Managing junctional haemorrhage in the combat environment

Tactical combat casualty care and the application of extremity tourniquets have saved lives in combat. In the modern combat environment junctional injuries are common and difficult to treat. Recently, junctional tourniquets have emerged as a potential solution to this problem. Junctional tourniquets can be used as an adjunct to persistent haemorrhage despite application of conventional tourniquets or in the persistently hypotensive casualty. Surgeons must have an approach to receiving patients with junctional tourniquets in place in the operating room. The algorithms presented allow for an evidence-based and command-driven implantation of junctional tourniquets as part of tactical combat casualty care.

Automated summary

Tactical combat casualty care and the use of extremity tourniquets have been effective in saving lives during combat, but junctional injuries present a challenge. Junctional tourniquets have emerged as a potential solution, providing a supplementary measure for persistent bleeding or hypotension in combat casualties. Surgeons need protocols for handling patients with junctional tourniquets, and evidence-based algorithms support their implementation as part of tactical combat casualty care.