Summary of Changes
- Inclusion of data from the DoD Trauma Registry (DoDTR) on incidence/prevalence and resuscitation requirements of this unique population.
- Considerations for Zone 3 resuscitative endovascular balloon occlusion of the aorta (REBOA) for proximal control in casualties with high bilateral amputations.
- Updated initial transfusion requirements and guidelines. Whole blood should be used preferentially, and crystalloid should not be used for resuscitation of these patients secondary to their profound shock state.
- Clarified PI metrics to include the addition of:
- Number/percentage of patients who undergo REBOA placement upon arrival to the medical treatment facility (MTF).
- Documentation and tracking of transfusion requirements.
- Use standardized OR sheet to be included in notes to Performance/Adherence Metrics (Appendix A: DCBI H&P supplement).