Page 127 - Journal of Special Operations Medicine - Spring 2014

shot during the Watertown incident in conjunction with the Boston Marathon bombing. Trooper Dumont gave
descriptive details of the tactical situation, the wounds, and his medical decision making that ultimately contributed
to saving Officer Donahue’s life. We would like to thank Trooper Dumont for sharing this information directly with
the Committee, as well as for his bravery and medical acumen during that incident.

We then heard presentations from two large well-established training entities that have developed training around
TECC. GPS Defense and Eastern New Mexico University in Roswell, NM, presented the details of a new program of
TECC training courses that they co-developed and are offering for academic credit through the university and that
qualifies for tuition funding under the GI Bill. Next, Dr. Lawrence Heiskell, the founder and director of the well-
known International School of Tactical Medicine in Palm Springs, CA, gave a presentation on how the school has
embraced TECC and is incorporating TECC guidelines throughout the ISTM curriculum. The Committee congratu-
lates both of these entities on their incorporation of TECC and their progress with developing training programs.

Our next agenda item revolved around the need for language in the TECC guidelines regarding the management
of junctional hemorrhage. Guidelines Committee member Michael Shertz, MD, presented a well-researched lecture
with the data, both military and civilian, on junctional hemorrhage including the significance of, incidence of, and
potential field interventions for the management of junctional hemorrhage in a civilian setting. To augment the
discussion around this topic, the Committee asked the creators/vendors of the most commonly used junctional hem-
orrhage devices (JETT , Junctional Emergency Treatment Tool; CRoC , Combat Ready Clamp; SAM Junctional
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Tourniquet, and the AAJT , Abdominal Aortic and Junctional Tourniquet) to present a 15-minute overview of their
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device and the evidence behind its use and efficacy. Committee members and attendees then held an excellent discus-
sion on the need for included language, and junctional hemorrhage was set as a guidelines discussion topic to be
fully discussed and voted on at the next full Committee meeting.
The rest of the morning agenda and the working lunch for the meeting involved the TECC Pediatric Guidelines. Led
by the special populations working group lead, Josh Bobko, MD, all of the solicited subject matter expert responses,
as well as public comments to the draft Pediatric TECC guidelines, were heard and discussed. Dr. Bobko went line
through line with the pediatric guidelines, and language was adjusted as needed to reflect the received feedback.
After discussion, the quorum of Guidelines Committee members in attendance voted for unanimous approval of the
pediatric guidelines. As such, these are on the agenda for final approval by the Board of Directors. We anticipate that
version 1.0 of the Pediatric TECC Guidelines will be on the website (C-TECC.org) and available for distribution by
the end of January 2014.

At the end of the December meeting, the following new additions to the Committee were announced. The Board of
Directors welcomes all of these experts, and we look forward to their active involvement in the committee’s mission
to develop civilian high-threat medical guidance.

New Guidelines Committee Members
Rich Kamin, MD – State of Connecticut Department of Public Health
Jason Pickett, MD – Wright State University Dept. of Emergency Medicine
Russ Kotwall, MD – U.S. Army, Joint Trauma System Division Director for Trauma Care Delivery
Chief Robert Wylie, EMT – Cottleville Community Fire Protection District
Scott Kimball, EMT-P – Special Operations Group, U.S. Marshall’s Service
Vincent Johnson, EMT-P – Fire Department of New York
Eileen Bulger, MD – Harborview Medical Center (Seattle, WA)

New Board of Advisors Members
Lawrence Heiskell, MD – International School of Tactical Medicine
James McGinnis, PA-C – George Washington University
David Slattery, MD – Las Vegas Fire and Rescue
Chief Michael Touchstone – Philadelphia Fire Department
SGT James Gordon – Los Angeles Police Department
Scott Sasser, MD – Emory University
Alex Isakov, MD – Emory University

TacMed Update 119