Page 138 - JSOM Winter 2024

■ What are the specific wound patterns that junctional de- Pediatric Considerations in TCCC
vices should be used for? ■ What interventions can be employed on pediatric patients
■ Are pelvic binders a hemorrhage control measure or a splint? with adult sets/kits/outfits?
■ What TCCC medications can be used for both pediatric
Hemostatic Agents casualties and how do the doses change?
■ Should additional hemostatic agents be considered?
■ Is one agent preferred over another? Tactical Combat Casualty Care continues to evolve in response
■ Are there any hemostatic agents that require less than 3 to emerging evidence and the operational demands of modern
minutes of pressure? warfare. By prioritizing rapid intervention, streamlined proto-
■ Do hemostatic agents need to be removed/replaced? At cols, and practical solutions, these updates reaffirm TCCC’s
what intervals? role as a cornerstone of military medicine. Ongoing research
■ Do hemostatic agents result in infectious complications? At and training will be essential to sustaining and enhancing these
what time interval? advancements.
■ Is there a need to “convert” hemostatic agents (similar to
tourniquets)? The CoTCCC meets in January 2025 for final review of the
topics above with change proposal voting occurring imme-
March Sequence diately afterward. The projected 2025 TCCC Guidelines are
■ Should the MARCH sequence be adjusted to prioritize the expected to be published in February 2025 on the Deployed
management of hemorrhagic shock over less common or Medicine website and mobile application.
less life-threatening conditions?
■ Are there changes to the top known preventable combat Reference
death injury patterns? 1. Butler FK. Leadership lessons learned in Tactical Combat Casualty
■ Should reassessment of casualty condition and interventions Care. J Trauma Acute Care Surg. 2017;82(6S Suppl 1):S16–S25.
be a dedicated paragraph/section of the TCCC guidelines? doi:10.1097/TA.0000000000001424
PMID: 39661461; DOI: 10.55460/ZVDM-AM8I

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136 | JSOM Volume 24, Edition 4 / Winter 2024