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.
Experienced providers will take the sum of their experiences and add the most current and applicable science to make the most informed decision possible. If you don’t have much experience in a given situation and haven’t read the most current applicable literature, it is safe to fall back on protocols written by those who do, usually unit surgeons and medical directors who are influenced by specialty committees, working groups and task forces. In order to conduct relevant and timely research, gaps in practices and training must be identified. Evidence based medicine requires us to gather evidence. This is where this AAR form comes into play. This is a way to objectively look at the facts of a single case and the outcome of the patient. With enough of these AARs you can begin to pull patterns and data points to identify trends in care and outcomes. Some of these trends can result in questions and hypotheses that will then be researched. The core functions of the Joint Trauma System are to Sense, Aggregate, Evaluate and Disseminate practical medical information. This form is the sensing part of the cycle. Once enough of these AARs are collected the data points will be aggregated and evaluated through studies and research. This is where our clinical practice guidelines came from. Right now reporting is strongly recommended but not required by USSOCOM 350-29. The newest version proposes an AAR mandate for all medical cases. The JTS recognizes our this shortfall and has begun collecting cases in the interim. The last dissemination of the first version of this form resulted in an article in the JSOM where data points were taken from 54 PFC cases. We implore you to use this form and submit cases to the JTS for review.