Page 154 - Journal of Special Operations Medicine - Spring 2015

uninjured. Formerly referred to as “bystanders,” these compatibility among local, state, and federal response
people represent medical force multipliers for tradi­ communities. Based on direct field experience, IAB
tional first responders and should be leveraged to initi­ members advocate for and assist the development and
ate needed medical care to the wounded. implementation of performance criteria, standards, test
protocols, and technical, operating, and training require­
As active violence continues to become more prevalent in ments for all­hazards incident response equipment with
our society, first responders strive to improve response to a special emphasis on chemical, biological, radiologi­
these events. However, despite these systemic improve­ cal, nuclear, and explosive issues. The IAB also informs
ments, there continues to be an ever­present shortcoming broader emergency preparedness and response policy,
in our ability to react to these horrific encounters quickly doctrine, and practice. Several members of C­TECC cur­
enough. There remains a major gap in public safety—ci­ rently serve on the IAB as well. Over the past 3 years, the
vilian medical response to atypical emergencies. There Health and Medical Responder safety subgroup has been
is clear evidence that demonstrates an inherent delay in discussing and developing recommendations to the first
the immediate medical care at the scene of an emergency. responder community for the incorporation of TECC
Additionally, through analysis of military data, it has into high­risk operations. Most notably, all TECC equip­
been demonstrated that immediately addressing the most ment (e.g., tourniquets, pressure bandages, hemostatic
common injury patterns following a traumatic event will agents) has been incorporated into the federal standard­
save lives. 1–5 The nature of these injuries makes the time ized equipment list, TECC has been added as a project
until arrival of medical care critical, often necessitating item to the HMRS working list, and a white paper on the
care prior even to the arrival of first responders. Analysis need for TECC training for Law Enforcement officers is
of current events shows repeatedly that bystanders pres­ in final review.
ent on scene can and will attempt to respond to these
6
medical emergencies. Implementing an approach similar
to the American Cardiac Arrest Act we can improve our Psychological Working Group
outcomes to traumatic events. We analyze the latest data Dr Rich Kamin, Psychological Trauma Mitigation work­
from the FBI report on Active Shooter incidents, and hy­ ing group leader, and Board of Advisors member Dr Matt
pothesize that by creating a network of trauma trained Wentzel spoke on the progress of the working group that
medic extenders, we can improve not only our response included distribution of the IAB white paper on psycho­
to these catastrophic events but also the resilience of our logical mitigation for first responders. We expect incor­
communities. poration of new language on psychological mitigation
into the guidelines at the Spring 2015 meeting.
International Application of TECC
TECC for K-9
Stewart Thomas, the proprietor of Line 9 Medic and for­
mer British military, presented a summary of the TECC Two other important projects came out of the meeting.
roll out in the United Kingdom and Europe. Stewart has First, Committee guest Dr Lee Palmer, DVM, volun­
developed TECC training programs for British first re­ teered to help the Committee create a TECC for work­
sponders called Hostile Environmental Medical Skills ing canines. Unanimously approved by the Committee,
And Tactics (HEMSAT). The HEMSAT course is based the working group will be lead by Board of Advisors
on the tenets of TECC and has been taught to a vari­ member Dr Allen Yee and Dr Palmer. This is a fantastic
ety of emergency response personnel over the past sev­ extension of TECC and is much needed for our working
eral years. As a result of his work, Stewart also recently canine partners in all areas of first response, not only
joined the C­TECC Board of Advisors as an interna­ law enforcement. The other project was the formation
tional asset to provide guidance on increased dissemina­ of a working group to examine the need for additions
tion of TECC outside of the United States. to the Evacuation Care/Cold Zone guidelines for ex­
tended care operations, such as post­Katrina or post­
earthquake missions.
InterAgency Board (IAB)
Guidelines Committee member John Delaney briefed the
Committee on the activities of the IAB (www.iab.gov) Guideline Changes
and the TECC work that is being done within the IAB. Co­Chairman Dr Smith then reintroduced the issue of in­
The IAB is a voluntary collaborative panel of emergency clusion of Hot, Warm, and Cold Zone into the names for
preparedness and response practitioners from a wide ar­ the TECC phases of care. This issue had been brought to
ray of professional disciplines that represent all levels of the Guidelines Committee online after the last meeting
government and the voluntary sector. The IAB provides a but was tabled by the Executive Committee in order to al­
structured forum for the exchange of ideas among opera­ low for open discussion in front of the entire Committee.
tional, technical, and support organizations to improve After much discussion among the members and guests,
national preparedness and promote interoperability and mainly hinging around ensuring all disciplines understood

144 Journal of Special Operations Medicine Volume 15, Edition 1/Spring 2015