Eliminating Preventable Death on the Battlefield

Kotwal, Russ S; Montgomery, Harold R; Kotwal, Bari M.; Champion, Howard R.; Butler, Frank K.; Mabry, Robert; Cain, Jeffrey S.; Blackbourne, Lorne H.; Mechler, Kathy K.; Holcomb, John B.

doi:10.1001/archsurg.2011.213

Cited by 373 publications

(191 citation statements)

References 37 publications

Supporting

Mentioning

177

Contrasting

Unclassified

Order By: Relevance

“…The resultant TCCC paradigm continues to save lives down-range. 2,8 A study of the TCCC-trained, 75 th Ranger Regiment found that 1.7% of regimental fatalities died of wounds, compared with 5.8% in the larger US military population (P = .02). 2 No Ranger fatality died from wounds potentially survivable through additional prehospital interventions.…”

Section: Discussionmentioning

confidence: 99%

“…2,8 A study of the TCCC-trained, 75 th Ranger Regiment found that 1.7% of regimental fatalities died of wounds, compared with 5.8% in the larger US military population (P = .02). 2 No Ranger fatality died from wounds potentially survivable through additional prehospital interventions. The TCCC training proved so effective that although exsanguinating hemorrhage remains the leading cause of possibly preventable combat death, fatalities from extremity hemorrhage decreased from 60% to 13.5%.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Operationalization of these guidelines at the unit level has resulted in dramatic decreases in case fatality rates and possibly preventable battlefield deaths. 2,7,8 In 2014, 117 law enforcement officers died in the line of duty. 9 According to US Federal Bureau of Investigation (Washington, DC USA) data, 51 of these officers died as a consequence of felonious assault, including seven officers who died during premeditated ambush situations.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Descriptive Analysis of Tactical Casualty Care Interventions Performed by Law Enforcement Personnel in the State of Wisconsin, 2010-2015

Stiles

Cook²,

Sztajnkrycer³

2017

Prehosp. Disaster med.

View full text Add to dashboard Cite

IntroductionBased upon military experience, law enforcement has developed guidelines for medical care during high-threat conditions. The purpose of the current study was to provide a descriptive analysis of reported outcomes of law enforcement medical interventions.MethodsThis was a descriptive analysis of a convenience sample of cases submitted to the Wisconsin Tactical Medicine Initiative (Wisconsin USA), after the provision of successful patient care, between January 2010 and December 2015. The study was reviewed by the Mayo Foundation Institutional Review Board (Rochester, Minnesota USA) and deemed exempt.ResultsNineteen agencies submitted information during the study period. Of the 56 episodes of care reported, four (7.1%) cases involved care provided to injured officers while 52 (92.9%) involved care to injured civilians, including suspects. In at least two cases, on-going threats existed during the provision of medical care to an injured civilian. Law enforcement rendered care prior to Emergency Medical Services (EMS) arrival in all but two cases.ConclusionsThe current case series demonstrates the life-saving potential for law enforcement personnel trained and equipped under current Tactical Combat Casualty Care (TCCC)/ Committee on Tactical Emergency Casualty Care (C-TECC) tactical casualty care guidelines. Although originally developed to save the lives of wounded combat personnel, in the civilian sector, the training appears more likely to save victims rather than law enforcement personnel.StilesCM, CookC, SztajnkrycerMD. A descriptive analysis of tactical casualty care interventions performed by law enforcement personnel in the State of Wisconsin, 2010-2015. Prehosp Disaster Med. 2017;32(3):284–288.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Descriptive Analysis of Tactical Casualty Care Interventions Performed by Law Enforcement Personnel in the State of Wisconsin, 2010-2015

Stiles

Cook²,

Sztajnkrycer³

2017

Prehosp. Disaster med.

