Joint Trauma System Damage Control Resuscitation Clinical Practice Guideline, 2019 with June/August 2023 updates

Front

1 of 3 · Front

📘 GuidelineCh 6 · Emergency, Trauma, Acute Care & Surgical Critical Care

Joint Trauma System Damage Control Resuscitation Clinical Practice Guideline, 2019 with June/August 2023 updates

In one breath

The Joint Trauma System damage-control resuscitation CPG for massively haemorrhaging combat casualties: haemorrhage control first, whole blood or balanced components over crystalloid, early calcium, and — since the June 2023 update — a 2-g tranexamic acid bolus as close to injury as possible.

Edition2019, with June/August 2023 updates

Issued byJoint Trauma System, Defense Health Agency / US military

Place of issueUnited States

⏳ Pending verification

FACE COLOURS Front — the summary · Back 1 — what it covers + key recommendations · Back 2 — evidence, changes + source

Back 1

2 of 3 · Back 1

Back colours mark the reading sections — the chapter colour is the band and chip.

§1 · What it covers

This guideline covers combat casualty and military medical-treatment-facility resuscitation for massively hemorrhaging trauma; not automatically civilian or non-trauma-center guidance.

Applies to: Combat casualty and military medical-treatment-facility resuscitation for massively hemorrhaging trauma; not automatically civilian or non-trauma-center guidance.

§2 · Key recommendations

Emphasize hemorrhage control, no crystalloid as the initial strategy when blood is available, low-titer group O whole blood or balanced components, early calcium, warmed products, rapid surgical care, and REBOA only for designated resuscitation teams.
The June 2023 update favors TXA 2-g bolus as close to injury as possible and within 3 hours.
.
August 2023 added calcium caution.
Listed targets include SBP 100 mmHg, or 110 mmHg with TBI.

FACE COLOURS Front — the summary · Back 1 — what it covers + key recommendations · Back 2 — evidence, changes + source

Back 2

3 of 3 · Back 2

Back colours mark the reading sections — the chapter colour is the band and chip.

§3 · Evidence & grading

The document is a CPG with operational recommendations but does not present a uniform GRADE certainty table. It explicitly says it is guidance, not a substitute for clinical judgment.

§4 · What changed in this edition

Not yet established — pending verification.

§5 · Source & working link

Joint Trauma System. Damage Control Resuscitation Clinical Practice Guideline. JTS CPG, 2019 (ID18), with June/August 2023 updates. DOI/PMID: Not yet established — pending verification.

Publisher — the record's original_url, carried verbatim ↗

Link check 2026-11-11: the publisher (JTS) PDF URL fetched live — HTTP 200. The record carries no DOI/PMID and none was established from a named source at build time — Not yet established — pending verification.

Source: Tamer-supplied guideline index, intake 2026-11-10 (record #112, Domain 10) · Card built 2026-11-11 (Wave D) from the record itself; the §5.2 verification pass (UpToDate + Medscape → Perplexity → Tamer decision) has not yet run on this card. ⚑ Conflict flag on the source record — documented cross-society disagreement (intake DOCX Table 2): Trauma resuscitation — European major-bleeding guideline 2023 vs JTS update 2023. The record's notes state the concrete point: the JTS 2-g TXA bolus differs from the European 1-g plus 1-g/8-hour regimen; the JTS recommendation is shaped by battlefield logistics. Unresolved — pending the verification pass (UpToDate + Medscape → Perplexity → Tamer decision).

FACE COLOURS Front — the summary · Back 1 — what it covers + key recommendations · Back 2 — evidence, changes + source

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