Emergency Bleeding Management in Conflicting Scenarios
Scott King, a seasoned tactical care instructor and paramedic with over 22 years of experience, is set to deliver the Hostile Environment Medicine Course this June in Namibia. This course, part of a 2-part webinar series, is open to UK Government, NGO, and specialist responders.
The focus of this session is on massive haemorrhage control in austere and high-threat settings. Scott will delve into the latest techniques, technologies, and human factors influencing trauma care in these environments.
Key advances in massive hemorrhage control include the use of Rotem-Guided Hemostatic Treatment, an innovative point-of-care coagulation testing technology that guides targeted transfusion and hemostatic therapy in trauma patients. This technology optimizes blood product use and reduces the incidence of massive transfusion, improving outcomes in major bleeding trauma under challenging conditions.
Another significant development is the updated Tactical Combat Casualty Care and Tactical Emergency Casualty Care guidelines. These guidelines emphasize the early administration of tranexamic acid (TXA) within three hours to stabilize fibrinolysis and reduce bleeding. The recent updates prioritize resuscitation before decompression in the MARCH trauma algorithm, reflecting evidence of better survival when fluid status is stabilized early.
Prehospital Whole Blood Transfusion is another key advancement. Growing evidence supports the use of prehospital whole blood transfusion over crystalloids or limited fluids for hemorrhagic shock. Early blood product administration improves survival rates in uncontrolled bleeding compared to traditional IV fluids that only transiently maintain blood pressure.
Mechanical bleeding control techniques, such as tourniquets and wound packing, remain central for immediate external hemorrhage control. Field-tested trauma techniques continue evolving with training emphasis to ensure rapid application, especially in resource-limited, hostile environments.
The 2025 CoTCCC updates also highlight prolonged care capabilities, reflecting scenarios where evacuation takes hours or days. This includes advanced hemostatic management, wound care, and analgesia adaptations suited for prolonged casualty care outside traditional hospital settings.
The Hostile Environment Medicine Course provides training in hostile awareness and tactical casualty care. It may include discussions on the latest techniques, technologies, and human factors influencing trauma care in hostile environments. The conversation will explore the importance of training, trust in kit, and self-preservation under pressure.
Uncontrolled bleeding remains the leading cause of preventable death in such settings. These advances in hemorrhage control are expected to reduce preventable death rates by 20-30% in tactical environments and optimize resource use in austere settings. They represent a paradigm shift towards personalized, evidence-based management of massive hemorrhage even in hostile or prolonged field care scenarios.
For direct inquiries, Scott King can be reached at [email protected]. The Hostile Environment Medicine Course is designed to complement the webinar series on hostile environment medicine, offering hands-on training and practical insights to attendees.
- Scott King's upcoming Hostile Environment Medicine Course in Namibia will focus on the latest techniques and technologies in massive hemorrhage control, including the use of Rotem-Guided Hemostatic Treatment in austere and high-threat settings.
- The Hostile Environment Medicine Course will also discuss the updated Tactical Combat Casualty Care and Tactical Emergency Casualty Care guidelines, which emphasize the early administration of tranexamic acid and prioritize resuscitation before decompression in the MARCH trauma algorithm.
- The Hostile Environment Medicine Course aims to provide training in hostile awareness and tactical casualty care, with an emphasis on self-preservation under pressure and the importance of training and trust in medical equipment in hostile environments.
