Advancing critical care: joint combat casualty research team and joint theater trauma system.
Despite the severity and complexity of injuries, survival rates among combat casualties are equal to or better than those from civilian trauma. This article summarizes the evidence regarding innovations from the battlefield that contribute to these extraordinary survival rates, including preventing hemorrhage with the use of tourniquets and hemostatic dressings, damage control resuscitation, and the rapid evacuation of casualties via MEDEVAC and the US Air Force Critical Care Air Transport Teams. Care in the air for critically injured casualties with pulmonary injuries and traumatic brain injury is discussed to demonstrate the unique considerations required to ensure safe en route care. Innovations being studied to decrease sequelae associated with complex orthopedic and extremity trauma are also presented. The role and contributions of the Joint Combat Casualty Research Team and the Joint Theater Trauma System are also discussed.
Bridges
Elizabeth
E
Clinical Investigations Facility, 60th Medical Group, Travis AFB, California, USA. ebridges@u.washington.edu
Biever
Kimberlie
K
D035843:Biomedical Research / Q000458:organization & administration*; D003422:Critical Care / Q000458:organization & administration*; D004635:Emergency Medicine; D016529:Emergency Nursing; D006801:Humans; D008887:Military Medicine / Q000458:organization & administration*; D008888:Military Nursing / Q000458:organization & administration*; D012151:Resuscitation / Q000379:methods / Q000451:nursing; D014481:United States; D014861:Washington; D014947:Wounds and Injuries / Q000451:nursing / Q000601:surgery*