Tactical Combat Casualty Care Maritime Scenario: Shipboard Missile Strike

Butler, Frank K.; Burkholder, Todd; Chernenko, Michael; Chimiak, James; Chung, J.E.; Cubano, Miguel A.; Gurney, Jennifer M; Hall, Andrew B.; Holcomb, John B.; Kotora, Joseph G.; Lenart, Mark J.; Long, Ann Walsh; Papalski, Wayne; Rich, Thomas A.; Tripp, M.; Shackelford, Stacy; Tadlock, Matt D; Timby, Jeffrey W; Drew, Brendon

doi:10.55460/zt9j-ei8z

Cited by 5 publications

(7 citation statements)

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“…Various resources are available to help prepare Role 1 and Role 2 maritime caregivers to manage critically ill patients with thermal injury [1,26,[58][59][60]; the most important and readily available are The Joint Trauma System Clinical Practice Guidelines (CPG). Box 2 lists the CPGs that describe optimal burn injury management across all roles of care, including Role 1 prolonged casualty care.…”

Section: The Good 611 Clinical Practice Guidelinesmentioning

confidence: 99%

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War at Sea: Burn Care Challenges—Past, Present and Future

Tadlock,

Edson,

Cancio

et al. 2023

EBJ

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Throughout history, seafarers have been exposed to potential thermal injuries during naval warfare; however, injury prevention, including advances in personal protective equipment, has saved lives. Thankfully, burn injuries have decreased over time, which has resulted in a significant clinical skills gap. Ships with only Role 1 (no surgical capability) assets have worse outcomes after burn injury compared to those with Role 2 (surgical capability) assets. To prepare for future burn care challenges during a war at sea, Military Medicine must re-learn the lessons of World War I and World War II. Burn injuries do not occur in isolation during war and are associated with concomitant traumatic injuries. To care for burn casualties at sea, there is an urgent need to increase the availability of whole blood and dried plasma, resuscitation fluids that were ubiquitous throughout the naval force during World War II for both hemorrhagic and burn shock resuscitation. Furthermore, those providing trauma care at sea require formal burn care training and skills sustainment experiences in the clinical management of Burn, Trauma, and Critical Care patients. While burn education, training, and experience must be improved, modern high-energy weapons systems and anti-ship ballistic missiles necessitate concurrent investments in prevention, countermeasures, and personal protective equipment to decrease the likelihood of burn injury and damage resulting from these attacks.

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Section: The Good 611 Clinical Practice Guidelinesmentioning

confidence: 99%

“…Tactical Combat Casualty Care (TCCC) principles (Table 1) should be followed during naval engagements and damage control efforts to save the ship. Therefore, any Sailor renders initial care at the point of injury [24][25][26]. Once the ship is no longer under threat and a safe treatment area can be established, standard TCCC algorithms can be enacted.…”

mentioning

confidence: 99%

War at Sea: Burn Care Challenges—Past, Present and Future

Tadlock,

Edson,

Cancio

et al. 2023

EBJ

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“…Rapid and safe casualty transfer will allow the injured to receive care as soon as possible, enhancing survival and post-operative recovery rates ( Bricknell, 2003 ; Cao et al, 2023 ; Yang et al, 2023 ). The complexity of casualty transfer is increased by the presence of narrow passageways, turns, gangways, and other obstacles in industrial environments like factories and ships ( Butler FK et al, 2022 ). A fast and efficient casualty transport aid can help rescuers overcome these challenges and ensure that the casualty reaches the medical facility without incident.…”

Section: Introductionmentioning

confidence: 99%

A reconfigurable multi-terrain adaptive casualty transport aid base on Watt II six-bar linkage for industrial environment

Jiao,

Wang,

Fei

et al. 2024

Front. Bioeng. Biotechnol.

