Wayne Sapsford

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BACKGROUND Hemorrhage is the leading cause of death in battlefield casualties and the second leading cause of death after civilian trauma. Evacuation time for military casualties to surgical care can be prolonged and improved hemostasis could greatly reduce mortality. There are several anecdotal reports that recombinant activated factor VII (rFVIIa) may(More)
BACKGROUND Fluid resuscitation of trauma victims currently differs, depending on whether the Advanced Trauma Life Support (ATLS), Prehospital Trauma Life Support (PHTLS) or Battlefield Advanced Trauma Life Support (BATLS) algorithm is utilised. Resuscitation protocol depends on the situation of the patient before definitive surgical control of the(More)
OBJECTIVES Management of blunt splenic injury (BSI) in battlefield casualties is controversial. Splenectomy is the traditional treatment, as setting the conditions for selective non-operative management (SNOM) is difficult in the operational environment. On mature operations, it may be feasible to adopt a more conservative approach and manage the patient(More)
One of the primary goals of the military scientist addressing the prevention of trauma, is to develop new concepts for attenuating energy transfer to the body from either penetrating, non-penetrating or blast impacts. Personal armours have deficiencies, both in the body coverage achievable without degrading military performance, and in the inherent ability(More)
The crystalloid – colloid debate regarding the most effective intravenous fluid for resuscitation from haemorrhagic shock has been raging over the past 60 years, and still continues without a satisfactory resolution (1). Crystalloid solutions are essentially isotonic salt solutions (270-310 mOsm/L) and have been in use since the 1800s but their use became(More)
It is possible that recombinant activated factor VII (rFVIIa) could revolutionise the medical and surgical management of haemorrhage following trauma and surgery due to its ease of administration and mechanism of action. This article reviews the evidence for the use of rFVIIa as a pro-coagulant, its mechanism of action, safety and recent research into its(More)
BACKGROUND Thoracic injuries are the third most common injuries in trauma patients with cardiac injuries amongst the most lethal. Imaging is essential in diagnosis and triage of patients with pericardial injuries, and this review aims to highlight the spectrum of imaging findings of pericardial trauma. Focussed assessment with sonography for trauma (FAST)(More)
BACKGROUND Acute myeloid leukemia (AML) is usually associated with coagulopathy and disorders of hemostasis, but cases of ischemic events have been reported. We present a case of AML with recurrent acute limb ischemia and multiple organ infarctions. METHODS AND RESULTS A 57-year-old woman diagnosed with AML subtype M1 developed recurrent bilateral acute(More)