This week, Aebhric O'Kelly talks with Dr John Quinn and Eirik Holmstrøm, who all went to Ukraine to teach the Damage Control Resus Ukraine (DCRU) course. They discuss the curriculum, the use of clinical practice guidelines (CPGs), and the importance of access to blood in the pre-hospital setting. They highlight the collaboration with Tactical Medicine North and the professional partner forces in Ukraine. The hosts also mention the Defence Health Administration's (DHA) role and the resources on the DHA website and app. The conversation emphasises evidence-based practices and knowledge exchange's significance in improving military medicine. The conversation focuses on the challenges and solutions in Ukraine's implementation of damage control resuscitation (DCR). The speakers discuss the need for interoperability in large-scale combat operations (LSCO) and the importance of rethinking traditional medical practices. They highlight the limitations of blood transfusion in the field and the need for a logistic system to support the transportation of blood. The conversation also covers training Ukrainian combat medics in advanced skills such as resuscitative endovascular balloon occlusion of the aorta (REBOA) and ultrasound. The speakers emphasise the importance of continuous learning, adapting to failures, and the potential for DCR to increase combat effectiveness in Ukraine. Keywords Damage Control Resus Ukraine, DCRU, curriculum, clinical practice guidelines, CPGs, pre-hospital setting, blood access, Tactical Medicine North, partner forces, Defence Health Administration, DHA, evidence-based practices, military medicine, damage control resuscitation, interoperability, large-scale combat operations, blood transfusion, logistic system, training, combat medics, REBOA, ultrasound, continuous learning, combat effectiveness Takeaways The DCRU course in Ukraine focused on damage control resuscitation in the pre-hospital setting. The curriculum was based on clinical practice guidelines (CPGs) from the Defence Health Administration (DHA). Access to blood and blood components was highlighted as crucial in effective care. Collaboration with Tactical Medicine North and professional partner forces in Ukraine was instrumental in the course's success. The DHA website and app provided valuable resources for learning and reference in austere environments. The exchange of knowledge and lessons learned is essential for improving military medicine. Implementing damage control resuscitation in large-scale combat operations requires interoperability and a logistic system to support the transportation of blood. Traditional medical practices need to be rethought to align with the evolving nature of warfare. Training combat medics in advanced skills such as REBOA and ultrasound can improve patient care and increase patient transport confidence. Continuous learning and adapting to failures are essential in austere medicine. Damage control resuscitation has the potential to increase combat effectiveness in Ukraine. Chapters 00:00 Introduction to Dr John Quinn and Eirik Holmstrom 02:07 Adding Co-Authors and References 04:01 Introduction to the DCRU Course 08:09 Overview of the DCRU Curriculum 13:49 Importance of Access to Blood 16:40 Acknowledging the Defence Health Administration 18:56 Interoperability and Logistic Challenges 23:35 Rethinking Traditional Medical Practices 29:24 Training Combat Medics in Advanced Skills 38:34 Continuous Learning and Adapting to Failures 41:10 The Potential of Damage Control Resuscitation

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