Page 149 - Journal of Special Operations Medicine - Fall 2015

Tactical Combat Casualty Care Preventable Death on the

Battlefield: OEF and OIF

The Prehospital Arm of the Joint Trauma System Eastridge 2012 Study

• 4,596 U.S. deaths
• 87% of combat fatalities
were pre-hospital

• Medics, Corpsmen, PJs • 24% of these deaths
TCCC • Combat Lifesavers were potentially
• All Combatant Self/Buddy Care preventable

• Includes Tactical Evacuation Care
Photo – MSG Harold Montgomery

Battlefield Trauma Care:
1970

“All seem uncertain regarding the best
method to implement factual knowledge
to the man most in need, the front line
trooper….citing our ineptness in the field
of self-help and first aid …..”little if any
improvement has been made in this
phase of treatment of combat wounds in
the past 100 years.”

CAPT J.S. Maughon
Mil Med 1970

Battlefield Trauma Care: Tactical Combat Casualty
2001 Care in Special Operations
• Based on trauma courses NOT developed for combat
• Medics were taught NOT to use tourniquets
• No hemostatic agents
• No junctional tourniquets
• Large volume crystalloid fluid resuscitation for shock Military Medicine Supplement
• 2 large bore IVs on all casualties with significant trauma August 1996
• Civil War-vintage technology for battlefield analgesia (IM
morphine)
• No focus on prevention of trauma-related coagulopathy
• No tactical context for care rendered Trauma care guidelines
• Heavy emphasis on endotracheal intubation for customized for the battlefield
prehospital airway management

TCCC Updates 137