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Damage control 

Damage control
Chapter:
Damage control
Author(s):

Jason Smith

, Ian Greaves

, and Keith M Porter

DOI:
10.1093/med/9780199543328.003.0019
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date: 15 September 2019

Damage control 352

Further reading 358

The majority of trauma patients require standard resuscitation and clinical decision-making. Improvements in pre-hospital care and resuscitation have increased the number of severely-injured patients reaching hospital alive. There is a small group of patients with severe injuries, which are accompanied by hypovolaemic shock leading to the physiological derangement of hypothermia, acidosis, and coagulopathy. A conventional management approach is associated with high mortality in this group of patients. These patients require expedient and intensive concomitant resuscitation and surgery to reduce morbidity and mortality. This is when a damage control approach is appropriate, analogous to that described by the US navy in relation to battleships: ‘… the capacity of a ship to absorb damage and maintain mission integrity’....

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