The Damage Control Resuscitation Concept at a Glance

The Damage Control Resuscitation concept has become the standard of care in military medicine. This concept is the results of the Damage Control Surgery or staged laparotomy concept whose efficiency was assessed for trauma patients with physiologic derangements threatening the vital prognosis and making harmful a long surgical procedure. The idea arose in these very affected patients to address physiologic derangements in the same time of a staged surgery. These physiologic derangements can be summed up as “lethal triad” associating hypothermia, coagulopathy and acidosis basically due to a massive uncontrolled hemorrhage.Although simple to depict in such a sketchy way, this lethal triad raises both therapeutic and diagnosis issues. Therapeutic issues come from the need of a thorough logistic and a strict discipline to address the lethal triad. Thus the anticipation is of paramount interest and an early identification of exsanguinated patients is mandatory. Nonetheless, the diagnosis is difficult since both the evaluation of blood loss and the diagnosis of hemorrhagic shock need a great expertise.