Page 35 - Journal of Special Operations Medicine - Summer 2015

Saving Lives on the Battlefield (Part II) – One Year Later
A Joint Theater Trauma System and Joint Trauma System Review
of Prehospital Trauma Care in Combined Joint Operations
Area–Afghanistan (CJOA-A)

Final Report, 30 May 2014

USCENTCOM Joint Theater Trauma System–Afghanistan
Samual W. Sauer, MD, MPH; John B. Robinson, MPAS, PA-C;
Michael P. Smith, NREMT-B; Kirby R. Gross, MD

DoD Joint Trauma System, Defense Center of Excellence for Trauma
Russ S. Kotwal, MD, MPH; Robert L. Mabry, MD; Frank K. Butler, MD;
Zsolt T. Stockinger, MD; Jeffrey A. Bailey, MD

USCENTCOM Command Surgeon
Mark E. Mavity, MD, MPH; Duncan A. Gillies II, MD, MPH

at the point of injury and continues through evacuation
CHANGING OLD PARADIGMS to those facilities. With up to 25% of deaths on the
battlefield being potentially preventable, the prehospital
“Treat for shock, but do not waste any time environment is the next frontier for making significant
doing it.” further improvements in battlefield trauma care. Strict
Fleet Marine Forces Manual adherence to the evidence-based Tactical Combat Casu-
alty Care (TCCC) Guidelines has been proven to reduce
“A tourniquet is a last resort for life-threatening morbidity and mortality on the battlefield. However,
injuries. Tourniquets cut off blood flow to full implementation across the entire force and commit-
and from the extremity and are likely to cause ment from both line and medical leadership continue to
permanent damage to vessels, nerves, and face ongoing challenges.
muscles.”
AMEDDC&S Pamphlet No. 350-10 This report on prehospital trauma in the Combined Joint
Operations Area–Afghanistan (CJOA-A) is a follow-on
to the one previously conducted in November 2012 and
EXECUTIVE SUMMARY published in January 2013. Both assessments were con-
ducted by the US Central Command ( USCENTCOM)
Introduction
Joint Theater Trauma System (JTTS). Observations
The United States has achieved unprecedented survival for this report were collected from December 2013 to
rates, as high as 98%, for casualties arriving alive at January 2014 and were obtained directly from deployed
the combat hospital. Our military medical personnel are prehospital providers, medical leaders, and combatant
rightly proud of this achievement. Commanders and Ser- leaders. Significant progress has been made between
vicemembers are confident that if wounded and moved these two reports with the establishment of a Prehos-
to a Role II or III medical facility, their care will be the pital Care Division within the JTTS, development of
best in the world. Combat casualty care, however, begins a prehospital trauma registry and weekly prehospital

This report in its entirety was reviewed by the US Central Command Communications Integration Public Affairs Office and
the Operational Security Office on 30 May 2014 and was determined to have an “Unclassified” classification with no limit for
distribution.

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