Page 159 - JSOM Spring 2020

EXAMPLE of the DHA Trauma Enterprise Report

---------------AFTERNOON Day 1-----------------

Management Kit (HPMK) with the end goal of anticipat-
9. Top 10 Battlefield Issues ing and preventing hypothermia in trauma casualties. He
a. Improve capability and capacity for whole blood reviewed the current wording in TCCC on hypothermia
transfusion throughout the continuum since 2006, Paul Allen’s paper out of ISR, TCCC guidelines
b. Improve ways to sustain trauma skills show treatment and changes in red font in CUF, and TFC
c. Recruit and retain medical personnel to support upgrade to insulated HPMK.
operations
d. Facilitate documentation and data collection Number one recommendation is to use an HPMK (insu-
e. Standardize trauma care training across the Services lated hood) because currently patients are getting cold in
f. Facilitate interoperability and standardization of the HPMK. If the HPMK is not available then one would
devices for patient movement items (monitors and need to use improvised hypothermia prevention from what
materiel products) throughout the continuum they are carrying: poncho, poncho liner, dry clothing, etc.
g. Standardize Joint evacuation platforms and com- Brought up the need for an IV warming device with one
munication plans temperature as not to confuse the end user. Discussed the
h. Optimal number, mix, and training of personnel for “Quantum” by North American Rescue, but stated that
variety of missions/scenarios there has not been an independent study conducted yet
i. Improve capability and capacity for FDP transfu- to confirm if it meets the requirements. There was some
sion throughout the continuum discussion on the CoTCCC not naming or picking specific
j. Relationship between time to definitive care and products as we had in the past.
outcomes
k. Validating and clarifying the “golden hour” concept In the question and answer period following his presenta-
10. Survival-vs-Time (24 hours) tion, there was great discussion as this is a very important
a. time to mortality study topic.
11. Joint Trauma Lexicon Q1: What about changing the wording from “anticipate”
a. On the JTS website to “recognize” hypothermia in all trauma patients in all
12. Joint Trauma Education and Training (JTET) phases of care?
a. Working on standardization of Combat Casualty A1: Dr Bennett agreed and is not hung up on the wording
Care Instruction at the present time.
i. TCCC Tiers 1-4
1. Start date: 1 June 2018 Q2: When do we determine they are hypothermic and
2. Delivery date: 30 April 2020 secondly when and where do they take a temperature to
3. On Deployed Medicine website determine hypothermia?
ii. Prolonged Field Care A2: We would never take a temperature on the battlefield.
EWSC Additionally, we are discussing “prevention” and the treat-
And many other projects ment for both prevention and actual hypothermia are go-
b. Facilitate military-civilian partnerships for trauma ing to be the same on the battlefield.
skill sustainment Q3: Why are we treating on the “X” or during care under
13. Fifty-eight (58) clinical practice guidelines (CPGs) fire?
a. On the JTS website
a. All CPGs will have at least one metric to track them A3: Agree that this might not be the appropriate place but
and will be reportable on the JTS website dashboard wanted to get discussion on where is the best place to rec-
ognize and start treatment.
Col Shackleford concluded with a couple stories of assist-
ing Dr Butler while in theater. Q4: Hypothermia can be reversed by profusion . . . are we
addressing it?
8. Proposed change for Hypothermia A4: This is not a relevant TCCC option, but at a receiving
Dr Brad Bennett stated the reason for a relook at the TCCC medical treatment facility.
guidelines was based upon two items: 1) Feedback from
the field, 2) civilian sector, specifically the Wilderness Med- Q5: Hypothermia is #7 on the TCCC guidelines . . . are we
ical Society had not heard of the Hypothermia Prevention not addressing it?

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