Tactical Emergency Casualty Care Research Articles

Proceedings of the 2016 Spring/Summer Meeting of the Committee for Tactical Emergency Casualty Care

Proceedings of the 2016 Spring/Summer Meeting of the Committee for Tactical Emergency Casualty Care

The Hartford Consensus on Active Shooters: Implementing the Continuum of Prehospital Trauma Response

BackgroundActive shooter incidents have led to the recognition that the traditional response paradigm of sequential response and scene entry by law enforcement, first responders, and emergency medical service (EMS) personnel produced delays in care and suboptimal victim outcomes. The Hartford Consensus Group developed recommendations to improve the response to and outcomes from active shooter events and urged that a continuum of care be implemented that incorporates not only EMS response, but also the initiation of care by law enforcement officers and potentially by lay bystanders. ObjectiveTo develop and implement tiered educational programs designed to teach police officers and lay bystanders the principles of initial trauma care and bleeding control using as a foundation the U.S. military's Tactical Combat Casualty Care course and the guidelines of the Committee on Tactical Emergency Casualty Care. DiscussionThe Tactical Casualty Care for Law Enforcement and First Responders course is a 1-day program combining didactic lecture, hands-on skills stations, and clinical scenarios designed primarily for police officers. The Bleeding Control for the Injured is a 2- to 3-h program for the potential citizen responder in the skills of hemorrhage control. In addition, we document the application of these skills by law enforcement officers and first responders in several real-life incidents involving major hemorrhage. ConclusionsDeveloping and implementing tiered educational programs for hemorrhage control will improve response by police officers and the lay public. Educating law enforcement officers in these skills has been demonstrated to improve trauma victim survival.

The Operational Canine and K9 Tactical Emergency Casualty Care Initiative

Approximately 20% to 25% of trauma-related, prehospital fatalities in humans are due to preventable deaths. Data are lacking, however, on the nature and the prevalence of operational canine (OC) prehospital deaths. It is plausible that OCs engaged in high-threat operations are also at risk for suffering some type of preventable death. Tactical Combat Casualty Care has significantly reduced human fatality rates on the battlefield. Standardized guidelines specifically for prehospital trauma care have not been developed for the OC caregiver. An initiation has been approved by the Committee for Tactical Emergency Casualty Care to form a K9-Tactical Emergency Casualty Care (TECC) working group to develop such guidelines.The intent of the K9-TECC initiative is to form best practice recommendations for the civilian high-risk OC caregiver. These recommendations are to focus on interventions that (1) eliminate the major causes of canine out-of-hospital preventable deaths, (2) are easily learned and applied by any civilian first responder, and (2) minimize resource consumption.

The Ranger First Responder Program and Tactical Emergency Casualty Care Implementation: A Whole-Community Approach to Reducing Mortality From Active Violent Incidents.

Active violent incidents are dynamic and challenging situations that can produce a significant amount of preventable deaths. Lessons learned from the military?s experience in Afghanistan and Iraq through the Committee on Tactical Combat Casualty Care and the 75th Ranger Regiment?s Ranger First Responder Program have helped create the Committee for Tactical Emergency Casualty Care (C-TECC) to address the uniqueness of similar wounding patterns and to end preventable deaths. We propose a whole-community approach to active violent incidents, using the C-TECC Trauma Chain of Survival and a tiered approach for training and responsibilities: the first care provider, nonmedical professional first responders, medical first responders, and physicians and trauma surgeons. The different tiers are critical early links in the Chain of Survival and this approach will have a significant impact on active violent incidents.

TacMed Updates: The Committee for Tactical Emergency Casualty Care (C-TECC): Summer Update.

TacMed Updates: The Committee for Tactical Emergency Casualty Care (C-TECC): Summer Update.

TacMed updates. The Committee for Tactical Emergency Casualty Care: fall update.

TacMed updates. The Committee for Tactical Emergency Casualty Care: fall update.

