Schauer Steven G, Naylor Jason F, Uhaa Nguvan, April Michael D, De Lorenzo Robert A
J Spec Oper Med. 2020 Spring;20(1):61-64. doi: 10.55460/FUHO-CU87.
Tactical Combat Casualty Care (TCCC) recommends life-saving interventions; however, these interventions can only be implemented if military prehospital providers carry the necessary equipment to the injured casualty. Combat medics primarily use aid bags to transport medical materiels forward on the battlefield. We seek to assess combat medic materiel preparedness to employ TCCC-recommended interventions by inventorying active duty, combat medic aid bags.
We sought combat medics organic to combat arms units stationed at Joint Base Lewis McChord. Medics volunteered to complete a demographic worksheet and have the contents of their aid bag photographed and inventoried. We spoke with medic unit leadership prior to their participation and asked that the medics bring their aid bags in the way they would pack for a combat mission. We categorized medic aid bag contents in the following manner: (1) hemorrhage control; (2) airway management; (3) pneumothorax treatment, or (4) volume resuscitation. We compared the items found in the aid bags against the contemporary TCCC guidelines.
In January 2019, we prospectively inventoried 44 combat medic aid bags. Most of the medics were male (86%), in the grade of E4 (64%), and had no deployment experience (64%). More medics carried a commercial aid bag (55%) than used the standard issue M9 medical bag (45%). Overall, the most frequently carried medical device was an NPA (93%). Overall, 91% of medics carried at least one limb tourniquet, 2% carried a junctional tourniquet, 31% carried a supraglottic airway (SGA), 64% carried a cricothyrotomy setup/kit, 75% carried a chest seal, and 75% carried intravenous (IV) fluid. The most commonly stocked limb tourniquet was the C-A-T (88%), the airway kit was the H&H cricothyrotomy kit (38%), the chest injury set were prepackaged needle decompression kits (81%), and normal saline was the most frequently carried fluid (47%). Most medics carried a heating blanket (54%).
Most medics carried materiels that address the common causes of preventable death on the battlefield. However, most materiels stowed in aid bags were not TCCC-preferred items. Moreover, there was a small subset of medics who were not prepared to handle the major causes of death on the battlefield based on the current state of their aid bag.
战术战斗伤救治(TCCC)推荐了挽救生命的干预措施;然而,只有当军事院前急救人员携带必要设备前往受伤伤员处时,这些干预措施才能得以实施。战斗医护兵主要使用急救包在战场上向前线运送医疗物资。我们旨在通过清点现役战斗医护兵的急救包,评估战斗医护兵运用TCCC推荐干预措施的物资准备情况。
我们寻找驻扎在刘易斯-麦克科德联合基地的作战部队所属的战斗医护兵。医护兵自愿填写一份人口统计学工作表,并让他们的急救包内容物被拍照和清点。在他们参与之前,我们与医护兵所在单位的领导进行了交谈,并要求医护兵按照他们为战斗任务打包的方式携带急救包。我们将医护兵急救包的内容物按以下方式分类:(1)出血控制;(2)气道管理;(3)气胸治疗,或(4)容量复苏。我们将在急救包中发现的物品与当代TCCC指南进行了比较。
2019年1月,我们前瞻性地清点了44个战斗医护兵的急救包。大多数医护兵为男性(86%),军衔为E4(64%),且没有部署经验(64%)。携带商业急救包的医护兵(55%)比使用标准配发的M9医疗包的医护兵(45%)更多。总体而言,最常携带的医疗设备是鼻咽气道(NPA,93%)。总体而言,91%的医护兵携带至少一个肢体止血带,2%携带关节止血带,31%携带声门上气道(SGA),64%携带环甲膜切开术装置/套件,75%携带胸部密封装置,75%携带静脉输液(IV)液体。最常用的肢体止血带是C-A-T(88%),气道套件是H&H环甲膜切开术套件(38%),胸部损伤套装是预包装的针式减压套件(81%),最常携带的液体是生理盐水(47%)。大多数医护兵携带了加热毯(54%)。
大多数医护兵携带了可应对战场上可预防死亡常见原因的物资。然而,急救包中存放的大多数物资并非TCCC推荐的首选物品。此外,根据他们急救包的当前状况,有一小部分医护兵没有准备好应对战场上的主要死亡原因。