Consider autotransfusion in the field

Abstract

Massive hemothorax is a life-threatening condition that can present as hemorrhagic shock, cardiogenic shock, or elements of both. It is described by the American College of Surgeons, in the 9th Edition of Advanced Trauma Life Support, as a rapid accumulation of more than 1,500 mL of blood or one-third or more of the patient’s blood volume. The use of autotransfusion systems has been implemented for the treatment of hemothorax in hospital settings. The implementation of autotransfusion has been documented in situations where an extended period can elapse before definitive treatment can occur. This article is the first described case where an autotransfusion system has been implemented in a prehospital setting, at a Role 1 medical facility, for massive hemothorax in Afghanistan.