Page 137 - JSOM Fall 2019

needed. Maj Gen Payne responded that the JTS does not have platforms by priority. A filtering capability allows you to focus
that authority at present. on certain casualties as needed, e.g. only those in your unit.
Developers at the Air Force Research Laboratory are working
3. Combat Medic Presentation: SO1 Terence Byrne – to link this system to the DODTR and to AHLTA.
Naval Special Warfare Combat Medic Training Center,
Stennis AFB, MS Encryption enables transmission of HIPAA-regulated informa-
tion over NIPRnet, SIPRnet, and the open internet.
SO1 Byrne, a SEAL medic, presented a casualty scenario from Initial fielding of the BATDOC is currently planned for Sep-
his recent deployment to Iraq. He presented helmet cam video tember 2019.
footage of this event. He thanked Mr Rick Strayer, one of his
instructors at the Joint Special Operations Medical Training Q+A:
Center, for training him so well and preparing him to deal with
scenarios like the one presented today. Q: Dr Mel Otten: Will this device work if it is dropped in the
water?
While setting up sniper positions in Mosul, his vehicle was
struck by an RPG. The unit’s indigenous translator suffered A: Depends on the tactical case that it is used with.
shrapnel wounds high on both thighs with arterial bleeding.
First responders in the unit placed tourniquets high and tight Q: Will BATDOK work with an iPhone?
on both legs, which controlled the bleeding. SO1 Byrne was A: No – it is designed for use with Android devices.
severely concussed by the blast but soon took over the casu-
alty’s care. He was helped by an Air Combat Controller who 5. JTS Director’s Brief: COL Stacy Shackelford –
had joined the unit the day before. They carried out treatment Joint Trauma System
in the rear of the Mine Resistant Ambush Protected All-Ter-
rain Vehicle (M-ATV). The transfer of the Joint Trauma System to the Defense Health
Agency is now complete. The JTS falls under the DHA As-
Ketamine, first IM and then IV, was given for pain control. sistant Director for Combat Support, and its mission has ex-
When given IV, it was titrated to keep the casualty calm. TXA panded. Col Shackelford introduced MSG Mike Remley, the
was given twice – first by IV push, then by slower infusion. first Senior Enlisted Advisor for the JTS.
The first tourniquets became loose and slipped and were re- The Defense Committee on Trauma now oversees the
placed. A thermal blanket from an HPMK was applied to pre- CoTCCC, the Committee on En Route Combat Casualty
vent hypothermia.
Care, and the Committee on Surgical Combat Casualty Care.
The evacuation helo went to an unrequested LZ, so the unit Because the JTS is now part of the DHA, it can now readily
had to move with the casualty. They put the casualty on a communicate with the Combatant Commanders to give them
TALON litter and strapped the litter to the hood of the M-ATV. what they need in terms of trauma care support.
SO1 Byrne’s observations from this casualty scenario were: Dr Mary Ann Spott, Deputy Director of the JTS, discussed
the results of the JTS operational assessment. Eighteen new
– Ketamine at the medic level works well. When given in-
tranasally, it does not work as well as when given IV command policies have been identified for development. The
or IM. Combatant Command Trauma System and the Joint Trauma
– Responders trained in TCCC (i.e., SO1 Byrne and Education and Training Branch, which will now have over-
the Air Traffic Controller) worked well together, even sight for the development of DoD trauma training curricula,
though they had not trained together or worked to- including TCCC, are being set up at present.
gether previously. MSG Remley discussed the evolving plans for the Joint
– He worked as he had trained despite his concussion. Trauma System to fully assume its congressionally mandated
– Packing his med bag in a standard way facilitated the role as the reference body in the DoD for developing trauma
rapid deployment of gear and medications. care standards.

4. BATDOK: 1st LT David Feibus – 6. TCCC Update: Dr Frank Butler –
Air Force Research Laboratory Chairman, Committee on Tactical Combat Casualty Care
The Battlefield Assisted Trauma Distributed Observation Kit Noncompressible torso hemorrhage is the largest remaining
(BATDOK) is a software tool designed to facilitate point of cause of preventable death on the battlefield for which com-
injury casualty care documentation by combat medics. The bat medical personnel have had no definitive treatments in the
software resides on an electronic device about the size of a past.
mobile phone. Data entered or collected via various sensors The TCCC paper on Advanced Resuscitative Care (ARC) has
(e.g. Spo2) can be handed off to the next medic by Bluetooth
link with no interruption of care. The device can also transfer now been published in the Journal of Special Operations Med-
icine to address that capability gap. The ARC in TCCC change
information to a plastic card like a hotel door key for trans- advocates for the earlier prehospital use of whole blood trans-
port with the casualty.
fusion for casualties in hemorrhagic shock and for far-forward
Network capability allows for wireless monitoring of multiple Zone 1 REBOA in prehospital settings for casualties with non-
casualties at the same time. The system can produce trend- compressible torso hemorrhage who meet the TCCC-recom-
ing graphs with custom warnings for each parent. Walking mended selection criteria for this procedure. The DoD now
blood bank management is also included. Networking data needs to work with the Services and the combatant commands
from multiple casualties allows casualty collection point man- to help accelerate the fielding of an ARC capability for units
agement wherein casualties can be assigned to evacuation that are interested in implementing this change.

CoTCCC Meeting Minutes | 135