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https://www.readbyqxmd.com/read/28411934/tactical-combat-casualty-care-and-wilderness-medicine-advancing-trauma-care-in-austere-environments
#1
REVIEW
Frank K Butler, Brad Bennett, Colonel Ian Wedmore
Tactical Combat Casualty Care (TCCC) is a set of evidence-based, best-practice prehospital trauma care guidelines customized for use on the battlefield. Military units that have trained all of their unit members in TCCC have now documented the lowest incidence of preventable deaths in the history of modern warfare and TCCC is now the standard for battlefield trauma care in the US Military. TCCC and wilderness medicine share the goal of optimizing care for patients with trauma in austere environments that impose significant challenges in both equipment and evacuation capability...
May 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28392170/translating-tactical-combat-casualty-care-lessons-learned-to-the-high-threat-civilian-setting-tactical-emergency-casualty-care-and-the-hartford-consensus
#2
REVIEW
David W Callaway
Combat operations necessitate bold thought and afford the opportunity to rapidly evolve and improve trauma care. The development and maturation of Tactical Combat Casualty Care (TCCC) is an important example of a critical process improvement strategy that reduced mortality in high-threat combat-related trauma. The Committee for Tactical Emergency Casualty Care (C-TECC) adapted the lessons of TCCC to the civilian high-threat environment and provided important all-hazards response principles for austere, dynamic, and resource-limited environments...
April 6, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28383472/battlefield-pain-management-a-view-of-17-years-in-israel-defense-forces
#3
Avi Benov, Margaux M Salas, Helit Nakar, Ben Antebi, Bader Tarif, Avraham Yitzhak, Elon Glassberg
INTRODUCTION: Pain control in trauma is an integral part of treatment in combat casualty care (CCC). More soldiers injured on the battlefield will need analgesics for pain than those who will need life-saving interventions (LSI). It has been shown that early treatment of pain improves outcomes after traumatic injury, while inadequate treatment leads to higher rates of PTSD. The purpose of this article is to report the Israel Defense Forces Medical Corps (IDF-MC) experience with point of injury (POI) use of analgesia...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28383471/clinical-practice-guideline-adherence-during-operation-inherent-resolve
#4
Timothy P Plackett, Darren C Cherry, Gerald Delk, Steven Satterly, Jared Theler, Derek McVay, Jacqueline Moore, Stacy A Shackelford
BACKGROUND: The Joint Trauma System (JTS) Clinical Practice Guidelines (CPGs) contributed to the decrease in battlefield morality over the past 15 years. However, it is unknown to what degree the guidelines are being followed in current military operations. METHODS: A retrospective review was performed of all patients treated at three separate US Army Role II facilities during the first ten months of Operation Inherent Resolve in Iraq. Charts were reviewed for patient demographics, clinical care, and outcomes...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28383466/relative-device-stability-of-anterior-vs-axillary-needle-decompression-for-tension-pneumothorax-during-casualty-movement-preliminary-analysis-of-a-human-cadaver-model
#5
Matthew L Leatherman, Jenny M Held, Laura M Fluke, Christian S McEvoy, Kenji Inaba, Daniel Grabo, Matthew J Martin, Angela S Earley, Robert L Ricca, Travis M Polk
BACKGROUND: Tension pneumothorax (tPTX) remains a significant cause of potentially preventable death in military and civilian settings. The current pre-hospital standard of care for tPTX is immediate decompression with a 14 gauge 8cm angiocatheter (14G AC); however, failure rates may be as high as 17-60%. Alternative devices, such as 10G AC, modified Veress needle (mVN) and laparoscopic trocar (LT), have shown to be potentially more effective in animal models; however, little is known about the relative insertional safety or mechanical stability during casualty movement...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28376019/combat-casualty-care-research-for-the-multi-domain-battlefield
#6
Todd E Rasmussen, David G Baer, Kyle N Remick, George V Ludwig
No abstract text is available yet for this article.
April 4, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28333837/leadership-lessons-learned-in-tactical-combat-casualty-care
#7
Frank K Butler
The US Military has achieved remarkable success in improving survival for our nation's combat wounded throughout the 14 years of conflict in Iraq and Afghanistan. For the prehospital phase of care, where most combat fatalities occur, these advances have been embodied in Tactical Combat Casualty Care (TCCC.) TCCC is a set of evidence-based, best-practice, prehospital trauma care guidelines that are customized for use on the battlefield. The TCCC Guidelines have been updated on an ongoing basis over the last 15 years through the work of the Committee on TCCC and the TCCC Working Group...
