Leadership and a casualty response system for eliminating preventable death.
Combat casualties who die from their injuries do so primarily in the prehospital setting. Although most of these deaths result from injuries that are nonsurvivable, some are potentially survivable. Of injuries that are potentially survivable, most are from hemorrhage. Thus, military organizations should direct efforts toward prehospital care, particularly through early hemorrhage control and remote damage control resuscitation, to eliminate preventable death on the battlefield. A systems-based approach and priority of effort for institutionalizing such care was developed and maintained by medical personnel and command-directed by nonmedical combatant leaders within the 75th Ranger Regiment, U.S. Army Special Operations Command. The objective of this article is to describe the key components of this prehospital casualty response system, emphasize the importance of leadership, underscore the synergy achieved through collaboration between medical and nonmedical leaders, and provide an example to other organizations and communities striving to achieve success in trauma as measured through improved casualty survival.
From the Department of Defense Joint Trauma System (R.S.K., H.R.M.), Joint Base San Antonio-Fort Sam Houston, Texas; Headquarters, 75th Ranger Regiment (E.A.M., C.C.C.), Fort Benning, Georgia; MT Hall Leadership Services (M.T.H.), Nashville, Tennessee; McChrystal Group (S.A.MC.), Alexandria, Virginia.
Russ S
RS
Kotwal
Harold R
HR
Montgomery
Ethan A
EA
Miles
Curtis C
CC
Conklin
Michael T
MT
Hall
Stanley A
SA
McChrystal
D004632:Emergency Medical Services / Q000379:methods / Q000458:organization & administration*; D004634:Emergency Medical Technicians; D006801:Humans; D007373:Interinstitutional Relations; D007857:Leadership; D008887:Military Medicine / Q000379:methods* / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D058996:Quality Improvement; D012151:Resuscitation / Q000379:methods; D014187:Transportation of Patients; D014481:United States; D014857:Warfare; D014947:Wounds and Injuries / Q000628:therapy*