TacMed Updates: Spring Committee for Tactical Emergency Casualty Care (C-TECC) Update

TacMed Updates: Spring Committee for Tactical Emergency Casualty Care (C-TECC) Update

Management of Open Chest Wounds in Tactical Emergency Casualty Care: Application of Vented Versus Nonvented Chest Seals

The 2014 midyear, full meeting of the Committee for Tactical Emergency Combat Care (C-TECC) was hosted by the Johns Hopkins University Center for Law Enforcement Medicine on June 9 and 10 in Baltimore, Maryland. As the C-TECC guidelines are increasingly recognized as the best-practice recommendations for civilian, high-threat, prehospital trauma response, a focused guidelines discussion occurred to develop best-practice recommendations for the management of open chest wounds, specifically regarding the application of vented and nonvented chest seals.

TacMed Updates: Tactical Emergency Casualty Care (TECC) Update: Winter 2014.

TacMed Updates: Tactical Emergency Casualty Care (TECC) Update: Winter 2014.

Committee for Tactical Emergency Casualty Care (C-TECC) Update: Summer 2014.

Committee for Tactical Emergency Casualty Care (C-TECC) Update: Summer 2014.

Committee for Tactical Emergency Casualty Care (CoTECC) Update: Summer 2014.

Committee for Tactical Emergency Casualty Care (CoTECC) Update: Summer 2014.

Committee for Tactical Emergency Casualty Care (C-TECC) Update: Fall 2014

Committee for Tactical Emergency Casualty Care (C-TECC) Update: Fall 2014

Tactical Emergency Casualty Care-Pediatric Appendix: Novel Guidelines for the Care of the Pediatric Casualty in the High-Threat, Prehospital Environment

Active shooter events and active violent incidents are increasingly targeting civilians, placing children at heightened risk for complex and devastating trauma. The U.S. Department of Homeland Security has identified as a priority preparing domestic first responders to manage complex mass casualty incidents as a primary step in strengthening our medical system. Existing literature suggests that many prehospital providers are uncomfortable treating critically ill or injured pediatric patients and that there is a gap in the consistent provision of high-quality trauma care to these patients. The success of threat-based care developed by the military has led to an exponential rise in the familiarity and utilization of these concepts within certain specialized elements of civilian care. Evolution of these concepts is accelerating to meet the demands of the nonmilitary civilian environment through the formation and subsequent work of the Committee for Tactical Emergency Casualty Care (C-TECC). However, a gap remains in the available literature describing the application of these principles to specialized populations.In the absence of an evidence-based set of guidelines for prehospital care of the pediatric casualty, the C-TECC sought to establish a set of peer-reviewed guidelines to serve as a foundation describing current best practices. The Pediatric Working Group (PWG) utilized the adult TECC guidelines as a starting point and identified a series of key questions regarding trauma interventions. The PWG conducted a standard PubMed search to identify key relevant or potentially relevant literature. The literature review was presented to the C-TECC Guidelines Committee for review and approval of recommended principles.Given the dearth of supporting literature on the subject, the TECC committee was purposefully conservative in the adaptation of the adult TECC guidelines to a pediatric standard. The guidelines highlight information tailored to the pediatric population and were designed to be a resource for individual agencies seeking guidance for high-threat operations. To our knowledge, the TECC Pediatric Appendix is the first published recommendation for the widespread use of tourniquets in pediatric hemorrhage. In addition, the Guidelines are meant to highlight gaps in trauma literature and stimulate discussion regarding future research in the area of prehospital care of the pediatric casualty.

Tactical Emergency Casualty Care (TECC): Guidelines For The Provision Of Prehospital Trauma Care In High Threat Environments

Tactical Emergency Casualty Care (TECC): Guidelines For The Provision Of Prehospital Trauma Care In High Threat Environments

The ethics of treatment decision making: The elderly patient's perspective

Combat operations necessitate bold thought and afford the opportunity to rapidly evolve and improve trauma care. The development and maturation of Tactical Combat Casualty Care (TCCC) is an important example of a critical process improvement strategy that reduced mortality in high-threat combat-related trauma. The Committee for Tactical Emergency Casualty Care (C-TECC) adapted the lessons of TCCC to the civilian high-threat environment and provided important all-hazards response principles for austere, dynamic, and resource-limited environments. The Hartford Consensus mobilized the resources of the American College of Surgeons to drive public policy regarding a more singular focus: hemorrhage control. The combined efforts of C-TECC and Hartford Consensus have helped redefine the practice of trauma care in high-threat scenarios across the United States.