Walker Jennifer J, Stockinger Zsolt T, Chinn Colin G
Graduate Medical Education, Womack Army Medical Center, 2817 Reilly Road, Fort Bragg, NC 28310.
Joint Trauma System, 3698 Chambers Pass, Suite B, U.S. Army Institute of Surgical Research, Fort Sam Houston, TX 78234.
Mil Med. 2017 Mar;182(S1):41-46. doi: 10.7205/MILMED-D-16-00167.
Military personnel risk injury due to accidents, disasters, and military threats during Phase Zero "shaping" operations. Medical facilities must be poised to respond.
The U.S. Pacific Command (PACOM) Area of Responsibility (AOR) covers more than 50% of the earth's surface; relevant Clinical Practice Guidelines must include the maritime setting and extended evacuation periods. Military hospitals in the region are not connected by a defined Trauma System. There is variable adherence to trauma training requirements before assignment in this AOR. Demand for trauma care at any 1 location is low and trauma teams have little opportunity to maintain competency for high-risk/low-volume interventions. There is no documentation of total demand for trauma care in the AOR. Trauma care in PACOM is often deferred to civilian facilities.
Core elements of a Joint Theater Trauma System (JTTS) as established during combat operations in U.S. Central Command are applicable during Phase Zero. A PACOM JTTS was established to address the region's readiness to respond to Phase Zero trauma as well as escalation of regional threats. Information technology coordination was a critical hurdle to overcome.
PACOM lessons learned are applicable to other Geographic Combatant Commands developing a JTTS during Phase Zero operations.
在零阶段“塑造”行动期间，军事人员因事故、灾难和军事威胁而面临受伤风险。医疗设施必须做好应对准备。
美国太平洋司令部（PACOM）的责任区（AOR）覆盖了地球表面50%以上的区域；相关临床实践指南必须纳入海上环境和延长的后送时间。该地区的军事医院并未通过明确的创伤系统相互连接。在被分配到该责任区之前，对创伤培训要求的遵守情况各不相同。任何一个地点对创伤护理的需求都很低，创伤团队几乎没有机会维持高风险/低频次干预的能力。没有该责任区创伤护理总需求的记录。太平洋司令部的创伤护理通常被推迟到民用设施。
在美国中央司令部作战行动期间建立的联合战区创伤系统（JTTS）的核心要素在零阶段同样适用。为应对该地区对零阶段创伤的应对准备以及地区威胁升级，建立了太平洋司令部联合战区创伤系统。信息技术协调是需要克服的一个关键障碍。
太平洋司令部的经验教训适用于其他在零阶段行动期间建立联合战区创伤系统的地理作战司令部。
