Page 19 - Journal of Special Operations Medicine - Winter 2015

The Combat Medic Aid Bag: 2025
WHEN TIME COUNTS CoTCCC Top 10 Recommended Battlefield Trauma Care Research,

RELY ON TELEFLEX. T.A.L.O.N. 7-SITE TACTICAL ADVANTAGE Development, and Evaluation Priorities for 2015
™
NEEDLE SET
When faced with difficult vascular access, our
Military-use solutions provide pre-hospital NSN: 6515-01-626-6395 Frank K. Butler, MD; Lorne H. Blackbourne, MD; Kirby Gross, MD
providers the opportunity to impact lives.

The EZ-IO T.A.L.O.N. Needle Set and the T.A.L.O.N. ™
®
™
Needle Set
Arrow EZ-IO Intraosseous Vascular Access Introduction
®
®
System offer users an intraosseous (IO) vascular EZ-Connect ® The conflicts in Afghanistan and Iraq have seen the US time to a medical treatment facility is often more lengthy
Extension Set
access solution for rapid medication and fluid Sternal Military achieve the highest casualty survival rates in than that encountered in urban civilian setting; (4) Com-
Locator
delivery during casualty resuscitation. its history. Innovations brought about by military medi- bat medics are well trained but often have less trauma
cal research have been a major factor in these remark- care experience than their civilian counterparts; and (5)
able improvements in combat casualty care. As our Combat medics may be required to provide care in ex-
1–3
nation continues to explore ways to improve combat treme environments.
casualty care in future conflicts, the military’s Combat
Casualty Care Research Program will continue to play Since the individuals who will be using TCCC to save
• LIFE-SAVING: Delivers fluids and medications a key role. 4–6 lives on the battlefield are Combat medical personnel,
rapidly for casualty resuscitation
their input into the proposed new guidelines was sought.
• SIMPLE: Designed for any level responder One product of military medical research has been Tac- Multiple workshops were held with military medics,
tical Combat Casualty Care (TCCC). TCCC is a set of corpsmen, and pararescuemen (PJs) about battlefield
evidence-based, best-practice, prehospital trauma care trauma care strategies—those in use in 1993 and the pro-
guidelines customized for use on the battlefield. The posed new TCCC recommendations.
7,8
TCCC Guidelines are produced by the Committee on
EZ-IO INTRAOSSEOUS VASCULAR ACCESS TCCC (CoTCCC), which is the prehospital arm of the Since the development of TCCC, military medical re-
®
SYSTEM FOR MILITARY USE Department of Defense’s Joint Trauma System (JTS). search has enabled numerous advances in battlefield
EZ-IO ® trauma care that now have been incorporated into the
Power Driver TCCC started as a biomedical research project initiated TCCC Guidelines. Prehospital care in the combat envi-
by the Naval Special Warfare Command and expanded ronment has been almost completely transformed from
by the US Special Operations Command (USSOCOM) the standards used at the start of the wars in Afghani-
EZ-Stabilizer ® in partnership with the Uniformed Services University of stan and Iraq. 9
Dressing the Health Sciences (USUHS). The existing, largely tra-
dition-based, prehospital trauma care practices in place Evaluating the Evidence in Prehospital Trauma Care
in 1993 were systematically re-evaluated, and there was
PROXIMAL HUMERUS
found to be a need to reconsider these principles for use The prehospital environment does not lend itself well
STERNUM 45 mm in combat. TCCC was introduced as a new framework to the conduct of carefully designed, randomized con-
25 mm EZ-Connect ® on which to build trauma care guidelines customized for trolled trials (RCTs) in trauma care; this is especially
PROXIMAL TIBIA EZ-IO ® Extension Set the battlefield. true in combat. Informed consent is not easily obtained
Needle Sets
DISTAL TIBIA from the recently wounded, the administrative aspects
In developing the first set of TCCC Guidelines, military- of RCTs are not appropriate for the battlefield, and
specific factors were taken into account as part of the rapid transport to the hospital is often lifesaving for the
process. These factors include the following: (1) care critically injured patient and should not be delayed for
will be rendered in an austere prehospital environment research purposes.
TELEFLEX.COM/MILITARY where the enemy may be actively shooting at you, and,
under the best of circumstances, “safe” is a relative term The lack of RCTs, however, is not an excuse for inac-
and care must be rendered expeditiously; (2) TCCC tion. Decisions about how best to care for the Combat
Product of the U.S.A. Potential complications may include local or systemic infection, hematoma, extravasations or other complications associated with percutaneous insertion of sterile devices. interventions are sharply focused on the causes of pre- wounded must be made with the evidence at hand, not
Teleflex, Arrow, EZ-Connect, EZ-IO, EZ-Stabilier and T.A.L.O.N. are trademarks or registered trademarks of Teleflex Incorporated or its affiliates. ventable death on the battlefield: hemorrhage, airway deferred for want of additional or higher quality evi-
© 2015 Teleflex Incorporated. All rights reserved. MC-000955 Rev 1
obstruction, and tension pneumothorax; (3) evacuation dence. Prehospital trauma care is by no means the only

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