• The experience of deployed military healthcare providers and subsequent documentation and evaluation of clinical outcomes through registries such as the Department of Defense Trauma Registry has allowed for translation of lessons learned in pediatric combat trauma to improvements in pediatric civilian peacetime trauma. • Examples of lessons translated from the military regarding pediatric damage control resuscitation include prioritization of external exsanguination in the primary survey, prehospital administration of blood products, and balanced blood product resuscitation including whole blood administration. The United States military has pioneered advancements in trauma medical care since World War I. During the conflicts in the Middle East, the Joint Trauma System formalized combat trauma research, allowing for rapid advancements in resuscitative care. Military providers in austere settings adopted the principles of adult damage control resuscitation for combat-injured children. The resultant research spearheaded a similar transition for the treatment of injured children in a civilian setting. This chapter discusses military and civilian advancements in pediatric damage control resuscitation, such as control of exsanguinating hemorrhage, recognition of pediatric signs of shock, and early balanced blood product administration.
Holtestaul et al. (Sun,) studied this question.