| Prehospital Tourniquet Use in Operation Iraqi Freedom: Effect on Hemorrhage Control and Outcomes |
FEB 2008 |
11 pages |
| Authors:
Alec C. Beekley; James A. Sebesta; Lorne H. Blackbourne; Garth S. Herbert; David S. Kauvar; David G. Baer; Thomas J. Walters; Philip S. Mullenix; John B. Holcomb; MADIGAN ARMY MEDICAL CENTER TACOMA WA
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 | We hypothesized that prehospital tourniquet use decreased hemorrhage from extremity injuries and saved lives, and was not associated with a substantial increase in adverse limb outcomes. Methods: This was an institutional review board-approved, retrospective review of the 31st combat support hospital for 1 year during Operation Iraqi Freedom. Inclusion criteria were any patient with a traumatic amputation, major extremity vascular injury, or documented prehospital tourniquet. Results: Among 3,444 total admissions, ... |
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| The Effect of Recombinant Activated Factor VII on Mortality in Combat-Related Casualties With Severe Trauma and Massive Transfusion |
FEB 2008 |
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| Authors:
Philip C. Spinella; Jeremy G. Perkins; Daniel F. McLaughlin; Sarah E. Niles; Kurt W. Grathwohl; Alec C. Beekley; Jose Salinas; Sumeru Mehta; Charles E. Wade; John B. Holcomb; ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX
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 | Background: The majority of patients with potentially survivable combat-related injuries die from hemorrhage. Our objective was to determine whether the use of recombinant activated factor VII (rFVIIa) decreased mortality in combat casualties with severe trauma who received massive transfusions and if its use was associated with increased severe thrombotic events. Methods: We retrospectively reviewed a database of combat casualty patients with severe trauma (Injury Severity Score [ISS] >15) and massive ... |
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| The Ratio of Blood Products Transfused Affects Mortality in Patients Receiving Massive Transfusions at a Combat Support Hospital |
OCT 2007 |
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| Authors:
Matthew A. Borgman; Philip C. Spinella; Jeremy G. Perkins; Kurt W. Grathwohl; Thomas Repine; Alec C. Beekley; James Sebesta; Donald Jenkins; Charles E. Wade; John B. Holcomb; BROOKE ARMY MEDICAL CENTER FORT SAM HOUSTON TX
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| Background: Patients with severe traumatic injuries often present with coagulopathy and require massive transfusion. The risk of death from hemorrhagic shock increases in this population. To treat the coagulopathy of trauma, some have suggested early, aggressive correction using a 1:1 ratio of plasma to red blood cell (RBC) units. Methods: We performed a retrospective chart review of 246 patients at a US Army combat support hospital, each of who received ... |
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| The Ratio of Fibrinogen to Red Cells Transfused Affects Survival in Casualties Receiving Massive Transfusions at an Army Combat Support Hospital |
OCT 2007 |
8 pages |
| Authors:
Harry K. Stinger; Philip C. Spinella; Jeremy G. Perkins; Kurt W. Grathwohl; Jose Salinas; Wenjun Z. Martini; John R. Hess; Michael A. Dubick; Clayton D. Simon; Alec C. Beekley; BROOKE ARMY MEDICAL CENTER FORT SAM HOUSTON TX
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| Background: To treat the coagulopathy of trauma, some have suggested early and aggressive use of cryoprecipitate as a source of fibrinogen. Our objective was to determine whether increased ratios of fibrinogen to red blood cells (RBCs) decreased mortality in combat casualties requiring massive transfusion. Methods: We performed a retrospective chart review of 252 patients at a U.S. Army combat support hospital who received a massive transfusion (>10 units of RBCs ... |
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| Effect of Plasma and Red Blood Cell Transfusions on Survival in Patients with Combat Related Traumatic Injuries |
OCT 2007 |
11 pages |
| Authors:
Philip C. Spinella; Jeremy G. Perkins; Kurt W. Grathwohl; Alec C. Beekley; Sarah E. Niles; Daniel F. McLaughlin; Charles E. Wade; John B. Holcomb; CONNECTICUT CHILDREN'S MEDICAL CENTER HARTFORD
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| Hemorrhage from traumatic injuries is the second most common cause of death and the most common cause of potentially preventable deaths from combat related injuries. Upon autopsy review, it was estimated that 15% to 20% of deaths that occur in combat were preventable with appropriate treatment, with 66% to 80% of these deaths occurring from hemorrhagic shock. Death from severe traumatic injuries occurs quickly, usually within 6 hours to 12 ... |
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| Colon and Rectal Injuries During Operation Iraqi Freedom: Are There Any Changing Trends in Management or Outcome |
APR 2007 |
9 pages |
| Authors:
Scott R. Steele; Kate E. Wolcott; Philip S. Mullenix; Matthew J. Martin; James A. Sebesta; Kenneth S. Azarow; Alec C. Beekley; MADIGAN ARMY MEDICAL CENTER TACOMA WA
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| %: Despite the evolution in the management of traumatic colorectal injuries in both civilian and military settings during the previous few decades they continue to be a source of significant morbidity and mortality. The purpose of this study was to analyze management and clinical outcomes from a cohort of patients suffering colorectal injuries. |
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| Risks Associated with Fresh Whole Blood and Red Blood Cell Transfusions in a Combat Support Hospital |
2007 |
7 pages |
| Authors:
Philip C. Spinella; Jeremy G. Perkins; Kurt W. Grathwohl; Thomas Repine; Alec C. Beekley; James Sebesta; Donald Jenkins; Kenneth Azarow; John B. Holcomb; ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX
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| B Objective: Fresh whole blood (FWB) and red blood cells (RBCs) are transfused to injured casualties in combat support hospitals. We evaluated the risks of FWB and RBCs transfused to combat-related casualties. Design: Retrospective chart review. Setting: Deployed U.S. Army combat support hospitals. Subjects: Donors of FWB and recipients of FWB and RBCs. Measurements and Results: The storage age of RBCs at transfusion was measured as an indicator of overall ... |
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