AM24-MN-37-O: Hemorrhage Control and Resuscitation: New Tools (Enduring)

Saving lives of severely injured individuals requires 1) control of hemorrhage and 2) resuscitation. Lack of people or materials to carry out these activities means that individuals injured in rural and remote areas have high mortality rates. Making blood products available for pre-hospital resuscitation can help more injured and bleeding patients reach the hospital alive but are limited by the small numbers of blood products available and the problem of continued bleeding. Non-surgical hemorrhage control has been limited to packing and binding wounds, tournication of extremities, and methods to apply direct pressure to non-tournicable areas such as the neck, axilla, or groin. However, many sources of bleeding in the severely injured involve truncal hemorrhage sites in the chest, abdomen, retroperitoneum, and pelvis. This session will present two advances with the potential to improve rural and remote injury care and transportation of the injured to trauma centers for definitive hemorrhage control, corrective surgery, and rehabilitation. First are hydrophobically modified chitosan-based hemostats in solid, gel, flowable, and foam forms for direct and indirect hemostasis including intracavitary infusion with a high probability of hemorrhage control. Second is an 8-week whole blood storage system with retained platelet function that would allow whole blood to be made more widely available in rural and remote areas with reduced wastage. The synergistic combination of the two technologies offers the potential for saving many lives. Recognition of the existence of the technologies, their synergy, and their in-hospital uses are important for physicians and blood center CEOs as they will shape blood product use in the future.