Background

Resuscitation goals for trauma patients have undergone significant change in the past decade. Appropriate blood product transfusion ratios, use of pharmacologic adjuncts (e.g., TXA) and other modalities have improved survival for the wounded combatant. In the operating room (OR), resuscitation occurs in the context of providing an anesthetic which minimizes hemodynamic instability in the severely injured patient. It is imperative, therefore, that the management of this resuscitation occurs simultaneously with surgery and anesthesia. While recent review articles, checklists and textbooks have drawn attention to the role of anesthetic resuscitation concurrent with surgical correction of injury, there is no guideline for the induction, maintenance, and transfer of anesthetic care of the military trauma patient in extremis.1-4