Wilderness Medical Society snowmass 2005 Page 280
4
Care under Fire
- Control of hemorrhage is the top priority.
- Bleeding to death from extremity wounds is the number one cause of preventable
death on the battlefield.
- Cause of death in more than 2500 American casualties in Vietnam who had no other
injuries.
Tourniquets
- Discouraged by civilian trauma courses in 1996
- Most reasonable initial choice to stop extremity bleeding in the Care under Fire Phase.
- Direct pressure is hard to maintain during casualty transport under fire.
Tourniquets
The need for immediate access to a tourniquet in such situations makes it clear that all
Special Operations personnel on combat missions should have a suitable tourniquet readily
available at a standard location on their battle gear and be trained in its use.
Ranger Tourniquet After-Action Report from Iraq
- At least 7 Ranger lives saved with tourniquets
Tactical Field Care Antibiotics
Antibiotics: Recommended for all open combat wounds
- Cefoxitin 2 gms IV
Blackhawk Down Picture and Mabry Paper
Mogadishu casualties
15 hours before evac
No antibiotics given in field
54 WIA
16 Wound Infections
Special Forces After-Action Report from Iraq
No wound infx in population that got antibiotics