View full text Add to dashboard Cite

show abstract

“…[1][2][3][4] Unfortunately many combat-type injuries, such as those seen during the Boston Marathon bombing, occur in the United States. 5 To address this, The Joint Committee to Create a National Policy to Enhance Survivability from Mass Casualty Shooting Events produced recommendations known as the Hartford Consensus I and II.…”

mentioning

confidence: 99%

Just‐in‐Time to Save Lives: A Pilot Study of Layperson Tourniquet Application

Goolsby

Branting

Chen

et al. 2015

Academic Emergency Medicine

View full text Add to dashboard Cite

Objectives: The objective was to determine whether just-in-time (JiT) instructions increase successful tourniquet application by laypersons.Methods: This was a randomized pilot study conducted in August 2014. The study occurred at the Uniformed Services University campus in Bethesda, Maryland. A total of 194 volunteers without prior military service or medical training completed the study. The participant stood in front of a waist-down mannequin that had an exposed leg. An observer read a scenario card aloud that described a mass casualty event. The observer then asked the participant to apply a Combat Application Tourniquet (C-A-T) to the mannequin. Test participants received a 4 9 6-inch card, with JiT instructions, in addition to their C-A-T; controls received no instructions. Participants were randomized in a 3:1 ratio of instructions to no instructions. The study's primary outcome was the proportion of successfully applied tourniquets by participants receiving JiT instructions compared to participants not receiving instructions. Secondary outcomes included the time for successful tourniquet placement, reasons for failed tourniquet application, and participants' self-reported willingness and comfort using tourniquets in real-life settings.Results: Just-in-time instructions more than doubled successful tourniquet placement. Participants supplied with JiT instructions placed a tourniquet successfully 44.14% of the time, compared to 20.41% of the time for controls without instructions (risk ratio = 2.16; 95% confidence interval = 1.21 to 3.87; p = 0.003).

show abstract

“…Det kan vara att agera i extrem kyla eller värme och under mörker, att vara ensam vid omhändertagandet, att flera skadas samtidigt, och att tvingas begränsningar avseende sjukvårdsutrustning och/eller fördröjd avtransport från skadeplats (Kotwal et al, 2011). Dessutom påverkar alltid även den taktiska situationen omhändertagandet (Butler, 2003;Veliz, Montgomery & Kotwal, 2010).…”

Section: Militär Personalunclassified

Militär akutsjukvård i fält : när den övade verkligheten blir verklig

Andersson¹

2014

View full text Add to dashboard Cite

Aims: Governing for the Armed Forces health care is respect for human dignity and the view of each individual as irreplaceable. The quality of the military care will be at a level equivalent to that of today's civil peace healthcare, which requires that the training is of high quality. Casualty care in the military environment is a complex, challenging and dangerous task. Today there is a lack of knowledge about how to learn these skills. The purpose of the research was to identify the knowledge area pre-hospital care in the military environment by examining what doctors, nurses, paramedics and officers learn about military health care during preparation and exercise. Method: A phenomenographic approach was used in all sub-studies, and empirical data were collected by means of semi-structured interviews. Study I‐III are cross-sectional studies and study IV is a longitudinal study. Twelve registered nurses who had served in Bosnia were interviewed for study I, and 24 conscript paramedics were interviewed for study II. Study III included 20 officers in their pre-deployment training for service in Afghanistan and Liberia, and Study IV included 7 doctors and twenty nurses who previously had served in Afghanistan, Bosnia, Kosovo and Liberia. Results: Learning military health care by training and gaining experience can be seen as different abilities; interaction, action and reflection. In-depth analysis at a meta--‐level revealed that the integration between the military and military medical fields of knowledge was missing. The results indicate that participants' understanding of their respective fields of knowledge is inadequate and needs to be integrated in education in a clearer way. Implications: To create opportunities for better education and integration in these fields of knowledge are proposed (1) that the findings of the thesis could be utilised to develop the design of the curriculum (2) the inter-professional learning is introduced as a part of creating a safer and more effective pre-hospital care, (3) the clinical competence becomes part of the development of pre-hospital emergency care in the field, and (4) that the training is built according to the principle of "train as you fight" with emphasis on the requirements in the combat zone

show abstract

Eliminating Preventable Death on the Battlefield

Abstract: To evaluate battlefield survival in a novel command-directed casualty response system that comprehensively integrates Tactical Combat Casualty Care guidelines and a prehospital trauma registry. Design: Analysis of battle injury data collected during combat deployments.

Cited by 373 publications

References 37 publications

A Descriptive Analysis of Tactical Casualty Care Interventions Performed by Law Enforcement Personnel in the State of Wisconsin, 2010-2015

A Descriptive Analysis of Tactical Casualty Care Interventions Performed by Law Enforcement Personnel in the State of Wisconsin, 2010-2015

Just‐in‐Time to Save Lives: A Pilot Study of Layperson Tourniquet Application

Militär akutsjukvård i fält : när den övade verkligheten blir verklig

Contact Info

Product

Resources

About