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The authors thank the staffs of the Telemedicine and 13. Gerhardt RT, Berry JA, Blackbourne LH. Analysis of life-
Technology Research Center, Fort Detrick, Maryland, saving interventions performed by out-of-hospital combat
The Department of Defense Trauma Registry, and the medical personnel. J Trauma. 2011;71(1 Suppl):S109–S113.
Defense Medical Readiness Training Center’s Tactical 14. Shuker ST. The immediate lifesaving management of
Simulator for Military Medicine (TacSiMM) facility for maxillofacial, life-threatening haemorrhages due to IED
their valuable assistance in conducting this study. and/or shrapnel injuries: “When hazard is in hesitation,
not in the action.” J Craniomaxillofac Surg. 2011.
15. Kragh JF Jr, et al. Survival with emergency tourniquet use
Previous Presentation to stop bleeding in major limb trauma. Ann Surg. 2009;
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Presented at the American Association for the Surgery of 16. Holcomb JB, et al. Causes of death in U.S. Special Opera-
Trauma and Acute Care Surgery Annual Meeting, Chi- tions Forces in the global war on terrorism: 2001–2004.
cago, Illinois, 28 September 2011. Ann Surg. 2007;245:986–991.
17. U.S. Department of Health and Human Services, Office of
Planning and Emergency Operations, Chemical Hazards
Disclaimers Emergency Medical Management. Triage of Chemical
The conclusions as reported herein are those of the au- Casualties. 2012, U.S. Government Printing Office.
thors, and do not necessarily represent the Department 18. Gerhardt RT, et al. Out-of-hospital combat casualty care
of Defense or the United States Army. in the current war in Iraq. Ann Emerg Med. 2009;53:
169–174.
19. Mabry RL, et al. Impact of critical care-trained flight
Disclosure paramedics on casualty survival during helicopter evacu-
ation in the current war in Afghanistan. J Trauma Acute
This research was supported by U.S. Defense Health Pro- Care Surg. 2012;73(2 Suppl 1):S32–S37.
gram Grant USAMRMC TATRC AAMTI 2008011662. 20. Lam DM. Telemedicine in the Context of Force Protec-
tion. Force Health Protection: NATO Research and Tech-
nology Organization. 2007;HFM 137(11):1–12.
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56 Journal of Special Operations Medicine Volume 14, Edition 1/Spring 2014