Haemostatic resuscitation in practice: a descriptive analysis of blood products administered during Operation HERRICK, Afghanistan.

Introduction: Life-threatening haemorrhage is the leading cause of potentially survivable injury in battlefield casualties. During Operation HERRICK (Afghanistan), mortality rates improved year on year due to a number of advances in trauma care, including haemostatic resuscitation. Blood transfusion practice has not previously been reported in detail during this period.

The UK defence anaesthesia experience with the Zambia Anaesthesia Development Programme.

For 18 months UK military anaesthetic trainees have been travelling to Zambia for a 3-month fellowship under the auspices of the Zambia Anaesthesia Development Programme. In this article we will discuss the history, current state and future intent of the fellowship in order to better inform the anaesthetic cadre and wider UK Defence Medical Services.

Should whole blood replace the shock pack?

When haemorrhage occurs on the battlefield, the soldier rapidly loses whole blood; it therefore stands to reason that the optimum fluid for resuscitation is whole blood. Indeed, this was the case for the first 250 years of transfusion practice, but since the 1970s component therapy has been used, with little evidence for that change. It is hardly surprising that 'balanced' component therapy, which seeks to replicate whole blood, has been found to offer the best results in resuscitation.