March 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28333833/leadership-and-a-casualty-response-system-for-eliminating-preventable-death
#8
Russ S Kotwal, Harold R Montgomery, Ethan A Miles, Curtis C Conklin, Michael T Hall, Stanley A McChrystal
Combat casualties who die from their injuries do so primarily in the prehospital setting. Although most of these deaths result from injuries that are non-survivable, some are potentially survivable. Of injuries that are potentially survivable, most are from hemorrhage. Thus, military organizations should direct efforts toward prehospital care, particularly through early hemorrhage control and remote damage control resuscitation, in order to eliminate preventable death on the battlefield. A systems-based approach and priority of effort for institutionalizing such care was developed and maintained by medical personnel and command-directed by non-medical combatant leaders within the 75th Ranger Regiment, U...
March 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28318991/bleeding-control-using-hemostatic-dressings-lessons-learned
#9
REVIEW
Brad L Bennett
Based on lessons learned, many military battlefield trauma advances ultimately transition to enhance civilian trauma care. However, even with major strides to enhance battlefield hemorrhage control, it is unclear how effectively these techniques and products are being translated to civilian trauma. The purpose of this brief review is to present the evidence of current hemostatic product effectiveness, determine the evidence for transitioning of this technology to prehospital civilian application, and provide recommendations about potential use in the wilderness/austere setting...
March 16, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28318990/junctional-hemorrhage-control-for-tactical-combat-casualty-care
#10
REVIEW
Russ S Kotwal, Frank K Butler
During historic, as well as more recent, conflicts, most combat casualties who die from their injuries do so in the prehospital setting. Although many of the injuries incurred by these casualties are nonsurvivable, a number of injuries are still potentially survivable. Of those injuries that are potentially survivable, the majority are truncal, junctional, and extremity hemorrhage. Novel and effective approaches directed toward prehospital hemorrhage control have emerged in recent years, some of which can prove useful in the management of junctional hemorrhage whether in a military or civilian setting...
March 16, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28291503/regenerative-and-antibacterial-properties-of-acellular-fish-skin-grafts-and-human-amnion-chorion-membrane-implications-for-tissue-preservation-in-combat-casualty-care
#11
Skuli Magnusson, Baldur Tumi Baldursson, Hilmar Kjartansson, Ottar Rolfsson, Gudmundur Fertram Sigurjonsson
BACKGROUND: Improvised explosive devices and new directed energy weapons are changing warfare injuries from penetrating wounds to large surface area thermal and blast injuries. Acellular fish skin is used for tissue repair and during manufacturing subjected to gentle processing compared to biologic materials derived from mammals. This is due to the absence of viral and prion disease transmission risk, preserving natural structure and composition of the fish skin graft. OBJECTIVES: The aim of this study was to assess properties of acellular fish skin relevant for severe battlefield injuries and to compare those properties with those of dehydrated human amnion/chorion membrane...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291497/variation-in-postinjury-antibiotic-prophylaxis-patterns-over-five-years-in-a-combat-zone
#12
Bradley A Lloyd, Clinton K Murray, William Bradley, Faraz Shaikh, Deepak Aggarwal, M Leigh Carson, David R Tribble
In 2008, a clinical practice guideline (CPG) was developed for the prevention of infections among combat casualties and was later revised in 2011. We evaluated utilization of antimicrobials within 48 hours following injury in the combat zone over a 5-year period (June 2009 through May 2014) with regard to number of regimens, type of antimicrobial, and adherence to the 2011 CPG. The study population consisted of 5,196 wounded military personnel. Open fractures and skin and soft-tissue injuries were the most frequent injuries...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291456/anesthesia-and-postoperative-respiratory-compromise-following-major-lower-extremity-surgery-implications-for-combat-casualties
#13
Samuel M Galvagno, Jordan Brayanov, George Williams, Edward E George
Care of military casualties requires not only assessment of patient, injury, and setting, but also the consequences of care decisions on other organ systems. In contemporary conflicts, pelviperineal and lower extremity trauma are common injuries, yet the optimal perioperative anesthetic and analgesic care remains unclear. Residual anesthesia and opioids can cause respiratory depression, specifically postoperative respiratory depression and opioid-induced respiratory depression. This observational study quantified and compared the incidences of respiratory depression following general anesthesia (GA) and spinal anesthesia (SA) for lower extremity surgery...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291449/the-afghan-theater-a-review-of-military-medical-doctrine-from-2008-to-2014
