Some more on how Resuccitation is done here at Bastion

Ok. So I have said the big difference that I have seen is how resuscitation is done here.  Let me give you an example and I remember this case really distinctly and it has stuck in my mind of how different it is here. Marine comes in basically triple amp (hi aka's on lower ext =commonly what we see) pH 6.8 BE -25, core temp about 31 deg C.  Gets resuscitated in ER then goes to OR emergent Proximal Vascular Control (more on that later). Within 45 mins of being in OR his temp is close to normal (36 deg C) his BE is like -1 and he has a normal ROTEM (more on that later too, basically it means he has normal cloting and is NOT coagulopathic).  He then goes to CT where the resucc is continued then back to OR for 2-3 more hours of dedridment of his wounds which is absolutely essential to having a good outcome. The key is NONE of the normal indicators to do damage control surgery are present at any time in the OR, ie: normothermic, normal clotting, not in shock with a normal BE).  It is truly amazing.  The patient goes to the ICU basically resuscitated! He may need more ongoing in the ICU but when he leaves the OR it is pretty much as good as it gets. Just going to have to say when I get back home there definitely needs to be a change in the paradigm of how resuscitation in the ER and OR is done.  They have clearly demonstrated here that patients don't need to go to the ICU to get resuscitated.  Pic is of OR team working on injured patient from dismounted IED blast