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DoD Trauma Registry Data in Action

DoD Trauma System

  • Development of Clinical Practice Guidelines
  • Continuous review and update of CPGs
  • Robust performance improvement monitoring
  • Rapid implementation of data driven improvements
  • Weekly Performance Improvement Trauma video teleconferences
  • Monthly killed in action preventable death reviews
  • Ranger Prehospital Trauma Registry
  • Rapid publication of clinical and research results

Tactical Evacuation (TACEVAC)

  • Use of paramedic-level providers or higher in TACEVAC platforms
  • Fresh whole blood use and guidelines
  • Tranexamic acid (TXA) on evacuation platforms
  • Advanced capability evacuation platforms (e.g., Medical Emergency Response Team)
  • Overfly Role 2's when Role 3 is close

Guidelines support

  • Critical care air transportation teams in en route care (intra theater and strategic evacuation)
  • Extracorporeal membrane oxygenation teams in en route care (strategic evacuation)

Tactical Combat Casualty Care

  • Aggressive use of tourniquets for extremity hemorrhage
  • Surgical airways for maxillofacial trauma with obstructed airway
  • Hypotensive resuscitation with Hextend for casualties in shock
  • Hypothermia prevention in casualties
  • Battlefield antibiotics (PO and IV)
  • Tranexamic acid for casualties at risk of significant hemorrhage
  • Eye injuries
  • PO pain meds

Facility-Based Clinical Care

  • Damage Control Resuscitation
  • Damage Control Surgery
  • 1:1:1 plasma: platelets: Packed red blood cells transfusion ratio for hemorrhagic shock
  • FWB when needed
  • Decompressive craniectomy
  • Temporary vascular shunting at all Role 2 and above
  • Delayed removal of intraocular foreign bodies
  • Aggressive use of fasciotomy in extremity injuries
  • Negative pressure wound therapy
  • Improved management of wound infections



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Last Modified Date: 01/31/2018