Emergency Bleeding Management in Dangerous Settings
Scott King, a seasoned tactical care instructor and paramedic with over 22 years of experience in ambulance services, military instruction, and hostile environment training, led a captivating webinar series on hostile environment medicine. This inaugural session marked the beginning of a comprehensive exploration into the field, with a focus on massive hemorrhage control.
The webinar series is part of a larger educational offering and is intended to complement a specific course, the Hostile Environment Medicine Course in Namibia, which is set to take place in June. It serves as an invaluable resource for UK Government, NGO, and specialist responders, providing insights into hostile awareness and tactical casualty care.
In a high-threat setting, uncontrolled bleeding is the leading cause of preventable death. To address this critical issue, King covered various aspects of hemorrhage control, including junctional injury management and the limits of field intervention. The importance of training, trust in equipment, and self-preservation under pressure was emphasized throughout the discussion.
The series delved into the latest advancements in massive hemorrhage control. Key points included the use of 25% human serum albumin (HSA), which stabilizes fluids within blood vessels better than traditional crystalloids or colloids, reducing fluid leakage and limiting complications related to large-volume resuscitation. Prehospital ultrasound (Focused Assessment with Sonography in Trauma – FAST) combined with predictive scores like the phTASH score was highlighted for its ability to improve early identification of severe hemorrhage and the need for massive transfusion, enabling faster decision-making in the field.
A "circulation-first" approach focusing immediately on controlling bleeding through extremity tourniquets and junctional hemorrhage devices before airway interventions was also discussed. The evolution of Tactical Combat Casualty Care (Co-TCCC) to include early transfusion of whole blood or blood components in prehospital settings was highlighted, recognizing that conventional IV fluids lack survival benefit in ongoing hemorrhage.
Traditional methods like tourniquet placement techniques, including 'high and tight' and deliberate application, were addressed, as well as updated hemorrhage control techniques using wound packing and advanced trauma dressings tailored for life-threatening bleeding control in austere environments.
The second part of the series will focus on massive haemorrhage control, touching upon future developments in the field such as AI and nanotechnology. Wound packing techniques, tactical triage, and decision-making in mass casualty incidents will also be part of the conversation.
For more information about the Hostile Environment Medicine Course in Namibia, interested individuals can click the provided link. Scott King can be contacted directly via [email protected].
- Scott King's webinar series, focused on hostile environment medicine, is a valuable resource for UK Government, NGO, and specialist responders, offering insights into hostile awareness and tactical casualty care.
- The Hostile Environment Medicine Course in Namibia, led by Scott King, is a comprehensive exploration into the field, covering aspects like massive hemorrhage control, and is set to take place in June.
- The webinar series delved into the latest advancements in massive hemorrhage control, discussing topics like the use of 25% human serum albumin, prehospital ultrasound, and the circulation-first approach for immediate bleeding control.
- Future developments in the field of hostile environment medicine, such as AI and nanotechnology, will be a focus in the second part of Scott King's webinar series, along with discussion on wound packing techniques, tactical triage, and decision-making in mass casualty incidents.
