Page 55 - Journal of Special Operations Medicine - Summer 2014

combat environment. This study demonstrates that doc- 4. Gerhardt RT, Adams BD, De Lorenzo RA, et al. Panel
umentation on the TCCC card by combat medic train- synopsis: pre-hospital combat health support 2010: what
ees can be performed efficiently and accurately. Further should our azimuth be? J Trauma. 2007;62:S15–S16.
investigation and future studies may compare other pre- 5. Butler FK. Tactical Combat Casualty Care: update 2009.
J Trauma. 2010;69(Suppl 1):210–213.
hospital data collection methods to the TCCC card in 6. Therien SP, Nesbitt, ME, Duran-Stanton AM, et al. Pre-
terms of timely and accurate data collection.
hospital documentation in the Joint Theater Trauma
Reg istry: A retrospective study. J Trauma. 2011;71:S103–
Subsequent to the publication of this study in 2013, Kot- S108.
wal et al. published an article in the Journal of Special 7. ALARACT 010/2010–Enhancements to pre-hospital battle-
Operations Medicine proposing changes to the TCCC field care. Combat Lifesaver Program and unit assemblage.
card. The revisions preserve the “Soldier-centric” na- December 2009.
10
ture of the card, but integrated several modifications 8. Bellamy RF. The causes of death in conventional land
allowing for better documentation of prehospital care. warfare: implications for combat casualty care research.
Shortly thereafter, in July 2013, United States Forces- Mil Med. 1984;149:55–62.
Afghanistan (USFOR-A) Fragmentary Order (FRAGO) 9. Ennis JL, Chung KK, Renz EM, et al. Joint Theater
13-139 was issued directing the use of updated TCCC Trauma System implementation of burn resuscitation
guidelines improves outcomes in severely burned military
card and submission of TCCC after action reports. 11
casualties. J Trauma. 2008;64(2 Suppl):S146–S151; dis-
cussion S151–S142.
The final version of the TCCC card, revised DD form 10. Kotwal RS, Butler FK, Montgomery HR, et al. The Tacti-
1380 received final approval by Washington Headquar- cal Combat Casualty Care Casualty Card. J Spec Oper
ters in May 2014 (direct e-mail correspondence with Med. 2013;13:82–87.
COL Kotwal) (Figure 5). 11. United States Forces-Afghanistan (USFOR-A) Fragmen-
tary Order (FRAGO) 13-139. Directs the use of updated
tactical combat casualty care (TCCC) cards and submis-
Acknowledgments sion of TCCC after action reports (AAR), dated July 30,
The authors give special thanks to the Department of 2013.
Combat Medic Training at Fort Sam Houston, TX.
Thanks also go to CPT Donald Stevenson and his team
of Non-commissioned officers and Instructors for their MAJ Therien is affiliated with the Department of Emergency
help with data collection and to Cristy Landt for her Medicine, San Antonio Military Medical Center, JBSA Fort
help with statistical interpretation. Sam Houston, Texas. He is an emergency medicine physician
assistant who serves as the research director and assistant pro-
Disclosures fessor of the U.S. Army/Baylor University Emergency Medi-
cine Physician Assistant Doctoral Program.
The authors have nothing to disclose.
MAJ Andrews is an emergency medicine fellowship–trained
physician assistant who completed his training at Brooke
Disclaimers
Army Medical Center in December 2011. He is currently in
The opinions and assertions contained herein are the the U.S. Army and is stationed at Fort Belvoir, Virginia, where
private views of the authors and are not to be construed he works in the emergency department of Fort Belvoir Com-
as official or reflecting the views of the Department of munity Hospital.
the Army or Department of Defense. This study was MAJ (Ret) Nesbitt is affiliated with the Department of
conducted under a protocol reviewed and approved by Emergency Medicine, Audie L. Murphy Veterans Hospital,
the Brooke Army Medical Center Institutional Review San Antonio, Texas. He is the former U.S. Army physician
Board, and in accordance with the approved protocol. assistant graduate education manager, has been the program
The authors have no financial relationships. manager for the U.S. Army/Baylor University Physician As-
sistant Emergency Medicine Residency and the Joint Special
Operations Command Senior Physician Assistant.
References
1. Butler FK Jr, Hagmann J, Butler EG. Tactical combat casualty LTC Mabry is affiliated with the Department of Emergency
care in special operations. Mil Med. 1996;161(Suppl):3–16. Medicine, San Antonio Military Medical Center, San Antonio,
2. Kotwal RS, Montgomery HR, Mechler KK. A pre-hospital Texas. He is the program director for the Military EMS and
trauma registry for tactical combat casualty care. U.S. Army Disaster Medicine Fellowship program, San Antonio Military
Med Dep J. 2011;April:15–17. Medical Center.
3. Wilcox WW, Pugh WM. Evaluation of a revised field medi-
cal card for Navy and Marine Corps personnel. 1990.

TCCC Card Completion by Combat Medic Trainees 45