Page 54 - Journal of Special Operations Medicine - Summer 2014

as injury patterns. This is where the TCCC card can be “worst case” scenario in terms of time and accuracy. Ad-
9
most helpful. By demonstrating that it is user-friendly ditionally, the “fluids” and “drugs” fields were not used
for medics, requiring only minimal time to record the in this study because the combat medic trainees were not
essential data, prehospital documentation can be im- yet trained in administering intravenous fluids or drugs.
proved and allow us to better understand injury patterns With regular training, the authors anticipate greater ac-
and predict outcomes based on the POC data collected. curacy and quicker times of TCCC card completion than
those observed in this study.
Study Limitations
Several limitations exist in this study. Trauma manne-
quins were used, which, although well-made with simu- Conclusion
lated bleeding and airway difficulties, do not demonstrate Prehospital documentation is vital in the chain of events
the complex challenges associated with treating living from POI on the battlefield to successful evacuation and
Soldiers in a combat environment. Darkness, noise, fear, treatment at higher echelons of care, yet it remains an
dirty conditions, sweat, and real-life threats can never be ongoing hindrance to capture. By understanding injury
truly reproduced in the manner that they are present in patterns, timelines, and interventions performed on the
combat. Additionally, although the Soldiers were stressed battlefield by the first responders, we can enhance re-
physically and mentally by the instructors and devices search and ultimately improve survivability of Wounded
such as smoke grenades and noise-makers were used to Warriors. We observed that the mean completion time
simulate combat sounds, it is not possible to truly rep- of the TCCC card was 26.8 seconds in an unstressed
licate combat situations where life-threatening risks are (academic) environment (N = 444) and 115 seconds in
inherent. It is also important to understand that the med- a simulated combat environment (N = 284). The respec-
ics enrolled in this study were still in training and largely tive accuracy of the data was observed to be 94.6% in
unfamiliar with the TCCC card, thus representing a the unstressed environment and 85% in the simulated

Figure 5 Final approved TCCC card, May 2014.

44 Journal of Special Operations Medicine Volume 14, Edition 2/Summer 2014