Page 136 - JSOM Fall 2019

Committee on Tactical Combat Casualty Care Meeting Minutes

San Antonio, TX
20–21 February 2019

Dr Frank Butler; Dr Stephen Giebner

Chairman’s Note: 2. Senior Leader Remarks: Maj Gen Lee Payne – Assistant
These minutes mark the last meeting at which CAPT (Ret) Director, Defense Health Agency, (Combat Support)
Stephen Giebner served as the Developmental Editor of the Maj Gen Payne is double-boarded in Emergency Medicine and
Committee on Tactical Combat Casualty Care (CoTCCC). Internal Medicine, as well as being a Flight Surgeon. He was
CAPT Giebner was the Founding Chairman of the CoTCCC formerly the Command Surgeon for Air Mobility Command
and continued in that capacity for 6 years before assuming and commanded the hospital at Travis AFB.
the position of Developmental Editor. His contributions to im-
proving the care that the US military provides to its wounded Maj Gen Payne noted that the DHA is leading the effort to de-
Servicemembers over the past 25 years have been sustained velop standards for cross-Service operations in medicine and
and remarkable. Without CAPT Giebner’s leadership, there that the JTS and the COTCCC are excellent models of such
would have been no CoTCCC. A heartfelt thank you, Steve! DHA-led initiatives.
We need to preserve advances and capabilities to be ready for
Wednesday – 21 February 2019
the next major conflict. Clinical currency is a big problem
1. Chairman’s Welcome: Dr Frank Butler – at all levels of medical care. Our military direct care system
Chairman of the CoTCCC as currently structured cannot provide the currency that the
US military needs in trauma care. Where possible, we must
Dr Butler, Chairman, welcomed the attendees, reminded strengthen our direct care system to provide that currency
every one to sign the attendance sheets, and then had all of the first. Any additional capacity will likely be met by establishing
attendees introduce themselves.
partnerships with civilian medical centers, and multiple efforts
He announced that COL Bob Mabry and LTC Steve DeLellis are under way to develop this kind of synergy.
will soon be leaving the CoTCCC as a result of their pending
retirements. MSG Danny Morrisette is leaving the committee With respect to standardized cross-Service medical training,
in anticipation of beginning medical school in the near future. the TCCC for All Servicemembers course is coming online
Dr Butler thanked all three members for their outstanding ser- soon. Standardized training at higher levels of prehospital care
vice on the CoTCCC. is on the way.
MHS Genesis, the electronic health record, is a tool that will
Dr Butler thanked Mrs Danielle Davis, Mr Dallas Burelison, help with the transition to medical interoperability. It will
Ms Margarita Carter, and Mr Darin Schwartz of the Joint drive commonality and standardization across the DoD and
Trauma System for their outstanding work in preparing for the VA.
this meeting. He noted that the next CoTCCC meeting will be
held either at the Uniformed Services University in Bethesda or In the Question and Answer (Q+A) session, COL Bob Mabry
here in San Antonio. The planned dates are September 10th asked who was going to own battlefield trauma care under
and 11th. the new DHA model and whose responsibility it was going to
be to implement corrective action when preventable combat
Dr Butler extended a call for combat medics to present combat
casualty scenarios at future meetings and noted the importance fatalities are identified? Maj Gen Payne responded that op-
of these presentations in helping the group to be aware of the erational medicine is still within the Services responsibilities,
challenges encountered by combat medics, corpsmen, and but the JTS will have the responsibility of collecting the data
pararescuemen (PJs) in caring for casualties on the battlefield. to provide oversight of the care being delivered, sharing that
data across the system for leader visibility, and setting up the
Dr Butler continued with a brief summary of the history of process improvement structure necessary to improve where
TCCC and then reviewed this meeting’s agenda. He requested needed.
that attendees reveal any financial interest that they might Dr Butler asked if the JTS has the authority to communicate
have in items to be discussed at the meeting. Dr John Holcomb directly with line combat commanders when potentially pre-
disclosed that he is the Chief Medical Officer of Prytime, the ventable combat deaths are identified and corrective action is
company that markets the ER-REBOA catheters.

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