ABSTRACT

Damage Control Resuscitation (DCR) is a strategy across a trauma system rather than a single intervention at a specific location, aimed at stabilising or correcting the adverse physiological consequences of major traumatic injury and preventing deterioration. Key interventions are aimed at preventing further haemorrhage which could contribute to shock and acidosis and deplete clotting reserve.

In its fullest form, it requires considerable resources to implement—critical care, blood product delivery, and monitoring—leading the patient to the right location at the right time for definitive care. Recognising that major injuries frequently occur in resource-limited environments (RLE), consideration must be given as to how this strategy may be implemented and what the requirements on the trauma system are to support this; this is particularly pertinent to planning military operations. Remote and resource limitation may not necessarily be synonymous, as resource limitation can be profound even in less remote regions if timelines are protracted and resources cannot be bought to bear the casualty in a timely fashion. As with trauma management, planning is generally the key to deliver RLE DCR.