Originally Posted By: ILBob
I watched part of an interesting lecture on video the other day. A reserve (or maybe NG) surgeon was talking about a revised treatment plan the military has started using on wounded soldiers with severe blood loss. He is calling it hemostatic resuscitation.
No Ringers or other IV fluids containing crystalloids (whatever that is) are used because it causes swelling.
Mostly they are using packed red blood cells, whole blood, and hypertonic saline. Also something called R factor VII which seems to cost a bunch of money but apparently promotes clotting directly at the wound site(s).
I gather they have started using the same protocol in LA with good results.

Yup. They've found that using lots of saline or Lactate Ringer's actually decreases clotting, and that large volumes may worsen outcomes. The military is going back towards blood products, at very low ratios (ie, 1 unit of red cells with 1 unit of platelets with one unit of plasma). Another reason to donate...

Recombinant Factor VII is pricey as heck. Like, $10,000/dose, and multiple doses needed. That price is probably low, too.