Page 155 - JSOM Summer 2018

A New Standard for Battlefield Trauma Care
in the US Military

he Department of Defense Instruction on Medical Read- A great many JSOM readers have helped to bring about the
Tiness Training (MRT) was finalized on Friday, 16 March remarkable improvements in battlefield trauma care that our
2018, and follows this introduction. combat medics, corpsmen, and PJs now use to care for their
casualties, but special thanks go to Mr Ed Whitt, Ms Elizabeth
Battlefield trauma care for most of the US military at the start Fudge, and Mr Kevin Kelley at the Defense Health Agency
of the conflict in Afghanistan in 2001 did not include tourni- for their pivotal role in making state-of-the-art prehospital
quets or hemostatic dressings; called for resuscitation of casu- trauma care a permanent fixture in the US military through
alties in shock with two rapidly infused liters of crystalloid; the publication of this instruction.
had no intraosseous devices; and saw analgesia attempted
with IM morphine. Today’s TCCC-trained combat medical Frank K. Butler, MD
providers are far more capable of providing lifesaving care to CAPT, MC, USN (Ret)
our combat wounded. This new DoD Instruction will help to Chairman
preserve those advances and ensure that they are carried for- Committee on Tactical Combat Casualty Care
ward into future conflicts. Joint Trauma System
Adjunct Professor of Military and Emergency Medicine
A quote from the Instruction states: Uniformed Services University of the Health Sciences

“1.2. POLICY. It is DoD policy that:
b. TCCC is the DoD standard of care for first responders
(medical and non-medical) and the All Service Member Disclaimers
TCCC course replaces Service trauma skills currently The opinions or assertions contained herein are the private
taught in first aid and self-aid buddy care courses. . . . views of the author and are not to be construed as official or as
All Service members receive role based TCCC train- reflecting the views of the Department of the Army or the De-
ing and certification in accordance with the skill partment of Defense. This recommendation is intended to be
level (i.e., All Service Members, Combat Lifesaver, a guideline only and is not a substitute for clinical judgment.
Combat Medic/Corpsmen, and Combat Paramedic/
Provider) outlined by the Joint Trauma System, the Disclosures
DoD’s Center of Excellence for trauma as designated The authors have no disclosures.
in DoD Instruction (DoDI) 6040.47.”
Release
This document is now posted on the defense.gov website: This document was reviewed by the Director of the Joint
https://www.defense.gov/Resources/Forms-Directives/. Trauma System and by the Public Affairs Office and the Op-
erational Security Office at the US Army Institute of Surgical
A pdf of the MRT instruction is available at: Research. It is approved for unlimited public release.
http://www.esd.whs.mil/Portals/54/Documents/DD/issuances
/dodi/132224p.pdf?ver=2018-03-16-140510-410

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