Late Breaking News
Military Battles to Improve Prehospital Care for Wounded Troops Cont.
Battlefield Care Study
A number of scientific papers were presented at the conference, including one entitled, Eliminating Preventable Death on the Battlefield. Researchers in this study sought to evaluate battlefield survival rates for the 75th Ranger Regiment, which used a command-directed casualty response system on the battlefield that integrated the use of Tactical Combat Casualty Care (TCCC) and a prehospital trauma registry (PHTR).
The TCCC guidelines are prehospital trauma-care guidelines for the battlefield. PHTR is a software tool designed to capture prehospital injury and treatment data with integrated features for basic analysis and instant graphing.
The paper pointed out that, historically, approximately 90% of combat-related deaths occur prior to a casualty reaching a medical-treatment facility.
The study authors hypothesized that “training the entire fighting force in TCCC, tactical leader ownership of the casualty response system, and near-real-time feedback from PHTR data would improve outcomes for combat casualties.”
Currently, training exists but has not been fully implemented, the study noted.
“Although most of the U.S. military has now included TCCC in combat medic education, they have largely continued medical training in their previous model — lacking comprehensive, all-inclusive, command directed casualty response systems — leaving medical care to the medics, with nominal input from tactical leaders and without continuous feedback from a registry to guide performance improvements at the combat unit level,” according to the authors.
With substantial prehospital care provided by nonmedical personnel, the 75th Ranger Regiment sustained a total of 419 battle-injury casualties during seven years of continuous combat in Iraq and eight and a half in Afghanistan, according to the study. The regiment’s rates of 10.7% killed in action and 1.7% who died of wounds were lower than DoD average rates of 16.4% and 5.8%, respectively. The authors noted that the 75th Ranger Regiment’s implementation of a comprehensive casualty-response system and data from a unit-based PHTR resulted “in historically low casualty rates for a frontline unit of its type, to include virtual elimination of preventable combat death.”
“They trained everybody. Not just the medics, not just the doctors, but everybody,” commented Frank Butler, retired Navy captain and former Navy SEAL chairman of the committee on Tactical Combat Care Defense Health Board.
“They did a very good job of keeping track of their casualties and what they were doing for each casualty. They documented the injuries, the care provided prehospital and the outcomes. And they got their line leadership to take ownership in a very definitive way of the casualty scenarios,” Butler said.