Page 123 - Journal of Special Operations Medicine - Summer 2014

Committee on Tactical Combat Casualty Care
Meeting Minutes

Davis Conference Center
MacDill AFB, FL, 4–5 February 2014
Attendance: See Enclosure (1)
Agenda: See Enclosure (2)

CoTCCC Action Items • The ability to adapt to and overcome obstacles is
something that needs to be taught to medics at all
a. Vote – Proposed hemostatic dressing change levels.
b. Teleconference/Vote – Proposed surgical airway
change Improves
c. Teleconference/Vote – Proposed fluid resuscitation • Do not have loose items in the aid bag.
change • When time permits, be sure to record vital signs.
d. Remove the pressure-patch ocular injury first aid • Always carry webbing to use to drag and carry pa-
kit from Department of Defense inventories and tients, especially when dealing with pressure-plate
purchase lists IEDs.
e. Pursue selected action items from Enclosure (3)
• Consider cricothyroidotomy early if the patient is
not guarding his or her airway.
• Never leave your aid bag at the casualty collection
Combat Medical Presentations
point.
Corporal Bryan Anderson (75th Ranger Regiment) pre- – A Servicemember left his bag at the casualty
sented the cases of six casualties from a multiple (12 collection point, thinking that was the loca-
detonation) dismounted IED incident. This scenario tion where he would be working on casualties.
included the first use of freeze-dried plasma by a U.S. However, he was unable to return there until
medic on the battlefield. just before evacuation.
– All WALK bags [Warrior Aid and Litter Kit; an
NAR product] were also lying on the ground by
LESSONS LEARNED
time the initial blast went off. This made getting
Sustains to extra medical supplies extremely difficult.
• First responder training is done on a weekly basis • Communicate with leadership early and often.
and paid dividends on the night of the incident. • Two C-A-T Tourniquets broke while being applied.
®
• Fentanyl lozenges did an outstanding job control- – Ensure that, if you are carrying C-A-T tourni-
ling pain while allowing the patient to remain quets, they are new and have not been previously
conscious. used for training or have been exposed to the ele-
• Knowing exactly where everything is located in ments for an extended period. Approximately one-
my aid bag made it easy to quickly communicate tenth of the tourniquets broke while being applied.
to others exactly what I needed and where they • Ensure that all IV sites are properly secured.
could find the items. – If possible, use saline locks and attach an 18-
• The use of pressure points on the femoral arteries gauge needle to the set to administer fluids.
bought me time while acquiring extra tourniquets.
• Regular SKEDCO training with first respond- CPT Andy Fisher (75th Ranger Regiment) presented a
ers allowed for medical personnel to continue series of nine casualties whose pain was managed suc-
treatment while patients were being prepared for cessfully with ketamine. His view is that ketamine is
transport. much better than any other medication that is used on
• The use of ketamine to sedate a casualty allowed the battlefield for analgesia.
for a medic to use his fingers to find and stop an
arterial bleed inside of the patient’s face.
• A quick call on the ground to not package a casu- LESSONS LEARNED
alty allowed for a quick manual carry of an urgent • Ketamine has been far superior to any other drug
patient and ultimately led to a faster evacuation. that is used at the point of injury (POI).

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