New methods of hemorrhage Control in Pre-Hospital and Battlefield Conditions: Mini Review

Document Type : Mini Review

Authors

Trauma Research Center, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran

Abstract

Background and Aim: Hemorrhage has been a major cause of casualties on the battlefield, which can be prevented in many cases. The aim of this study was to evaluate the results of hemorrhage control methods in pre-hospital and battlefield conditions.
Methods: In this mini-review, search was conducted using different combination of keywords including Hemorrhage control, Hemorrhage blocking agents, new methods of hemorrhage control, pre-hospital care, war scene, battlefield, nurse from the databases like IranMedex, Sid, Scopus, Magiran, PubMed, Google Scholar, Scopus, Pro Quest, CINHAL, Science Direct from 2000 to 2019. The articles were reviewed by three researchers independently.
Results: The databases search yielded 42 records. Based on inclusion and exclusion criteria, 13 articles were selected for study purpose. The results obtained from the articles showed that among the major factors controlling hemorrhage, two major factors play more prominent role. The first is combat tourniquets that have an important role in saving people's lives from hemorrahge, and the second category is the novel Hemostatic agents, which are manufactured under different trademarks and in various forms, including powder, bond or gas impregnated with these materials.
Conclusion: Tourniquet can be life-saving if used at the right time. The modern blood coagulation factors may not fulfill all expectations in the process of controlling hemorrage on the battlefield. But any blood hemostatic factor with its properties can have a significant impact on controlling bleeding and subsequently saving lives.

Keywords


1. Schauer SG, April MD, Naylor JF, Maddry JK, Arana AA, Dubick MA, et al. Prehospital Application of Hemostatic Agents in Iraq and Afghanistan. Prehospital Emergency Care. 2018:1-10. doi:10.1080/10903127.2017.1423140 2. Kragh Jr JF, Littrel ML, Jones JA, Walters TJ, Baer DG, Wade CE, et al. Battle casualty survival with emergency tourniquet use to stop limb bleeding. The Journal of emergency medicine. 2011;41(6):590-7. doi:10.1016/j.jemermed.2009.07.022 3. Kragh Jr JF, O'Neill ML, Walters TJ, Jones JA, Baer DG, Gershman LK, et al. Minor morbidity with emergency tourniquet use to stop bleeding in severe limb trauma: research, history, and reconciling advocates and abolitionists. Military medicine. 2011; 176(7):817-23. doi:10.7205/MILMED-D-10-00417 4. TCCC. Guidelines for Medical Personnel. 5. Butler DF. Special Operations Medical Association Scientific Assembly 25 May 2017. 6. Conley SP, Littlejohn LF, Henao J, DeVito SS, Zarow GJ. Control of junctional hemorrhage in a consensus swine model with hemostatic gauze products following minimal training. Military medicine. 2015;180(11):1189-95. doi:10.7205/MILMED-D-14-00541 7. Achneck HE, Sileshi B, Jamiolkowski RM, Albala DM, Shapiro ML, Lawson JH. A comprehensive review of topical hemostatic agents: efficacy and recommendations for use. Annals of surgery. 2010; 251 (2): 217-28. doi:10.1097/SLA.0b013e3181c3bcca 8. Whang HS, Kirsch W, Zhu YH, Yang CZ, Hudson SM. Hemostatic agents derived from chitin and chitosan. Journal of Macromolecular Science, Part C: Polymer Reviews. 2005;45(4):309-23. doi:10.1080/15321790500304122 9. Cox ED, Schreiber MA, McManus J, Wade CE, Holcomb JB. New hemostatic agents in the combat setting. Transfusion. 2009;49:248S-55S. doi:10.1111/j.1537-2995.2008.01988.x 10. Hatamabadi HR, Zarchi FA, Kariman H, Dolatabadi AA, Tabatabaey A, Amini A. Celox-coated gauze for the treatment of civilian penetrating trauma: a randomized clinical trial. Trauma monthly. 2015;20(1). doi:10.5812/traumamon.23862 11. Garcia-Blanco J, Gegel B, Burgert J, Johnson S, Johnson D. The Effects of Movement on Hemorrhage When QuikClot® Combat Gauze™ Is Used in a Hypothermic Hemodiluted Porcine Model. Journal of special operations medicine: a peer reviewed journal for SOF medical professionals. 2015;15(1):57-60. 12. Kordestani S, Shahrezaee M, Tahmasebi M, Hajimahmodi H, Ghasemali DH, Abyaneh M. A randomised controlled trial on the effectiveness of an advanced wound dressing used in Iran. Journal of wound care. 2008;17(7):323-7. doi:10.12968/jowc.2008.17.7.30525 13. Mortazavi S, Atefi M, Roshan-shomal P, Tanide N, Raadpey N, Bagheri Z. Characteristics of CoolClot, the invented novel hemostatic agent. Scientific Journal of Iran Blood Transfus Organ. 2011; 8(2):115-21. doi:10.1504/IJLR.2011.040644