Major medical advances occur during wartime because of the presence of a high concentration of overwhelming casualties and the resulting requirement for innovative solutions. Examples of these advances include the propagation of hospitals with sanitary conditions, the use of blood transfusions, dialysis, air transportation of casualties, and advancements in vascular reconstruction. Similar advances made during Operation Iraqi Freedom III have contributed to the lowest case fatality rates in military medical history. The approach to the injured soldier has involved every aspect of patient care to include prevention using body armor, hypotensive resuscitation, tourniquets, intravenous and topical hemostatic agents, and a proactive approach of aggressive correction of coagulopathy using blood products. These advances currently are being translated to civilian practice altering the care of the urban patient.
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