Page 38 - Journal of Special Operations Medicine - Summer 2015

Intent Primary Team, Prehospital Division,
Joint Theater Trauma System, USCENTCOM
To observe, discuss, record, and evaluate prehospital Samual W. Sauer, MD, MPH; COL, MC, USA; Director,
trauma-care tactics, techniques, and procedures con- Prehospital Care
ducted in the prehospital battlefield environment as John Robinson, MPAS, PA-C; MAJ, SP, USA; Prehospi-
obtained directly from deployed prehospital provid- tal Coordinator
ers, medical leaders, and combatant leaders among Michael P. Smith; SSG, US Army; Prehospital NCOIC
the various US military services 1 year after the initial
assessment.
Support Team, Joint Theater Trauma System (JTTS)
and Joint Trauma System (JTS)
The overall goal of this re-assessment is to provide rec- Kirby R. Gross, MD; COL, MC, USA; Deployed Direc-
ommendations that will reduce preventable combat tor of JTTS
death among US, Coalition, and Afghan forces to the Russ S. Kotwal, MD MPH; COL, MC, USA; Outgoing
lowest incidence achievable. Three primary areas of fo- Director of JTS Trauma Care Delivery
cus are to (1) identify best practices that can be cross- Robert L. Mabry, MD; LTC, MC, USA; Incoming Direc-
leveled among the force; (2) identify actionable areas of tor of JTS Trauma Care Delivery
performance improvement that will optimize prehospi- Frank K. Butler, MD; CAPT, MC, USN; Director of JTS
tal trauma-care timing, delivery, and casualty survivabil- Prehospital Trauma Care
ity; and (3) identify potential gaps in prehospital trauma Zsolt T. Stockinger, MD; CAPT, MC, USN; Director of
care across the Doctrine, Organization, Training, Ma- JTS Performance Improvement
teriel, Leadership and Education, Personnel, Facilities, Jeffrey A. Bailey, MD; Col, MC, USAF; Director of JTS
and Policy (DOTMLPF-P) domain.

CJOA-A Assessment Locations of the ROLE-1s
Leatherneck Lashkar
SECTION 2. METHODOLOGY
Shank Sabit
The assessment team comprised CJOA-A deployed per- Frontenac Lam
sonnel from the Joint Theater Trauma System (JTTS) Dwyer Gah
Prehospital Division. This prehospital division was in- Boldak Qadam
tegrated into the JTTS as a result of the initial CJOA-A Rushmore Gamberi
prehospital report recommendations to USCENTCOM. Airborne Kandahar
As this team is now an organic theater asset, the assess- Shukvani Ebbert
ment was conducted over 45 days, allowing for the in-
clusion of more geographically isolated ROLE-1s. Spin Bagram
Lightning Pasab
Unique to this assessment was the decision to limit the Tokham Walton
assessment to conventional forces. There were three Boldak Ghazni
driving factors in this decision: (1) Conventional forces Eredvi Clark
suffer the most casualties (including Afghanistan se- Mehtar
curity forces); (2) US SOF have previously achieved Note: The term “medic” is used throughout this docu-
demonstrable success in the area of Tactical Combat ment and generically refers to enlisted medical personnel
Casualty Care (TCCC); and, (3) thus, the team focused of all services providing prehospital care. Service- specific
on organizations whereby the largest benefits could yet branding and education-level titles are used when they
be realized.
are important to the message. The term “medical offi-
cer” generically refers to physicians and physician as-
The team focused on ROLE-1s and Tactical Evacua- sistants. The term “Unit Surgeon” specifically identifies
tion Care (TACEVAC) organizations, as these organiza- the officer designated as senior medical officer of a de-
tions are the providers of prehospital care. Individual ployed line unit. The term “Warfighter” generically re-
and group interviews were conducted with the spectrum fers to all combatants regardless of Service.
of ROLE-1 healthcare providers. This included enlisted
medical personnel, physicians, physician assistants, Assessment Methods
nurses, commanders, and Warfighters. In addition to
unstructured dialogue, the team used specified ques- Capability-Based Assessment (CBA) Questions
tions regarding TCCC Guidelines, using the DOTMLPF
structure to identify potential capability gaps in prehos- 1. What is the standard of care for prehospital care in
pital care delivery. US Department of Defense Combat Operations?

28 Journal of Special Operations Medicine Volume 15, Edition 2/Summer 2015