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to normal saline on small naval warships and submarines may Disclosures
be warranted. But if LR runs out, normal saline is acceptable. The authors declare no funding or conflicts of interest.
During World War II, U.S. and allied shipboard caregivers Disclaimer
routinely managed and resuscitated severely burned casual- The views expressed in this article are those of the authors and
ties; freeze-dried plasma was ubiquitous and critical to these do not necessarily reflect the official policy or position of the
efforts, particularly in those with burn shock. 24–26 Colloids, Department of the Navy, the Department of Defense, or the
such as plasma, used in burn shock resuscitation have been U.S. Government.
associated with a decrease in many resuscitation-related com-
plications, such as chest and extremity eschar syndromes and Copyright statement: I am a military Service Member of the
abdominal compartment syndromes. 27,28 While albumin may United States government. This work was prepared as part of
also be beneficial, many advocate for freeze-dried plasma over my official duties. Title 17, U.S.C., §105 provides that copy-
albumin for burn shock resuscitation in austere military and right protection under this title is not available for any work
shipboard environments. 25,26 It can be stored for up to 2 years of the U.S. Government. Title 17, U.S.C., §101 defines a U.S.
at room temperature either pre-positioned or on ships; it is Government work as a work prepared by a military Service
rapidly reconstituted with sterile water; it has an excellent member or employee of the U.S. Government as part of that
long-term safety profile (in the modern era) in multiple coun- person’s official duties.
tries; and it is likely beneficial in treating the epitheliopathy Aspects of this project, “Maritime Applications of Prolonged
of burn shock. At the time of this writing, freeze-dried plasma Casualty Care,” were presented at the Special Operation Med-
is only available to U.S. Special Forces through an emergency icine Association 2023 Scientific Assembly, 18 May 2023 in
release. 26
Raleigh, North Carolina.
Both appropriate resuscitation and burn wound care are inte- References
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MDT and MST conceived the study concept. DA, MDT, and doi:10.1097/BCR.0000000000000367
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