伊拉克和阿富汗的院前战斗创伤用药包管理：国防部创伤登记分析

Prehospital Combat Wound Medication Pack Administration in Iraq and Afghanistan: A Department of Defense Trauma Registry Analysis.

作者信息

Schauer Steven G, Naylor Jason F, Ahmed Yousef M, Maddry Joseph K, April Michael D

出版信息

J Spec Oper Med. 2020 Fall;20(3):76-80. doi: 10.55460/X4E8-NNXE.

DOI:10.55460/X4E8-NNXE

PMID:32969008

Abstract

BACKGROUND

The United States (US) military utilizes combat wound medication packs (CWMP) to provide analgesia and wound prophylaxis in casualties who are still able to fight. We compared characteristics of combat casualties receiving CWMP to those not receiving CWMP. We also describe the proportions of casualties with injury patterns consistent with Tactical Combat Casualty Care (TCCC) guideline indications for CWMP use who received this intervention.

METHODS

This is a secondary analysis of Department of a Defense Trauma Registry (DODTR) dataset of US military personnel from January 2007 to August 2016. We searched for all subjects with documented use of at least one medication from the CWMP (acetaminophen, meloxicam, moxifloxacin).

RESULTS

Within our dataset, 11,665 casualties were US military Servicemembers. Overall, <1% (84) of our study population received the CWMP. The median age and mechanism of injuries were similar between CWMP nonrecipients versus recipients. Median composite injury scores were higher for nonrecipients than recipients (6 versus 4, P < .001). Proportions of casualties with injury patterns meeting TCCC guideline CWMP indications who received this intervention were low: gunshot wound, <1% (14 of 1805), tourniquet applied, <1% (11 of 1912), major amputation, <1% (5 of 803), and open fracture, <1% (10 of 2425). Based on serious injuries by body region, we had similar findings for the thorax (<1%; 3 of 1122), abdomen (<1%; 1 of 736), and extremities (<1%; 11 of 2699).

CONCLUSIONS

Subjects receiving the CWMP were less severely injured compared to those who did not receive this intervention. The CWMP had very infrequent use among those casualties with injury patterns meeting indications specified in the TCCC Guidelines for use of this intervention.

摘要

背景

美国军方使用战斗创伤药物包（CWMP）为仍能作战的伤员提供镇痛和伤口预防。我们比较了接受CWMP的战斗伤员与未接受CWMP的伤员的特征。我们还描述了具有与战术战斗伤员护理（TCCC）指南中CWMP使用指征相符的损伤模式的伤员接受该干预措施的比例。

方法

这是对2007年1月至2016年8月美国军事人员国防部创伤登记处（DODTR）数据集的二次分析。我们搜索了所有记录使用过CWMP中至少一种药物（对乙酰氨基酚、美洛昔康、莫西沙星）的受试者。

结果

在我们的数据集中，11665名伤员为美国军事人员。总体而言，我们的研究人群中<1%（84人）接受了CWMP。未接受CWMP者与接受者的年龄中位数和损伤机制相似。未接受者的综合损伤评分中位数高于接受者（分别为6和4，P<.001）。具有符合TCCC指南CWMP使用指征的损伤模式的伤员接受该干预措施的比例较低：枪伤，<1%（1805例中的14例），使用止血带，<1%（1912例中的11例），大截肢，<1%（803例中的5例），以及开放性骨折，<1%（2425例中的10例）。根据身体部位的重伤情况，我们在胸部（<1%；1122例中的3例）、腹部（<1%；736例中的1例）和四肢（<1%；2699例中的11例）有类似的发现。