Page 158 - JSOM Spring 2020

the recent Middle Eastern conflicts was performed. Since 3. Defense Trauma Enterprise
then, the AFMES has helped to identify preventable deaths a. Looks complicated because it is – but vital
among combat casualties which is the most important b. Trauma care delivery and management on the
metric in evaluating the effectiveness of battlefield trauma battlefield
care and guiding improvements to that care. The AFMES c. JTS’s mission within the enterprise is to “Improve
“Feedback to the Field” series of presentations that iden- Care” wherever there is an opportunity to improve
tified specific opportunities to improve found in autopsies 4. JTS Organization Assessment
has been key to many CoTCCC recommendations in the a. Conducted by members of all Services
TCCC guidelines. AFMES has truly lived up to their motto b. 64 tasks identified to get the JTS up to full operating
of “Making Good from the Bad.” capability
i. 31 tasks – Serve as the reference body for trauma
Journal of Special Operations Medicine care
Accepted by the publisher, Lt Col (Ret) Michelle Landers ii. 13 tasks – Establish standards of care
The JSOM has served as the voice of battlefield and tacti- iii. 8 tasks – Translation of research
cal trauma care for over a decade and has been CoTCCC’s iv. 7 tasks – Standardized combat casualty care in-
most important strategic messaging partner. The JSOM struction
publishes all the TCCC change papers as TCCC Guidelines v. 5 tasks – Enter into partnerships with civilian
are updated as well as publishing CoTCCC meeting min- MTFs
utes and TCCC updates. The JSOM’s status as an Index 5. DoDI 6040.47
Medicus publication ensures that the evidence and ratio- a. DoD instruction that made JTS a requirement
nale for TCCC changes will be maintained as a perma- b. In this instruction, it requires every combatant com-
nent part of the indexed and searchable medical literature, mand to set up a combatant command system (CTS)
which will be of immense value to battlefield trauma care modeled after the CENTCOM JTTS
researchers and providers in the future. 6. 12 Core Functions of the Combatant Command Trauma
Joint Trauma System (JTS) System
Accepted by COL Stacy Shackleford, Dr Mary Ann Spott, 1. Address the full spectrum of injury
and MSG Michael Remley 2. Establish authority to enforce standards
The JTS truly lives up to its designation as the DoD Cen- 3. Establish multidisciplinary advisory group guid-
ter of Excellence for Trauma. The JTS is the natural home ance – DcoT
for the CoTCCC and the undersecretary of defense di- 4. Conduct trauma system planning – CTS
rected that it be moved there in 2013. From the weekly 5. Verify readiness
trauma conferences reviewing combat casualty cases to the 6. Provide infrastructure support
monthly preventable death reviews to maintaining the DoD 7. Collect and analyze data
Trauma Registry of casualty data, the JTS leads the effort o Ensure trauma names/lexicon are established
for the Department of Defense to provide optimal care for 8. Ensure patient identification and confidentiality
every one of its combat wounded. 9. Monitor performance
10. Establish a research capability
Ms Cynthia Barrigan o JTS will not do research but ensure they have an
Ms Cynthia Barrigan was presented a TCCC Special Award IRB-approved protocol before getting information
for her work as the principle investigator and project lead o JTS will guide researchers to ensure they know
for the Learning Strategy, Tactics, & Technology Research what needs to be researched
Program (aka Deployed Medicine). This project has assisted 11. Ensure preparedness
in the development of the TCCC for All Service Members 12. Facilitate interoperability and cooperation
(TCCC-ASM) curriculum that was recently released. Her 7. Discussed a case that implemented all the medical ad-
vision of combining up-to-date education methodology vances from POI-to-Role 4
with web-mobile based platforms will greatly assist in the a. Casualty received 189 blood products in theater
transmission of TCCC knowledge products to the next b. Alive and at BAMC
generation of medics, corpsman and pararescue men. i. Similar case in the Battle for Mogadishu who did
not survive
7. Joint Trauma System Director Remarks: 8. DHA Trauma Enterprise Report
Col Stacy Shackelford, the director of the JTS, discussed a. Report that gives a high-level breakdown of what
and reviewed the following items: kind of casualties are on the battlefield
1. Organizational Chart b. Report also reports trauma patients per MTF
a. Reflects JTS mission c. TCCC Card submission
b. Defense Committee on Trauma (DCoT) encompasses: i. Only about 25% compliance rate at the current
i. Committee on Tactical Combat Casualty Care time
ii. Committee on ii. Need to increase the submission rate
iii. Committee on 1. You can do an after-action review (AAR) on
c. Defense Medical Readiness Training Institute (DMRTI) the JTS website
d. Publication Branch 2. If you did not do one or it was lost, fill it out
2. DHA AD Combat Support Organizational Chart again and submit through AAR portal
a. JTS belongs to this organization and critical to inform-
ing and directing what is important for medical care

152 | JSOM Volume 20, Edition 1 / Spring 2020