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Provision of initial surgery to casualties within one hour of injury is associated with better survival. Where evacuation options are limited, surgery within the “golden hour” may have to occur close to the point of injury. Interventions close to the point of injury are limited by the adverse environment. Far-forward surgery has a long history going back to Dominique Larrey of the Napoleonic Army. We reviewed previous reports and used our own experience of far-forward surgery to describe the specifications of the ideal mobile operating room that would address some of these environmental barriers.
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http://dx.doi.org/10.1503/cjs.014718 | DOI Listing |
Mil Med
July 2025
Divisions of Trauma, Surgical Critical Care and Burns, Daughtry Family Department of Surgery, University of Miami Miller School of Medicine and Jackson Memorial Hospital Ryder Trauma Center, and US Army Trauma Training Center, Miami, FL 33136, United States.
Introduction: Role 2 (R2) U.S. military treatment facilities provide lifesaving far forward damage control resuscitation and surgery.
View Article and Find Full Text PDFJ Spec Oper Med
June 2025
University of Colorado School of Medicine, Aurora, CO.
Introduction: Airway obstruction is a leading cause of potentially survivable death on the battlefield. Intubation remains the most frequently performed prehospital airway intervention. Unfortunately, survival is lower after prehospital intubation compared to the emergency department.
View Article and Find Full Text PDFTransfusion
July 2025
Department of Surgery, University of Washington School of Medicine, Seattle, Washington, USA.
Background: The United States military has transfused room temperature platelets (RTPs) in combat since 2004, but distribution to far-forward locations is limited. To expand access, cold-stored platelets (CSPs) were approved for 10-day storage in 2017, increased to 14 days in 2019, but clinical outcome reporting has been limited. This study assessed whether CSPs were associated with mortality in combat trauma patients when compared with RTPs.
View Article and Find Full Text PDFCureus
October 2024
Department of Anesthesiology, Uniformed Services University of the Health Sciences, Bethesda, USA.
Mil Med
February 2025
Department of Military and Emergency Medicine, Uniformed Services University, Bethesda, MD 20814, USA.
Introduct Ion: The demands of future large-scale combat operations may require medics and corpsmen to increasingly perform expectant casualty care (ECC). However, no detailed guidelines currently exist for providing ECC within military medicine. To guide the development of education and training guidelines and advance team training of both medics and non-medics, an in-depth understanding is first needed regarding caregivers' experiences providing ECC in recent conflicts as well as perceived training gaps.
View Article and Find Full Text PDF