DCR focus specifically on restoration of venous return to the right heart before the patient's physiologic reserve is exhausted in concert with expedient correction and subsequent prevention of coagulopathies by hemostatic resuscitation with plasma and platelets. Crystalloid infusion is tightly restricted and colloid volume expanders are avoided. In military settings, fresh whole blood is often utilized for resuscitation. DCR is carried out most effectively if directed by a specific protocol or algorithm that delineates authority and clinical criteria for activation, outlines the responsibilities of various members of the resuscitation team, lists how and at what time points the patient is assessed, directs the timing and coordination of certain interventions, suggests resuscitation endpoints to monitor, and specifies under what circumstances a DCR is deactivated. Examples of MT prediction scores are shown in Table 2. Scores with a greater number of variables that have been weighted appear to be more accurate. The efficiency of a protocol-directed process decreases the time to transfusion, which may be a significant factor in observed reductions in organ failure, other post-injury complications, and mortality associated with DCR. Protocols also direct transfusion of blood components either in fixed ratios or as a goal-directed strategy.