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Introduction: This paper presents the Reconfigurable Multi-Terrain Adaptive Casualty Transport Aid (RMTACTA), an innovative solution addressing the critical need for rapid and safe pre-hospital casualty transport in industrial environments. The RMTACTA, leveraging the Watt II six-bar linkage, offers enhanced adaptability through six modes of motion, overcoming the limitations of traditional stretchers and stretcher vehicles by facilitating navigation across narrow and challenging terrains.Methods: The RMTACTA's design incorporates two branching four-bar mechanisms to form a compact, reconfigurable Watt II six-bar linkage mechanism. This setup is controlled via a single remote rope, allowing for easy transition between its multiple operational modes, including stretcher, stretcher vehicle, folding, gangway-passing, obstacle-crossing, and upright modes. The mechanical design and kinematics of this innovative linkage are detailed, alongside an analysis of the optimal design and mechanical evaluation of rope control.Results: A prototype of the RMTACTA was developed, embodying the proposed mechanical and kinematic solutions. Preliminary tests were conducted to verify the prototype's feasibility and operability across different terrains, demonstrating its capability to safely and efficiently transport casualties.Discussion: The development of the proposed Reconfigurable Multi-Terrain Adaptive Casualty Transport Aid (RMTACTA) introduces a novel perspective on the design of emergency medical transport robots and the enhancement of casualty evacuation strategies. Its innovative application of the Watt II six-bar linkage mechanism not only showcases the RMTACTA's versatility across varied terrains but also illuminates its potential utility in critical scenarios such as earthquake relief, maritime rescue, and battlefield medical support.

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“…Throughout history, seafarers have faced unique dangers, 1–4 and the modern naval warship—part weapons systems, industrial workspace, and aerodrome conducting fixed and rotary aircraft operations—is no exception 5 . While peacetime naval deployments are generally considered safe, modern sailors face the risk of potential injury due to the associated occupational hazards, 6–14 which is significantly increased during naval warfare 15–18 …”

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confidence: 99%

“…5 While peacetime naval deployments are generally considered safe, modern sailors face the risk of potential injury due to the associated occupational hazards, [6][7][8][9][10][11][12][13][14] which is significantly increased during naval warfare. [15][16][17][18] Currently, US Navy and Marine Corps operational planning is coalescing around the concept of Distributed Maritime Operations (DMO), where all components of the naval force are geographically separated and isolated across multiple domains within the maritime environment. During DMO, widely dispersed ground forces, air assets, and surface and subsurface naval vessels will be coordinated to provide sea control and sea denial over enormous geographic areas, presenting unique and challenging long-distance considerations for medical planners.…”

mentioning

confidence: 99%

Injury Trends aboard U.S. Navy Vessels: A 50-year analysis of Mishaps at Sea

Benham¹,

Vasquez²,

Kerns

et al. 2023

J Trauma Acute Care Surg

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BACKGROUND Maritime activities have been associated with unique dangers to civilian and military sailors. We performed a retrospective cohort study analyzing injury mechanisms and clinical outcomes of casualties onboard US naval ships to determine common injury mechanisms, trends, and outcomes. We hypothesized there would be a downward trend of injuries and fatalities on US naval ships during the study period. METHODS All mishaps recorded by the Naval Safety Command aboard active service US naval ships from 1970 through 2020 were reviewed. Only mishaps resulting in injury or fatality were included. Over time, injury mechanisms and casualty incidence rates were trended and compared based on medical capabilities. Ships without surgical capabilities were categorized as Role 1, and those with surgical capabilities as Role 2. RESULTS There were a total of 3,127 casualties identified and analyzed, with 1,048 fatalities and 2,079 injuries. The injury mechanisms associated with the highest mortality included electrocution, blunt head trauma, fall from height, man overboard, and explosion. There was a decrease in the trend of mishaps resulting in casualties, fatalities, and injuries over the 50-year study period. The mortality rate for select severe injury mechanisms was higher on Role 1 capable platforms, compared with Role 2 (0.334 vs. 0.250, p < 0.05). CONCLUSION Casualty incidences decreased over 50 years. However, mortality still remains high for certain mechanisms no matter the operational platform. Furthermore, Role 1 capable vessels have a higher overall mortality rate for severe injuries compared with Role 2. The authors propose training, process improvement, and technology-related solutions to improve outcomes on Role 1 capable naval vessels. LEVEL OF EVIDENCE Prognostic and Epidemiological; Level IV.

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Tactical Combat Casualty Care Maritime Scenario: Shipboard Missile Strike

Cited by 5 publications

References 0 publications

War at Sea: Burn Care Challenges—Past, Present and Future

War at Sea: Burn Care Challenges—Past, Present and Future

A reconfigurable multi-terrain adaptive casualty transport aid base on Watt II six-bar linkage for industrial environment

Injury Trends aboard U.S. Navy Vessels: A 50-year analysis of Mishaps at Sea

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