TABLE 2.
Overview of Expert Panel Responses Regarding the Standard Bleeding Control Toolbox, the Availability of Bleeding Control Modalities at the Different Levels of Care, and Providers of the Bleeding Control Modalities
| The Standard Toolbox for Bleeding Control in (Austere) Military Environments: | Panel Members Agreeing (n) | Consensus Reached |
|---|---|---|
| (1) Should at least include bandages, junctional and limb tourniquets, pelvic binders/stabilizers and hemostatic agents | 25/27; 92.6% | Yes |
| (2) Should include REBOA, for trained personnel | 21/28; 75.0% | Yes |
| (3) Should include a wound clamp | 12/27; 44.4% | No |
| (4) Should include abdominal gas insufflation | 0/27; 0% | Yes* |
| (5) Should include intra-abdominal self-expanding foam | 4/27; 14.8% | Yes* |
| Availability of resources: | Panel members agreeing (n) | Consensus reached |
|---|---|---|
| (6) The standard toolbox for bleeding control should be available at all levels of care (from POI to role 3 facilities)** | 27/28; 96.4% | Yes |
| (7) REBOA should be available at the POI/warm zone† | 19/27; 70.4% | Yes |
| (8) REBOA should be available at the casualty collection point near the combat zone† | 21/27; 77.8% | Yes |
| (9) REBOA should be available during en-route care† | 23/27; 85.2% | Yes |
| (10) REBOA should be available in role 1 MTFs or forward surgical hospitals‡ | 24/26; 92.3% | Yes |
| (11) REBOA should be available in fixed Role 2/3 MTFs‡ | 25/26; 96.2% | Yes |
| Providers: | Panel members agreeing (n) | Consensus reached |
|---|---|---|
| (12) Invasive bleeding control modalities should only be applied by trained physicians | 22/28; 78.6% | Yes |
| (13) Medics should be allowed to apply invasive bleeding control modalities | 7/28; 25.0% | Yes* |
| (14) All medical personnel should be allowed to apply noninvasive bleeding control modalities | 27/28; 96.4% | Yes |
| (15) Both medical and nonmedical personnel should be allowed to apply noninvasive bleeding control modalities | 27/28; 96.4% | Yes |
*Negative consensus was reached.
**Provided that there are protocols when and by whom to use the various modalities.
†Considering that adequate training conditions are met and the casualty can be transported into an OR within 45 minutes with a dedicated MEDEVAC.
‡Considering that adequate training conditions are met.