Page 48 - Journal of Special Operations Medicine - Fall 2015

tactical OC (e.g., available resources, operational en- anatomy and physiology. K9-TECC principles will re-
vironment, occupational hazards, injury risks). There- main flexible, thus allowing the provider to adapt to
fore, there are inherent limitations when trying to apply any particular operational task or situational threat risk
these guidelines to the civilian tactical situation. Canine based on the LE agencies’ operational doctrine. Since
TCCC guidelines are not comprehensive. They do not they are modeled on human-based TECC, K9-TECC
address noncombat, yet potentially life-threatening, guidelines should be easily learned and applied by vari-
conditions (e.g., heat-related injuries, gastric dilatation ous first responders.
volvulus) OCs may suffer in the field. Canine TCCC
was developed to mitigate the preventable deaths that To ensure the K9-TECC guidelines are effective, the
predominate in the human battlefield trauma casualty. working group will need to take into account many
To date, it remains unknown what types of preventable species differences between K9s and humans. As men-
deaths are most prevalent for either MWDs injured on tioned, direct pressure (not tourniquets) with or without
the battlefield or civilian OCs injured during noncombat hemostatic agents (e.g., QuikClot Combat Gauze )
®
™
situations. This fact alone brings into question the direct is considered the first-line intervention for controlling
applicability and effectiveness of using canine TCCC for extremity hemorrhage. Other differences to consider
noncombat OCs. will include the OC’s hair coat and how it may impede
placement of an occlusive chest seal, the conformational
Even if canine TCCC guidelines were directly applicable shape of the OC’s thoracic cavity and how it affects
to the civilian TEMS community, OCs have another ma- the anatomic landmark for needle decompression, and
jor disadvantage when compared to MWDs. Military that evaporation is through panting (not perspiration
K9s benefit from having the DODMWDVS serve as an through sweat glands).
overarching entity for unifying veterinary care doctrine
throughout the Armed Forces. Civilian OCs do not have Anatomic and physiologic differences are not the only
one all-encompassing organization to standardize or co- aspects that will need to be accounted for when modify-
ordinate their healthcare or training. Instead, each in- ing human-based TECC into K9-TECC. Working with
dividual civilian K9 unit and TEMS organization is left or around an injured canine is not the same as working
to develop and implement its own policy for training with or around people. One major consideration when
and providing out-of-hospital casualty care for the OCs drafting K9-TECC guidelines for TEMS personnel will be
they support. This lack of collaboration and standard- how to approach, restrain, and handle OCs, particularly
ization of canine tactical casualty care across the TEMS in situations where the handler is not readily available.
community hampers the ability to develop best practice
guidelines for OCs injured in the field. To fill the gap in Future Directions
standardizing out-of-hospital OC casualty care, a K9-
TECC working group was initiated at the C-TECC full Members of the K9-TECC working group will face
committee meeting held at the Special Operations Medi- many unique challenges as they collaborate to modify
cal Association Scientific Assembly in December 2014. the TECC guidelines to address issues encountered
The K9-TECC working group’s intent is to develop best with an injured canine. The amount of actual reported
practice recommendations for eliminating preventable data or user experience from the field regarding canine
deaths in civilian OCs exposed to high-threat environ- trauma casualty care is sparse. Further, we lack suffi-
ments. It comprises physicians, veterinarians, para- cient scientific data related to many physiologic aspects
medics, EMTs, and K9 handlers able to provide both of how the OC functions. Most information used to
deployed military combat and civilian tactical experi- guide veterinary care for OCs is based on anecdotal
ence. The first draft of the K9-TECC guidelines is pro- clinical experience or is extrapolated from experimen-
posed to be released in 2015. tal animal models and human observational studies.
Although data from these sources provide some valu-
able information, they are still not considered the best
K9-TECC: What to Expect
level of evidence. The lack of a trauma registry or other
K9-TECC principles will focus on interventions that formal collaborative system for collecting and reporting
eliminate the major preventable causes of OC death and data on prehospital trauma care in OCs is one primary
that are affordable, sustainable, and require minimal reason for this scant evidence. To continually reassess
training and resources. It will incorporate the same three and develop best practice recommendations, it will be
dynamic phases of care as TECC: direct threat care/hot necessary to extract and collect data from the front line
zone, indirect threat care/warm zone, and evacuation/ to determine what practices and interventions work
cold zone. Foundationally, the goals and principles for best. Another challenge presented to the K9-TECC
each phase of care will remain relatively the same; how- working group will be to devise a registry that allows
ever, modifications will be made to account for canine data reported from guidelines users across the globe to

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