New JTS AAR Submission Forms for Data Collection Trauma Registry

These singular stories are called anecdotes and while powerful and personal do not represent similar patient outcomes even in similar situations.  They are not science.  They do not take into account the vast number of variables that were present in that particular situation.  Often these stories can mislead and misinform medical practice by inexperienced medics and practitioners due to that powerful personal experience clouding that person’s own judgment. Experienced providers will take the sum of their experiences and add the most current and applicable science to make the most informed decision possible.

Stories and experiences can sometimes bring relevancy to a situation you are in or to a point you are trying to make while instructing. These singular stories are called anecdotes and while powerful and personal do not represent similar patient outcomes even in similar situations. They are not science. They do not take into account the vast number of variables that were present in that particular situation. Often these stories can mislead and misinform medical practice by inexperienced medics and practitioners due to that powerful personal experience clouding that person’s own judgment.

Continue reading “New JTS AAR Submission Forms for Data Collection Trauma Registry”

Podcast 23: Clinical Practice Guidelines for the SOF Medic

While at the 2017 Remote Damage Control Resuscitation(RDCR) conference put on by the Tactical Hemostasis, Oxygenation and Resuscitation(THOR) network in Norway, Sean took the time to corner Dr. Shackleford to get her thoughts on the Joint Trauma System Clinical Practice Guidelines. Be sure to check out the new JTS Facebook, LinkedIn Pages, Instagram and Twitter feeds and YouTube Channel for more updates.

While at the 2017 Remote Damage Control Resuscitation(RDCR) conference put on by the Tactical Hemostasis, Oxygenation and Resuscitation(THOR) network in Norway, Sean took the time to corner Dr. Shackleford to get her thoughts on the Joint Trauma System Clinical Practice Guidelines. Be sure to check out the new JTS Facebook, LinkedIn Pages, Instagram and Twitter feeds and YouTube Channel for more updates.

  • What is the process that the CPGs go through before publication?
    1. Medics identify what guidelines are needed
    2. A team consisting of a medic, unit surgeon and specialist in the field begin a draft.
    3. Additional authors, specialists and SMEs are added as identified
    4. Progress is monitored by the Prolonged Field Care Working Group Steering Committee and advisors from the Joint Trauma System.
    5. Final draft sent out to interested parties, other specialists and PFC working group members for review
    6. Published in the Journal of Special Operations Medicine(JSOM) with proprietary format
    7. Formatted for public release via the JTS website
    8. Presented as a Thursday morning JTS CME Conference Talk.
    9. Posted on prolongedfieldcare.org
      • Interviews with authors are published as podcasts.
      • Primary and Co-Authors may write additional thoughts as a blog post.
      • polldaddy quizzes may be included in the posts or separately.
      • Released and promoted through social media such as our Facebook Pages, Instagram and Twitter feeds.
  • Why not just update the Tactical Medical Emergency Protocols?
    • We wanted peer reviewed guidelines that could be updated individually as needed.  Independent medical providers can now see what studies were referenced per recommendation.  We have partnered with USSOCOM and advised several changes and additions to the TMEPs.  The CPGs will help guide the CEB as they update future additions of the TMEPS as a reference.
  • What are the origins of the CPGs?
    • Sharing lessons learned and best practices accross the theaters of war
  • Why are there CPGs specific to Prolonged Field Care and Critical Care Evacuation Teams(CCAT) in addition to the main JTS CPGs?
    • There are large enough differences in levels of training, equipment and medications available and general logistics involved that make providing an identical care in all environments impossible. The CPGs take into consideration the unique challenges of the operational environment so the the provider is presented with several best options for the unique issues presented with each etiology and environment.
  • What CPGs are in the works and when can we expect to see them published?
  •  Coming Soon
    • Austere Nursing Care – Submitted!
    • Austere Damage Control Resuscitation – Drafted!
    • Austere Airway – Drafted!
    • Sepsis, Recognition and Treatment – Concept
    • Prepare for Flight – Concept
    • Thoracic Injuries – Concept
    • Abdominal Injuries – Concept
  • Why don’t you publish them all at once?
    • Most of them have taken over a year from time of inception to release.  They are meticulously researched, debated and reviewed before publication in the JSOM. Quality is more important than quantity.
  • When will they be updated?
    • They can be individually updated once the need arises.

Here is our page with the current CPGs including Crush, Burn, Analgesia & Sedation and Wound Care


Download the episode from our SOMA Page now!

CALL FOR CASES!

JTS_Operational_Cycle

The U.S. Institute Of Surgical Research Joint Trauma Service and PFC Working Group need your help:

The JTS is working to conduct a retrospective case review relating to PFC in order to conduct an aggregate analysis.

We are currently collecting as many cases as we can obtain relating to prolonged role 1 care (anything greater than 4 hours) both trauma and non-trauma. We are accepting unclassified AAR’s, medical records, powerpoint summaries from meeting presentations, or even just personal memory/war stories. If the medic is available, we would like to interview them if possible. As there is really no database of such cases, many of the cases will be identified by word of mouth, although we are also searching the trauma registry, SOMA and SOCMSSC databases.

The results of our analysis will include the epidemiology of PFC cases and aggregate lessons learned. The report will be returned to the PFC working group and  operational communities and published (likely in JSOM).

Thank you for any assistance you can provide to help identify these cases and the medics who provided such care. Cases may be submitted to usarmy.jbsa.medcom-aisr.list.jts-prehospital@mail.mil

Click here to download the AAR Form


Once you open the PDF, click
Once you open the PDF, click “Fill and Sign” then “Add Text” to fill out as much as you can.

Telemedicine Issues

Who should medics call for help while managing a critical patient for prolonged periods of time?  Different aspects of this have been discussed via different forums such as the SOMSA lunchtime working sessions and email chain.  We are posting it here in order to reach a wider knowledge base including those who it affects directly such as the medics on the ground.

Continue reading “Telemedicine Issues”

Recommended Research?

What research would help Medics on the ground provide better care to sick patients in an austere, environment today?  Has anyone ever told you any dogma that you hear but question and can’t find studies for such as; less than 8 intubate, trendelenberg position for hypovolemic patients, etc.?  We have the opportunity to make some of this research happen and use real science to find the best practice for our patients.  We simply need ideas and suggestions for research to be conducted.