Page 46 - Journal of Special Operations Medicine - Fall 2015

first-responder EMS personnel as well. Conventional made tremendous strides toward improving tactical ca-
training for EMS emphasized withholding medical inter- sualty care for civilian high-risk situations.
vention until the scene was declared safe by on-site LE.
Although this conventional thinking of “scene-safety Veterinary Prehospital
first” mitigated the risk for undue injuries and fatality Trauma Care and Canine TCCC
among EMS responders, it delayed the medical care nec-
essary for reducing injury severity and eliminating case To date, standardized PHTLS guidelines are not available
fatalities in injured civilians and LE first responders. 24 for veterinary casualties. The American College of Veteri-
To accommodate the subsequent increased risk for in- nary Emergency and Critical Care, Veterinary Committee
jury to LE officers from their shift to a rapid deploy- on Trauma, has formed a prehospital subcommittee with
ment model, first-responder EMS personnel adopted a the intent of developing best practice, out-of-hospital,
concept referred to as TEMS or tactical medicine (TAC- veterinary care guidelines. Although similar to human
MED). The intent of TEMS is to prepare emergency phy- PHTLS guidelines, the veterinary guidelines are mainly
sicians, paramedics, EMTs, and other paraprofessional focused on out-of-hospital care for the noncombat, com-
first responders to support LE Special Operations teams panion animal. They are not intended to take into ac-
26
during high-risk operations. A major tenet of TACMED count the constraints of providing trauma care for the
doctrine is to train LE officers on the basics of self-care OC operating in a high-threat environment. Realizing
and “buddy care,” thus allowing all team members to their significant contribution to achieving mission success
remain engaged in accomplishing the mission. and their high risk for sustaining life-threatening injuries,
it is evident that standardized prehospital trauma care
It did not take long for the battlefield-proven success of principles for OCs need to be developed and taught to
TCCC to gain the attention of the civilian TEMS world, first responders.
particularly with the release of the TCCC-focused PHTLS
manual. Originally developed with the military battle- The Global War on Terrorism has led to a significant up-
field in mind, TCCC principles have been incorporated surge in the call to duty of both military and civilian OCs.
into many aspects of today’s civilian TEMS community. Similar to their human tactical counterparts, OCs engaged
Just as PHTLS did not completely fit the needs for battle- in a high-threat situation are also at an extreme risk for
field combat casualty care, TCCC does not completely suffering preventable deaths. Veterinary personnel do not
fit the needs for the civilian tactical community, due to typically deploy as part of a rapid TEMS response dur-
differences in situational environments, variances in pa- ing high-threat or hostile civilian urban situations. Even
tient populations, availability of resources, and scope of for the MWD deployed in an austere environment, it is
practice. Also, in the military, many Soldiers are trained not uncommon for one Veterinary Corps Officer to be re-
14
in the principles of TCCC before deploying and doctrine sponsible for 20 to 30 MWDs scattered over hundreds to
across the battlefield remains relatively common across thousands of miles. In fact, during Operation Iraqi Free-
all Armed Services. This contrasts with civilian high- dom, there were typically more than 600 OCs deployed
threat responses, in which very few LE officers actually in country and scattered over 100 different locations,
receive any type of prehospital trauma care training, with fewer than 30 total veterinary personnel available to
doctrine may vary significantly between LE agencies, provide care for these dogs. 27–29 Even for situations where
and the availability of trained tactical medics for most veterinary personnel are readily available, it is not atypi-
special response teams remains very limited. 24 cal that many of these veterinary care providers (both
military and civilian) have not received adequate training
In 2010, the Committee for Tactical Emergency Casu- for providing trauma care under high-threat situations
alty Care (C-TECC) was formed with the goal of modi- and/or that they have no direct experience with providing
fying lessons learned from TCCC to develop a set of best such care. The lack of veterinary care availability, or even
practice recommendations that would accommodate the just the lack of properly trained veterinary personnel,
operational and situational needs of the civilian LE and constitutes a major risk factor that jeopardizes the surviv-
TEMS community. These new principles were written ability of OCs injured in a high-threat environment. 30,31
by civilians TEMS to be used by civilian TEMS and are
referred to as TECC guidelines. C-TECC is a diversi- When OCs are injured in the field, first-responder care
25
fied group of leaders comprising physicians, paramed- often falls to the handler, a combat or TEMS medic, or
ics, EMTs, law enforcement officers, and fire fighters. other Tier-1 operator. Many of these first responders
Although C-TECC uses evidence-based medicine to have received little to no training in basic canine first
form the foundation of TECC principles, the commit- aid, let alone emergency trauma care. When placed in
tee also relies heavily on user input and representatives these types of situations, care providers on scene have
from the front line to mold their final recommendations. to fall back on their medical knowledge of humans in
Since its inaugural meeting in May 2011, C-TECC has attempts to provide appropriate field care to injured

34 Journal of Special Operations Medicine Volume 15, Edition 3/Fall 2015