Kotwal Russ S, Staudt Amanda M, Trevino Jennifer D, Valdez-Delgado Krystal K, Le Tuan D, Gurney Jennifer M, Sauer Samual W, Shackelford Stacy A, Stockinger Zsolt T, Mann-Salinas Elizabeth A
Joint Trauma System, DoD Center of Excellence for Trauma, 3698 Chambers Road, Joint Base San Antonio-Fort Sam Houston, TX 78234.
U.S. Army Institute of Surgical Research, 3698 Chambers Road, Joint Base San Antonio-Fort Sam Houston, TX 78234.
Mil Med. 2018 Mar 1;183(suppl_1):134-145. doi: 10.1093/milmed/usx211.
Critically injured trauma patients benefit from timely transport and care. Accordingly, the provision of rapid transport and effective treatment capabilities in appropriately close proximity to the point of injury will optimize time and survival. Pre-transport tactical combat casualty care, rapid transport with en route casualty care, and advanced damage control resuscitation and surgery delivered early by small, mobile, forward-positioned Role 2 medical treatment facilities have potential to reduce morbidity and mortality from trauma. This retrospective review and descriptive analysis of trauma patients transported from Role 1 entities to Role 2 facilities in Afghanistan from 2008 to 2014 found casualties to be diverse in affiliation and delivered by various types and modes of transport. Air medical evacuation provided transport for most patients, while the shortest transport time was seen with air casualty evacuation. Although relatively little data were collected for air casualty evacuation, this rapid mode of transport remains an operationally important method of transport on the battlefield. For prehospital care provided before and during transport, continued leadership and training emphasis should be placed on the administration and documentation of tactical combat casualty care as delivered by both medical and non-medical first responders.
重伤的创伤患者受益于及时的转运和治疗。因此，在距受伤地点适当近的地方提供快速转运和有效的治疗能力将优化时间并提高生存率。由小型、可移动、靠前部署的二级医疗设施尽早提供的院前战术战斗伤员救治、途中伤员护理的快速转运以及高级损伤控制复苏和手术，有可能降低创伤的发病率和死亡率。这项对2008年至2014年从一级单位转运至阿富汗二级医疗设施的创伤患者的回顾性研究和描述性分析发现，伤员的所属关系各不相同，且通过各种类型和方式进行转运。空中医疗后送为大多数患者提供了转运，而空中伤员后送的转运时间最短。尽管关于空中伤员后送收集的数据相对较少，但这种快速转运方式在战场上仍然是一种重要的作战转运方法。对于转运前和转运期间提供的院前护理，应继续强调领导作用并加强培训，重点是医疗和非医疗急救人员所提供的战术战斗伤员救治的管理和记录。
