2. Objectives
Describe Damage Control Resuscitation
Describe the differences in resuscitation between
colloids and crystalloids
Describe the pathophysiology and physiological
derangements in the bleeding/trauma patient
Discuss hemostatic resuscitation
Discuss the triggers for surgical intervention vs.
ongoing resuscitation
3. In the U.S. Trauma is the 5th cause of death in
people<44 years
Preventable deaths from trauma due to uncontrolled
hemorrhage and coagulopathy
4. DCR-Definition
The term “damage control” originated during WWII
as a description of the US Navy’s strategy to salvage
sinking ships
Recent combat experiences in Iraq and Afghanistan
has changed our understanding of the nature of
trauma-related coagulopathy
DCR is a systematic approach to the trauma patient
with severe injuries
It is designed along with damage control surgery to
reverse coagulopathy, acidosis and hypothermia
5. When combined with damage control surgery; it has
been shown to improve 30 day survival
DCR algorithym can then be used in other patients
who present with acute bleeding- ex GI
bleeding, liver transplantion, post-op patient with
generalized bleeding/coagulopathy
6. Damage Control Resuscitation Algorithym
Body Rewarming
Correction of acidosis
Permissive Hypotension
Restrictive Fluid Administration
Hemostatic Resuscitation
Editor's Notes
The strategy was to avoid immediate definitive repair of the vessel but focus instead on preserving only what was needed to get the ship safely back into port for eventual definitive repair ex. Maintaining propeller power and watertight integrity
