Technical Evaluation Report (HFM Panel Symposium)

Abstract : In ground based tactical situations casualties can not be avoided. It is well documented that immediate haemostatic surgery can be life saving, and the most significant factor for survival is the time from injury to surgery. Late complications like septicemia and multi organ failure are in most cases sequelae of the initial hypo perfusion. In situations where evacuation will be delayed, the prehospital handling and management are of critical importance. In recent tactical situations with long distances to hospital, forward surgical teams have been deployed to reduce the time to surgery. Fast and correct decisions in questions of triage, evaluation and initial treatment are life saving and may reduce complications for the individual soldier. New technologies allow rapid location of casualties and advanced diagnostic aid and decision support in the field. The application of sensors to monitor vital signs and computers with embedded knowledge provide such support. Recent technology advances allow for non-invasive and remote monitoring of physiologic parameters and vital signs, thereby increasing the possibility for accurate treatment and management by ground personnel. The main aim of casualty treatment is to secure oxygenation of critical tissues. Ventilation support, hemorrhage control and organ protection are thus crucial. Hemostatic devised such as improved bandages and tourniquets, haemostatic drugs, and agents such as platelet substitutes and oxygen carrier molecules based on per fluorocarbons or modified hemoglobin address the hemorrhagic challenge. Optimal fluid management, vasoactive drugs and resuscitation fluid additives to promote micro vascular perfusion may protect organ function and prevent organ failure and increase survival. The main objective of this symposium is to present recent knowledge on war casualty management, based on experience from tactical situations and scientific research.