This activity is supported by: The NATO Science for Peace and Security Programme
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Courses

Remote Damage Control Resuscitation (RDCR)

12–14
november
2019
Lead Instructor
Geir Strandenes
MD. Senior Medical Officer, Norwegian Naval Special Operation Commando
Instructor
Jørn E. Rasmussen
MD. Major and Doctor of Norwegian Army

RDCR is a concept envisioned for the use in the out of hospital combat casualty care setting, in cases where severely wounded casualty with continuing noncompressible torso hemorrhage, major bleeding and hemorrhagic shock, face delays in evacuation to resuscitative surgical intervention. RDCR can also be applied for severe civilian trauma especially for circumstances where there are prolonged evacuation times.

RDCR is anchored in the principles of Tactical Combat Casualty Care (TCCC), beginning with the identification of life-threatening conditions followed by the appropriate and timely performance of Life Saving Interventions (LSI) before tactical evacuation, with care continuing en route to resuscitative surgery and theater hospitalization medical direction.

In cases of NCTH when standard prehospital intervention have been exhausted, the RDCR algorithm would seek to further mitigate end-organ hypoxia and the "lethal triage" through the judicious employment of blood products, procoagulants and antifibrinolytic agents by far-forward combat medical personnel, leveraging remote decision support technology and emergency telemedical reach–back to a specialist capable of providing informed medical direction.

Summary of learning objectives

Core concepts of RDCR, the lethal triad of death of coagulopathy, hypothermia, and acidosis, as well as an approach to mitigate in the prehospital and disaster setting. Why give blood far forward and explanation of how to carry this out, avoiding common pitfalls.

Training audience

Emergency responders, prehospital emergency personnel, battalion aid station personnel, Special Operations Combat Medic, and military medics supporting units in the field.

Remote Damage Control Resuscitation (RDCR)

One class, 2 iterations every 8 hours. Two classes of 24 for a total of 48 providers or instructors of pre-hospital, remote or military medicine.

  • The pathophysiology of hemorrhagic shock, the blood and blood product risks. The benefits of blood far forward and RDCR.
  • Practical workshop
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Class schedule

1. Preliminaries

Introduction
History
Blood Physiology, Part 1
Blood Physiology, Part 2
Shock
Risk Benefit

2. Need Blood

Indications & Considerations

3. Get Blood

Donor Options
Whole Blood Donation
Cold Chain
Cold Chain video
Donor Performance
Eldon Card Testing

4. Give Blood

Transfusion Procedure
Complications
Endpoints
Track Blood

5. Training — How to Train

6. Conclusion

Remote Damage Control Resuscitation Round Table (4 hrs)

Implementation of Whole Blood Program

  • Subject Matter Experts' Working Group and Roundtable.
  • Discussion of advanced concepts in RDCR and current trends.
  • Discussion and debate of new and emerging concepts in RCDR.
  • Answer key questions of how to implement a walking donor.
  • Blood far forward and other RDCR instruments into a healthcare system.
  • Academic exchange of ideas.
  • Common areas of lessons learned.
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