Incidence of Hemorrhage
Trauma represents one of the leading causes of morbidity and mortality in both the civilian and military populations with uncontrolled hemorrhage as the major cause of death.,,,,,   Historically, about 20% of the combat causalities were killed in action with 90% of the deaths resulting before reaching the field hospital., The major cause of death in this group was hemorrhage.   Almost 40% of soldiers in Vietnam who died of exsanguination had a source of hemorrhage that may have been controlled by hemostatic measures.  
According to Holcomb, Trauma Consultant to the US Army Surgeon General, the majority of casualties on the battlefield with potentially survivable injuries died of hemorrhage.   This is consistent with Starnes and colleagues who found that 50 to 70% of all injuries during Operation Iraqi Freedom involved extremity vascular injuries.   Exsanguination from those wounds was the leading cause of preventable death.  
Depending on the tactical situation, casualties from combat may not be evacuated to advanced care for hours up to days.   Hemorrhage before evacuation accounts for 49% of overall battle deaths.   Even when the individuals survive long enough to be transported to a medical facility, hemorrhage still remains the leading cause of death.   Authorities emphasize that there are combat casualties who are potentially salvageable with improved methods of controlling early hemorrhage.,  
Early death in trauma and combat victims is almost entirely from uncontrolled hemorrhage.,   Even if hemorrhage is controlled, sufficient blood loss leaves victims vulnerable to hypothermia, coagulopathy, infection, acidosis, and multiple organ failure., ,   Because of hemorrhage, hypotension usually follows with deleterious consequences.   Specifically, Heckbert found that patients with isolated systolic hypotension (< 90 mm Hg) have up to 54 % mortality.   Therefore, rapid hemostasis is essential as a strategy not only for initial survival but...