Fluid resuscitation in modern combat casualty care: lessons learned from Somalia.

The medical issues faced by military medics in the combat environment frequently represent a significant variation from their training and civilian experience. The differences between care delivered by military medics under fire and care rendered by civilian medics are profound. The lessons assimilated from extensive discussion and focused conferences form the basis for the proposed changes in combat prehospital care. These differences revolve around a lack of basic monitoring capability, significant logistical constraints, and prolonged evacuation times. The resuscitation algorithm presented in this article represents a consensus of military and civilian trauma experts.