#14
Ian Lane, Zsolt Stockinger, Samual Sauer, Mark Ervin, Michael Wirt, Stephen Bree, Kirby Gross, Jeffrey Bailey, Brig Timothy Hodgetts, Elizabeth Mann-Salinas
This article forms part of a series that will explore the effect that Role 2 (R2) medical treatment facilities (MTFs) had on casualty care during the military campaign in Afghanistan and how we should interpret this to inform the capabilities in, and training for future R2 MTFs. Key aspects of doctrine which influence the effectiveness of R2 MTFs include timelines to care, patient movement capabilities, and MTF capabilities. The focus of this analysis was to review allied doctrine from the United States, United Kingdom, and the North Atlantic Treaty Organization to identify similarities and differences regarding employment of R2 related medical assets in the Afghan Theater, specifically for trauma care...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290925/two-decades-of-saving-lives-on-the-battlefield-tactical-combat-casualty-care-turns-20
#15
Frank K Butler
BACKGROUND: Twenty years ago, the original Tactical Combat Casualty Care (TCCC) article was published in this journal. Since TCCC is essentially a set of best-practice prehospital trauma care guidelines customized for use on the battlefield, the presence of a journal with a specific focus on military medicine was a profound benefit to the initial presentation of TCCC to the U.S. Military. METHODS: In the two ensuing decades, which included the longest continuous period of armed conflict in our nation's history, TCCC steadily evolved as the prehospital trauma care evidence base was augmented and as feedback from user medics, corpsmen, and pararescuemen was obtained...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28285493/the-use-of-pelvic-binders-in-tactical-combat-casualty-care-tccc-guidelines-change-1602-7-november-2016
#16
Stacy Shackelford, Rick Hammesfahr, Daniel Morissette, Harold R Montgomery, Win Kerr, Michael Broussard, Brad L Bennett, Warren C Dorlac, Stephen Bree, Frank K Butler
No abstract text is available yet for this article.
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28285480/pediatric-trauma-management-from-an-austere-prospective
#17
Joycelynn Gray, Derek R Linklater, James Johnston, Benjamin Donham
Pediatric trauma represents a notable proportion of casualties encountered by Combat medics, physician assistants, and physicians while in the deployed setting. Most of these resuscitation teams receive limited pediatric- specific training and suffer subsequent emotional stress due the perceived high-stakes nature of caring for gravely wounded children. Even when children survive long enough to arrive at combat support hospitals, there remain high risks for morbidity and mortality for many of them. There are numerous reports of the epidemiological characteristics of these pediatric patients, the common mechanisms of injury, the hospital lengths of stay, and calls for pediatric-specific equipment and specialist presence in-theatre...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28285473/a-modern-case-series-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-an-out-of-hospital-combat-casualty-care-setting
#18
Justin D Manley, Benjamin J Mitchell, Joseph J DuBose, Todd E Rasmussen
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used to mitigate bleeding and sustain central aortic pressure in the setting of shock. The ER-REBOAâ„¢ catheter is a new REBOA technology, previously reported only in the setting of civilian trauma and injury care. The use of REBOA in an out-of-hospital setting has not been reported, to our knowledge. METHODS: We present a case series of wartime injured patients cared for by a US Air Force Special Operations Surgical Team at an austere location fewer than 3km (5-10 minutes' transport) from point of injury and 2 hours from the next highest environment of care-a Role 2 equivalent...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28284484/tactical-combat-casualty-care-transitioning-battlefield-lessons-learned-to-other-austere-environments
#19
EDITORIAL
Brad Bennett, Ian Wedmore, Frank Butler
No abstract text is available yet for this article.
March 8, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28284483/tactical-combat-casualty-care-beginnings
#20
REVIEW
Frank K Butler
Tactical Combat Casualty Care (TCCC) is a set of evidence-based, best-practice prehospital trauma care guidelines customized for use on the battlefield. The origins of TCCC were nontraditional. The TCCC program began as a Naval Special Warfare biomedical research effort launched after the realization that extremity hemorrhage, a leading cause of preventable death on the battlefield, was not being treated with a readily available and highly effective intervention: the tourniquet. This insight prompted a systematic reevaluation of all aspects of battlefield trauma care that was conducted from 1993 to 1996 as a joint effort by special operations medical personnel and the Uniformed Services University of the Health Sciences...
March 8, 2017: Wilderness & Environmental Medicine
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