ORIGINAL ARTICLE ONLINE FIRST Russ S. Kotwal, MD, MPH; Harold R. Montgomery, NREMT; Bari M. Kotwal, MS; Howard R. Champion, FRCS; Frank K. Butler Jr, MD; Robert L. Mabry, MD; Jeffrey S. Cain, MD; Lorne H. Blackbourne, MD; Kathy K. Mechler, MS, RN; John B. Holcomb, MD Objective: To evaluate battlefield survival in a novel com- 10.7% killed in action and 1.7% who died of wounds were mand-directed casualty response system that compre- lower than the Department of Defense rates of 16.4% and hensively integrates Tactical Combat Casualty Care guide- 5.8%, respectively, for the larger US military population lines and a prehospital trauma registry. (P=.04 and P=.02, respectively). Of 32 fatalities incurred by the regiment, none died of wounds from infection, none Design: Analysis of battle injury data collected during were potentially survivable through additional prehos- combat deployments. pital medical intervention, and 1 was potentially surviv- able in the hospital setting. Substantial prehospital care was Setting: Afghanistan and Iraq from October 1, 2001, provided by nonmedical personnel. through March 31, 2010. Conclusions: A command-directed casualty response sys- Patients: Casualties from the 75th Ranger Regiment, US tem that trains all personnel in Tactical Combat Casualty Army Special Operations Command. Care
JAMA Surgery – American Medical Association
Published: Dec 1, 2011
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