Page 77 - JSOM Winter 2023

Bluetooth Tactical Headsets Improve
The Speed of Accurate Patient Handoffs

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Daniel J. Stinner, MD, PhD ; Cory McEvoy, MPH *; Michael A. Broussard, MPAS, PA-C ;
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Aaron D. Nikolaus, CRNA ; Charles H. Parker, MD ; Hector Santana ;
Jason Karnopp, FP-C, NRP ; Jigar A. Patel, MD 8
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ABSTRACT
Background: The Committee on En Route Combat Casualty tourniquets used on the battlefield were shown to prevent
Care recently ranked the patient handoff as their fourth re- catastrophic hemorrhage, and as a result, saved lives. That
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search priority. Bluetooth technology has been introduced to research subsequently led to widespread incorporation into
the battlefield and has the potential to improve the tactical prehospital medical training in the civilian environment. Like-
patient handoff. The purpose of this study is to compare the wise, many advances made in civilian trauma care over the
traditional methods of communication used in tactical medi- previous two decades have also been incorporated into TCCC,
cal evacuation by Special Operations medical personnel (radio contributing to overall improvements in morbidity and mor-
push-to-talk [PTT] and Tactical Medic Intercom System [TM- tality on the battlefield.
ICS]) to Bluetooth communication. Methods: Twenty-four
simulated tactical patient handoffs were performed to compare One area that has received a significant amount of attention
Bluetooth and traditional methods of communication used in in civilian medicine, likely due to its association with adverse
tactical medical evacuation. Patient scenario order and method medical events, is the patient handoff during transfer of care.
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of communication were randomized. Accuracy and time re- Recently, the Committee on En Route Combat Casualty Care
quired to complete the patient handoff were determined. The (CoERCCC), ranked it as the fourth research priority for en
study took place using a rotary-wing aircraft kept at level 2 route combat casualty care. The CoERCCC specifically stated
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to simulate real-world background noise. Preferred method of that “improved means of providing vital patient data during
communication for each study participant was determined. Re- handoffs is central to optimizing patient care and allocating
sults: There were no differences in accuracy of the received pa- resources on the battlefield.” In civilian medicine, there have
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tient handoffs between groups or patient handoff transmission been multiple studies evaluating the quality of patient hand-
times at the ramp of the aircraft. However, when comparing offs at all levels, often using audio and/or video to evaluate
patient handoff times to the medical team within the aircraft, and improve handoff processes. The quality of the patient
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Bluetooth communication was significantly faster than both handoff from prehospital providers has even been shown to
TM-ICS and radio PTT, while Bluetooth PTT and radio PTT be associated with improved trauma team communication fol-
were also significantly faster than TM-ICS. Bluetooth commu- lowing the patient handoff. However, until recently, this has
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nication was ranked as the preferred method of handoff by all not been a significant area of focus for combat casualty care.
study participants. Conclusion: The study demonstrated that
utilization of Bluetooth technology for patient handover results Currently, the vast majority of communication on the battle-
in faster handoffs compared with traditional methods without field between the medics on the ground and the medical team
sacrificing any accuracy in a scenario with high levels of noise. evacuating the patient is done through standard radio using
push-to-talk (PTT) or the use of an internal communication
Keywords: Tactical Combat Casualty Care; TCCC; communi- system. These allow for a direct plugin from one headset into
cation; Bluetooth; medical evacuation; handoff another, such as the Tactical Medic Intercom System (TM-
ICS) (Atlantic Signal , Topeka, Kansas; https://atlanticsignal.
™
com/). On the current battlefield, the patient handoff is often
complicated by noise due to both the combat environment
Background
and use of rotary-wing aircraft, the most common method
During the previous two decades, there has been a consistent of evacuation. Recently, headsets with Bluetooth capability,
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emphasis placed on research into different elements of tactical Bluetooth Peltors (ComTac VI NIB Headset, PELTOR 3M
™
™
™
combat casualty care (TCCC) that has resulted in decreased Personal Safety Division; https://www.3m.com/3M/en_US/p/d/
morbidity and mortality on the battlefield. For example, b5005083000/), have been fielded.
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*Correspondence to mcevoy.cory@gmail.com
1 COL Daniel J. Stinner is a physician affiliated with Blanchfield Army Community Hospital, Fort Campbell, KY and The Department of Ortho-
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paedic Surgery, Vanderbilt University Medical Center, Nashville, TN. SFC Cory McEvoy is a special operations medic affiliated with the United
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States Army Special Operations Command, Fort Bragg, NC. MAJ Michael A. Broussard is a physician assistant affiliated with Joint Special
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Operations Command, Fort Bragg, NC. CDR Aaron D. Nikolaus is a CRNA affiliated with the Department of Anesthesiology, Naval Medical
Readiness and Training Command, San Diego, CA. CPT Charles H. Parker is a physician affiliated with the Department of Emergency Medi-
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cine, Womack Army Medical Center, Fort Bragg, NC. MSG Hector Santana is affiliated with Joint Special Operations Command, Fort Bragg,
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NC. MSG Jason Karnopp is a paramedic affiliated with Joint Special Operations Command, Fort Bragg, NC. MAJ Jigar A. Patel is a physician
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affiliated with the Division of Vascular Surgery, Womack Army Medical Center, Fort Bragg, NC.
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