Prolonged Field Care Podcast Prolonged Field Care Podcast: Abdominal Trauma
Sep 12, 2025
In this engaging discussion, Colonel Stacey Shackelford, a trauma surgeon and chief of the Joint Trauma System, shares his battlefield insights on managing abdominal trauma. He highlights the alarming statistics on battlefield casualties and the critical role of advanced hemorrhage control techniques. Shackelford delves into the challenges of trauma care, emphasizing the importance of teamwork, postoperative management, and ongoing research. Listeners will gain valuable knowledge on innovative surgical practices and the need for enhanced training in trauma care.
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Truncal Hemorrhage Drives Pre-Hospital Deaths
- About 90% of battlefield casualties died before reaching surgical care and nearly 90% of pre-hospital deaths were from hemorrhage.
- Two-thirds of potentially survivable torso hemorrhages were abdominal or pelvic, highlighting truncal bleeding as a major target.
Tactical Constraints Limit Preventable Deaths
- Only about a quarter of battlefield deaths had potentially survivable injuries and ~6.8% were deemed preventable given operational constraints.
- Tactical context often limits the ability to deliver care, so many deaths are operationally unpreventable.
Consider Advanced Temporizing Measures
- Consider advanced pre-hospital options like REBOA, flow-through catheters, X-LAP, and pre-peritoneal packing when feasible.
- Keep abdominal aortic tourniquet (AAJT) in consideration but recognize data gaps and treat it as temporizing only.