Trauma resuscitation and the damage control approach

Abstract

Trauma is a leading cause of morbidity and mortality worldwide. Developments in trauma care, from point of wounding to rehabilitation, have often been led and driven by military medical experiences in recent conflicts. Trauma mechanisms are manifold, affecting an omnifarious patient population indiscriminately, and potentially resulting in significant multisystem dysfunction or damage, sometimes permanently. The horizontal approach to trauma resuscitation, whereby a patient is assessed and treated by multiple specialists to prioritize management of life-threatening issues swiftly and concurrently, was exploited to good effect by clinicians at Camp Bastion in Afghanistan. This tactic is just one element of the dynamic and synchronous teamwork that this complex and challenging area of clinical practice demands. Similarly, the damage control approach deploys medical and surgical treatment strategies in parallel, balancing therapies in pursuit of physiological equipoise, aiming to reduce mortality and accepting the risk of morbidity. Damage control therapy embodies bold, yet nuanced, clinical care.