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The inaugural HERETIC (HEmostatic REsuscitation and Trauma Induced Coagulopathy) Symposium convened a multidisciplinary panel of experts in prehospital trauma care to discuss what education and bioengineering advancements in the prehospital space are necessary to improve outcomes in hemorrhagic shock and traumatic brain injury. The panel identified several promising technological breakthroughs, including field point-of-care diagnostics for hemorrhage and brain injury and unique hemorrhage control options for non-compressible torso hemorrhage. Many of these technologies exist but require further advancement to be feasibly and reliably deployed in a prehospital or combat environment. The panel discussed shifting educational and training paradigms to clinical immersion experiences, particularly for prehospital clinicians. The panel discussed an important balance between pushing traditionally hospital-based interventions into the field and developing novel intervention options specifically for the prehospital environment. Advancing prehospital diagnostics may be important not only to allow more targeted applications of therapeutic options, but also to identify patients with less urgent injuries that may not need more advanced diagnostics, interventions, or transfer to a higher level of care in resource-constrained environments. Academia and industry should partner and prioritize some of the promising advances identified with a goal to prepare them for clinical field deployment to optimize the care of patients near the point of injury.<\/jats:p>","DOI":"10.1136\/tsaco-2023-001122","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:47:39Z","timestamp":1704847659000},"page":"e001122","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Commentary on gaps in prehospital trauma care: education and bioengineering innovations to improve outcomes in hemorrhage and traumatic brain injury"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6936-035X","authenticated-orcid":false,"given":"Joshua B","family":"Brown","sequence":"first","affiliation":[{"name":"Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4430-6779","authenticated-orcid":false,"given":"Martin","family":"Schreiber","sequence":"additional","affiliation":[{"name":"Surgery, Oregon Health and Science University, Portland, Oregon, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest E","family":"Moore","sequence":"additional","affiliation":[{"name":"Surgery, Ernest E Moore Shock Trauma Center at Denver Health, University of Colorado Denver, Denver, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald H","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric A","family":"Bank","sequence":"additional","affiliation":[{"name":"Harris County Emergency Services District No 48, Katy, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer M","family":"Gurney","sequence":"additional","affiliation":[{"name":"Defense Committees on Trauma, Joint Trauma System, JBSA Fort Sam Houston, San Antonio, Texas, USA"},{"name":"Department of Surgery, San Antonio Military Health System, San Antonio, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,1,6]]},"reference":[{"key":"2025081710572679000_9.Suppl_1.e001122.1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000292"},{"key":"2025081710572679000_9.Suppl_1.e001122.2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e318221147b"},{"key":"2025081710572679000_9.Suppl_1.e001122.3","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/s00383-019-04597-9","article-title":"Establishing a regional trauma preventable\/potentially preventable death rate","volume":"36","author":"Drake","year":"2020","journal-title":"Pediatr Surg Int"},{"key":"2025081710572679000_9.Suppl_1.e001122.4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.12"},{"key":"2025081710572679000_9.Suppl_1.e001122.5","doi-asserted-by":"crossref","unstructured":"Sperry JL , Guyette FX , Adams PW . 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