use throughout Europe and discover main indications.

Primary Blast Lung Injury: The UK Military Experience.

Introduction: Primary blast lung injury occurs when an explosive shock wave passes through the thorax and transits through tissues of varying densities. It requires close proximity to an explosion and presents quick with respiratory distress in survivors.

Materials And Methods: The Joint Theatre Trauma Registry and the Defence Statistics (Health) Database were interrogated for casualties injured as a result of an explosion during the conflict in Afghanistan.

Marauding terrorist attack (MTA): prehospital considerations.

Terrorist attacks are increasing each year as are the number of deaths associated with them. Recent incidents have seen a shift in tactics with the use of multiple terrorists across multiple locations with firearms or knives, referred to as the marauding terrorist attack. These methods are becoming more prevalent alongside the use of vehicles deliberately aimed at pedestrians.

Died of wounds: a mortality review.

Objectives: Combat casualty care is a complex system involving multiple clinicians, medical interventions and casualty transfers. Improving the performance of this system requires examination of potential weaknesses. This study reviewed the cause and timing of death of casualties deemed to have died from their injuries after arriving at a medical treatment facility during the recent conflicts in Iraq and Afghanistan, in order to identify potential areas for improving outcomes.

Rotational thromboelastometry-guided trauma resuscitation.

Purpose Of Review: Haemorrhage from major trauma is a significant cause of death worldwide. The UK Defence Medical Service (UK-DMS) has had significant experience in managing severely injured and shocked trauma casualties over the last decade. This has led to the integration of rotational thromboelastometry (ROTEM) into damage control resuscitation delivered at Camp Bastion Field Hospital in Afghanistan.

Impact of high ratios of plasma-to-red cell concentrate on the incidence of acute respiratory distress syndrome in UK transfused combat casualties.

Trauma transfusion strategies, which incorporate balanced red-cell concentrate (RCC)-to-fresh frozen plasma (FFP) ratios, may be associated with improved survival in massively transfused patients. However, the use of this approach in nonmassively transfused patients has led to concern regarding an increase in acute respiratory distress syndrome (ARDS). The aim of this study was to assess the incidence of ARDS in transfused UK military casualties.