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Introduction: Operative capability utilization time for casualties is an important metric for trauma planning in the military. Operative capabilities can be a choke point resulting in multiple patients waiting for the asset to become available during mass casualty events. The objective measurement of how long deployed operative capabilities are utilized for various categories of injury has not been described. This study provides the measurements for role 2 and role 3 facilities., Materials and Methods: The Department of Defense Trauma Registry was sampled for each composite injury severity score (ISS) category in the registry (mild, moderate, severe, and critical). Thirty randomly selected samples for role 2 and role 3 facilities for each composite ISS category with an anesthesia record including a start and end time for the index surgical case were included., Results: There were no statistical differences between role 2 and role 3 facility operative capability utilization times for any composite ISS category. The mean time (min) for mild, moderate, severe, and critical for role 2 and role 3 was 93.9 and 96.3, 142.2 and 144.3, 177.4 and 171.1, 182.9 and 205.6, respectively. The proportion of Department of Defense Trauma Registry surgical patients who were mild, moderate, severe, or critical were 57.5%, 18.2%, 13.6%, and 10.7%, respectively., Conclusion: There is no statistical difference between roles of care in operative asset utilization time. The provided operative capability utilization times will be useful for casualty management planning and improvement initiatives., (Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2022. This work is written by (a) US Government employee(s) and is in the public domain in the US.)

The purpose of this investigation is to determine if intraosseous infusion (IO) is a suitable method for the delivery of recombinant human factor VIIa (rFVIIa) during hemorrhagic shock. The measures that were used to evaluate IO delivery suitability included: (1) determination of clinically significant local or systemic toxicity and (2) demonstration that systemic blood levels of rFVIIa increased rapidly following administration. Our results indicate that there was no evidence of significant local or systemic toxicity following infusion and that the systemic blood concentration of rFVIIa peaks immediately after the end of infusion. This result suggests that the systemic blood level profiles of rFVIIa delivered by IO infusion are similar to those that could be produced by intravenous (IV) administration. Furthermore, in all 25 test animals, access to the systemic circulation during shock was achieved as evidenced by rapid increase in a marker dye (flourescein) or rFVIIa in the blood. We conclude that administration of rFVIIa via IO infusion is a reasonable safe method and is likely to produce blood levels required for improved hemostasis during shock.