Page 39 - Journal of Special Operations Medicine - Summer 2015

2. Are the TCCC Guidelines the US Department of De- • Organization: how we command/control the conduct
fense Combat Operation prehospital standard of care? of medical support operations
3. Are the TCCC Guidelines doctrine? • Training: how we prepare our medical forces to con-
4. What are the policies or regulations used to conduct duct specified and implied tasks (basic training to
prehospital quality assurance and quality improve- advanced individual medical training, unit medical
ment programs during US Department of Defense training with casualty care, and evacuation exercises)
Combat Operations? • Materiel: All items necessary to equip, operate, main-
5. Are the TCCC Guidelines currently enforceable as a tain, and support military activities without distinc-
prehospital standard of care? tion as to its application for administrative or combat
6. Is delivery of TCCC standardized across combatant purposes. (TCCC Guideline medical materials)
organizations? • Leadership and Education: how we prepare personnel
7. Does our current doctrine support the effective to organize and lead medical support operations
implementation of TCCC guidelines at the tactical • Personnel: Those individuals required in either a mili-
and operational levels on the battlefield? tary or civilian capacity to accomplish the assigned mis-
8. Are our tactical and operational organizations sion (availability of qualified [technically and tactically/
structured to support the delivery of prehospital operationally proficient] personnel in the delivery of
care? prehospital battlefield trauma care)
9. Does the current training structure support the ef- • Facilities: Real property entities consisting of one or
fective delivery of prehospital care using a standard more of the following: building, structure, utility sys-
of care that is tactically and operational available tem, pavement, or underlying land (medical training
across the spectrum of the battlefield? facilities for prehospital battlefield trauma care)
10. Do our currently fielded tactical medical sets, kits,
and outfits ensure the delivery of effective prehospi-
tal care using TCCC Guidelines? SECTION 3: OBSERVATIONS, DISCUSSION,
11. Do our current medical logistics techniques com- AND FINDINGS
prehensively and effectively supply our forces and Notable Successes–One Year Later
ensure adequate medical materials to provide pre-
hospital care using TCCC Guidelines? It is appropriate to begin any discussion of current find-
12. Are tactical, operational, and strategic Command ings and observations with full acknowledgement of
Surgeons correctly empowered under a DOTMLPF- the many successes over the past year between Parts I
P integration to ensure the delivery of effective pre- and II of this report, and the efforts of all who have so
hospital care using a standard of care? diligently dedicated their time and energy to achieve so
13. Are our maneuver commanders and medical lead- much over such a short period.
ers adequately trained and educated to ensure the
effective delivery of prehospital care using TCCC 1. A preventable death review and analysis of combat-
Guidelines across the battlefield? related fatalities is now conducted by a joint team
14. Does the human capital management process assign from both the Armed Forces Medical Examiner and
the right leaders and technical experts to the right the Joint Trauma System (JTS). This effort is provid-
levels to ensure the effective delivery of prehospital ing excellent feedback to the theater trauma surgeons
care using TCCC Guidelines across the battlefield? at the ROLE-2 and ROLE-3 levels. This effort is also
instrumental for identifying issues with prehospital
Responses to these questions and unstructured inter- care that would otherwise be missed due to the clas-
views were organized according to the DOTMLPF con- sification of a casualty as a killed in action (KIA).
struct, as defined by the Joint Capabilities Integration As this collaborative effort matures, this information
Development System process, to identify and address will be further disseminated to prehospital providers
gaps relating to the tactical and operational implemen- and into the training organizations.
tation of TCCC Guidelines. 2. Implementation of a prehospital Combat Medic
Trauma Conference that is for medics, by medics, and
hosted by the JTTS in CJOA-A. This effort improves
DOTMLPF
direct peer-to-peer communication about TCCC
• Doctrine: fundamental principles by which the mili- Guide lines, best practices, and practical solutions.
tary forces or elements thereof guide their actions 3. The JTS/JTTS implementation and deployment (via
in support of national objectives. It is authoritative US Forces Afghanistan [USFOR-A] fragmentary or-
but requires judgment in application. (current best der [FRAGO]) of the Prehospital Trauma Registry
thoughts on the methods by which we deliver prehos- along with implementation of the CJOA-A TCCC
pital battlefield trauma care). Casualty Card and TCCC-After Action Report (AAR)

Saving Lives on the Battlefield (Part II) 29