U.S. ARMY INSTITUTE OF SURGICAL RESEARCH
"Optimizing Combat Casualty Care"

Damage Control Resuscitation (DCR)


RESEARCH FOCUS

In efforts of optimizing combat casualty care, the focus of our research is to improve methods to control severe bleeding and to provide sufficient fluids and blood products to stabilize the injured casualty. The majority of this work focuses in the pre-hospital setting where the majority of combat casualties die, but the techniques are applicable at all levels of care.


RESEARCH GOALS

To provide cutting-edge techniques for control of bleeding and resuscitation aligned to the principles of Tactical Combat Casualty Care which include care under fire, tactical field care and en-route care during evacuation, no matter where our service members serve.


CORE COMPETENCIES

  • Hemorrhage model development
  • Human Research Studies
  • Manikin models

CURRENT RESEARCH EFFORTS

  • Evaluation of tourniquets for safety and effectiveness to control bleeding from the extremities or regions where the extremities join to the body.
  • Evaluation of safety and effectiveness of bandages that have special properties to stop arterial or large volume venous bleeding.
  • Investigations into the best use of blood products, fluids and drugs for stabilizing the injured casualty.

Contact the DCR Director, click here.


RECENT PUBLICATIONS

Burns JW, Baer LA, Hagerman EJ, Jordan BS, Nelson JJ, Jr., Batchinsky AI, Cancio LC, Jones JA, Dubick MA, Wade CE. Development and resuscitation of a sedated, mature male miniature swine severe hemorrhage model. The Journal of trauma. 2011;71(1):148-56.

Kheirabadi B. Evaluation of topical hemostatic agents for combat wound treatment. US Army Medical Department journal. 2011:25-37.

Kragh JF, Jr., Beebe DF, O'Neill ML, Beekley AC, Dubick MA, Baer DG, Blackbourne LH. Performance improvement in emergency tourniquet use during the Baghdad surge. The American journal of emergency medicine. 2013;31(5):873-5.

Kragh JF Jr, Littrel ML, Jones JA, Walters TJ, Baer DG, Wade CE, Holcomb JB. Battle casualty survival with emergency tourniquet use to stop limb bleeding. Journal of Emergency Medicine. 2011; 41(6):590-97.

Kragh JF, Jr., Mann-Salinas EA, Kotwal RS, Gross KR, Gerhardt RT, Kheirabadi B, Wallum TE, Dubick MA. Laboratory assessment of out-of-hospital interventions to control junctional bleeding from the groin in a manikin model. The American journal of emergency medicine. 2013;31(8):1276-8.

Kragh JF, Jr., O'Neill ML, Walters TJ, Dubick MA, Baer DG, Wade CE, Holcomb JB, Blackbourne LH. The military emergency tourniquet program's lessons learned with devices and designs. Military medicine. 2011;176(10):1144-52.

Mann-Salinas EA, Kragh JF, Jr., Dubick MA, Baer DG, Blackbourne LH. Assessment of users to control simulated junctional hemorrhage with the combat ready clamp (CRoC). International journal of burns and trauma. 2013;3(1):49-54.

Martini WZ, Cortez DS, Dubick MA. Comparisons of normal saline and lactated Ringer's resuscitation on hemodynamics, metabolic responses, and coagulation in pigs after severe hemorrhagic shock. Scandinavian journal of trauma, resuscitation and emergency medicine. 2013;21:86.

Sondeen JL, Prince MD, Kheirabadi BS, Wade CE, Polykratis IA, de Guzman R, Dubick MA. Initial resuscitation with plasma and other blood components reduced bleeding compared to hetastarch in anesthetized swine with uncontrolled splenic hemorrhage. Transfusion. 2011;51(4):779-92.

Torres LN, Sondeen JL, Ji L, Dubick MA, Filho IT. Evaluation of resuscitation fluids on endothelial glycocalyx, venular blood flow, and coagulation function after hemorrhagic shock in rats. The journal of trauma and acute care surgery. 2013;75(5):759-66.