Successful Management of Battlefield Traumatic Cardiac Arrest Using the Abdominal Aortic and Junctional Tourniquet – Stabilized (AAJT-S)
A frontline series in which the AAJT-S delivered non-invasive external aortic compression to combat casualties in traumatic cardiac arrest — achieving 100% ROSC.
Location: Ukraine
Clinical lead: Dr. Dmytro Androshchuk, Senior Lieutenant Ukrainian Armed Forces
Setting: Military & Tactical
Application site: Abdomen (aortic compression)
Case ID: UA-TCA-07
Clinical Case Summary
Synopsis
Injury, intervention, and outcome at a glance
- Severe hypovolemic shock
- Traumatic cardiac arrest (TCA)
- Austere combat environment
- AAJT-S at the umbilicus
- External aortic compression
- Increased mean arterial pressure
- Focused resuscitative efforts on the upper torso
- Preserved crucial field resources
- 100% ROSC (Return of Spontaneous Circulation)
- Hemorrhage controlled
- None required vasopressor support post-resuscitation
- Effectively managed TCA in a wartime FSSS
- MAP Increased
Frontline trauma in austere conditions
Prolonged warfare, resource constraints, and extended evacuation times in the Russo-Ukrainian war have forced significant adaptations in combat medicine. Traumatic cardiac arrest (TCA) from exsanguination is a leading cause of potentially survivable battlefield mortality, presenting a massive medical challenge. Because medical evacuation delays can cause casualties to bleed out rapidly, TCA management requires a strategic shift from traditional cardiopulmonary resuscitation toward immediate hemorrhage control and aggressive resuscitation.
Hemorrhage and cardiac arrest
Six patients in severe hypovolemic shock presented at an FSSS during fighting in Bakhmut (July 2022) and Slovyansk (May 2023). Following Traumatic cardiac arrest (TCA) due to exsanguination, the AAJT-S was applied.
AAJT-S Applied at Forward Surgical Stabilization Site
Across all six cases, the AAJT-S was applied to the abdomen to deliver non-invasive external aortic compression. Cardiopulmonary resuscitation (CPR) and transfusion with blood and/or plasma were initiated concurrently. No vasopressor support was required post-resuscitation in any patient.
100% ROSC in TCA Patients
Hemorrhage was controlled in all casualties and all six patients achieved ROSC (Return of Spontaneous Resuscitation. Five survived to the next level of care. One died awaiting evacuation, and another of wounds after 10 days. Four survived to discharge. Three were followed and neurologically intact, and no death records matched the fourth’s name and date of birth at 18 months. The AAJT-S effectively resuscitated TCA patients. effectively resuscitated TCA patients. It increased mean arterial pressure, focused resuscitative efforts on the upper torso, simplified care, and preserved crucial field resources.
“The device simplified care and preserved resources, crucial in the field environment.“
— Dr. Dmytro Androshchuk, Senior Lieutenant Ukrainian Armed Forces, Vascular Surgeon, Senior Officer of Frontline Surgical Group
