Page 33 - Journal of Special Operations Medicine - Spring 2016
P. 33

Altogether, the study findings are clear, consistent, co-  References
              herent, and without an unexpected result. Findings are     1.  The White House. Fact Sheet: Bystander: “Stop the Bleed”
              actionable now for (1) corporate discussion that may   broad private sector support for effort to save lives and build
              lead to a decision on production of the newly designed   resilience. https://www.whitehouse.gov/the-press-office/2015
              C-A-T 7, (2) committees (e.g., the Committee on Tacti-  /10/06/fact-sheet-bystander-stop-bleed-broad-private-sector
              cal Combat Casualty Care, which may consider review   -support-effort-save. Accessed 13 October 2015.
              of the present new knowledge), and (3) master instruc-    2.  Kragh JF Jr, Walters TJ, Westmoreland T, et al. Tragedy into
                                                                    drama: an American history of tourniquet use in the current
              tors, who may update lesson plans and instructions for   war. J Spec Oper Med. 2013;13:5–25.
              use of the C-A-T 7, since the technique of use is now     3.  Kragh JF Jr, Beebe DF, O’Neill ML, et al. Performance im-
              refined. The manufacturer of C-A-T 7 began production   provement in emergency tourniquet use during the Baghdad
              on 3 November 2015. Furthermore, the growing body     surge. Am J Emerg Med. 2013;31:873–875.
              of knowledge in the science of bleeding control contin-    4.  Kragh JF Jr, Walters TJ, Baer DG, et al. Survival with emer-
                                                                    gency tourniquet use to stop bleeding in major limb trauma.
              ues  to  show  that optimization  of user  performance  is   Ann Surg. 2009;249:1–7.
              an important aim in improving current care; such user     5.  Kotwal RS, Montgomery HR, Kotwal BM, et al. Eliminat-
              development stands shoulder-to-shoulder with materiel   ing preventable death on the battlefield. Arch Surg. 2011;146:
              development as a current research priority. Such user de-  1350–1358.
              velopment includes optimization of learning curves of     6.  Bulger EM, Snyder D, Schoelles K, et al. An evidence-based
                                                                    prehospital guideline for external hemorrhage control: Amer-
              individual students in attainment of skill, determination   ican College of Surgeons Committee on Trauma.  Prehosp
              of strategies for maintenance of skill level for individu-  Emerg Care. 2014;18:163–173.
              als or groups of individuals, and analysis of instructor     7.  Jacobs  LM Jr. Joint  Committee  to create a  national policy
              assessments of student performance.                   to enhance survivability from mass casualty shooting events:
                                                                    Hartford Consensus II. J Am Coll Surg. 2014;218:476–478e1.
                                                                   8.  Kragh JF Jr, O’Neill ML, Walters TJ, et al. The military emer-
              The limitations of the present study are based in its de-  gency tourniquet program’s lessons learned with devices and
              sign as a focused experiment, which is neither field test-  designs. Mil Med. 2011;176:1144–1152.
              ing nor healthcare delivery. There were only 10 users,     9.  Kragh JF Jr, Burrows S, Wasner C, et al. Analysis of recovered
              only two designs, only 10 tests per design, and assess-  tourniquets from casualties of Operation Enduring Freedom
                                                                    and Operation New Dawn. Mil Med. 2013;178:806–810.
              ment was on a manikin and not on a real person.    10.  Clumpner BR, Polston RW, Kragh JF Jr, et al. Single versus
                                                                    double routing of the band in the Combat Application Tour-
              Conclusion                                            niquet. J Spec Oper Med. 2013;13:34–41.

              In summary, in each measure C-A-T Generation 7 per-
              formed similar or better than C-A-T Generation 6, was
              easier to use, and was preferred.                  Dr Kragh is a tourniquet researcher at the USAISR, Joint Base
                                                                 San Antonio Fort Sam Houston, Texas. He is an orthopedic
                                                                 surgeon who was the 3rd Ranger Battalion Surgeon from 1990
              Funding                                            to 1993. He is an associate professor in the Department of
              This project was funded by US Army Medical Research   Surgery, Uniformed Services University of the Health Sciences,
                                                                 Bethesda, Maryland. E-mail: john.f.kragh.civ@mail.mil.
              and Materiel Command and the Defense Health Program
              (Proposal 201105: Operational system management and   Mr Moore is a research associate in the Bleeding Control sec-
              post-market surveillance of hemorrhage control devices   tion at the USAISR, Joint Base San Antonio Fort Sam Hous-
              used in medical care of US Servicepersons in the current   ton, Texas. He is a prior Army laboratory noncommissioned
              war).                                              officer.

                                                                 Dr Aden is a statistician at the USAISR, Joint Base San Anto-
              Disclaimers                                        nio Fort Sam Houston, Texas. He has published many papers
              The opinions or assertions contained herein are the pri-  in operational medicine.
              vate views of the authors and are not to be construed
              as official or reflecting the views of the Department of   Mr Parsons is Deputy Director of the Department of Combat
                                                                 Medic Training in the Army Medical Department Center and
              Defense or US Government. The authors are employees   School, Joint Base San Antonio Fort Sam Houston, Texas. He
              of the US Government. This work was prepared as part   is a prior Special Forces Medic and Army Physician Assistant.
              of their official duties and, as such, there is no copyright
              to be transferred.                                 Dr Dubick is a resuscitation researcher at the USAISR, Joint
                                                                 Base San Antonio Fort Sam Houston, Texas. He is the task
                                                                 area manager of the Department of Damage Control Resusci-
              Disclosures
                                                                 tation. He has published many papers in operational medicine.
              The authors have nothing to disclose.



              Comparing C-A-T  Gen 6 to Prototype Gen 7                                                       17
                            ®
   28   29   30   31   32   33   34   35   36   37   38