Combat Casualty Care

A discussion about the JTS Emergency General Surgery CPG with CDR Jacob Glazer, MD, a Navy Trauma & Critical Care Surgeon and Maj Andrew Hall, MD from USAF CSTARS.     Not all casualties are trauma patients on the battlefield. Listen to this podcast about the considerations for emergency surgery in the deployed setting that may seem like routine surgery but requires unique decisions. The following topics are discussed: Overall need and purpose for a emergency general surgery Surgical decision-making in the deployed environment Common non-trauma conditions requiring emergency surgery Various surgical patient populations in the deployed setting Approaches to surgical decision-making with limitations on diagnostics and reliance on physical exams Decision matrix in the CPG Identification of emergent versus urgent surgical patients Decisions based on follow-on care needs Integrating surgical decision-making with command and mission requirements Post-surgical and evacuation decision-making Listen on Deployed Medicine at:   https://deployedmedicine.com/market/29/content/552 Subscribe on iTunes: Search for “Combat Casualty Care” Subscribe on Android at: http://subscribeonandroid.com/tccc.blubrry.net/feed/podcast/ RSS Feed for the Combat Casualty Care Podcast:  http://tccc.blubrry.net/feed/podcast/ Always find the latest on Combat Casualty Care at: www/deployedmedicine.com or download the mobile app “Deployed Medicine”. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.  For more information, please visit https://creativecommons.org/.

Listen to COL Mark Pallis, Orthopedic Surgery Consultant for the US Army Surgeon General, discuss the Orthopedic Trauma Extremity Fracture Clinical Practice Guideline (CPG). Upwards of 70-80% of combat injuries involve extremity fractures.  The podcast discusses the importance of fracture management for all providers in the deployed environment.  With protective equipment worn on today’s battlefield, the survivability of wounding patterns increases the likelihood of fracture management.  In austere environments, assessment equipment can be limited, and evacuation routes can be lengthy in time.  The following topics are discussed by COL Pallis: Treatment of the casualty with awareness of austere constraints Treatment options in far-forward environments before evacuation Initial management of extremity fractures Options for stabilizing fractures before and during evacuation Fracture management in sequence of care for multi-injury casualties Antibiotics in early fracture management Documentation and marking of splints External versus internal fixation in the austere environment External fixator resources for the austere environment Considerations for the external fixator frame placement Splints versus fixator considerations Differences between management of upper and lower extremity fractures Factors to consider in austere scenarios This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.  For more information, please visit https://creativecommons.org/.

In this podcast, Col Stacy Shackelford, USAF, MC, Chief of Performance Improvement with the Joint Trauma System, discusses the Battle and Non-Battle Injury Documentation Clinical Practice Guideline (CPG). Listen to Col Shackelford as she explains the documentation process for the Trauma Resuscitation Record. Importance of documentation Documentation referenced in this CPG is specific to Role 2 and Role 3 levels of care Documentation requirements for trauma patients Continuity of the resuscitation record as the patient transitions to different levels of care Uploading records into the Theater Medical Data Store (TMDS) Documentation requirements in addition to the Trauma Resuscitation Record Determining which patients require a Trauma Resuscitation Record Steps to ensure records are transmitted to the Trauma Registry Where can providers find the Trauma Resuscitation Record template?   Always find the latest on Combat Casualty Care at: www/deployedmedicine.com or download the mobile app “Deployed Medicine”. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.  For more information, please visit https://creativecommons.org/.  

Listen to CDR Joshua Tobin, MC, USN, Chief of Trauma Anesthesiology at the University of Southern California and LTC Cord Cunningham, MC, USA, Emergency Medicine Physician and Chair of the JTS Committee on En Route Casualty Care (ERCCC) discuss the changes found within the current Airway Management Clinical Practice Guideline (CPG). In this podcast our subject matter experts expand on the implications of the following changes: Ketamine for Rapid Sequence Intubation (RSI) Principles of apneic oxygenation (pre-oxygenation) End tidal CO2 monitoring and waveform capnography Surgical airway options – cricothyroidotomy or tracheostomy Standardized RSI and intubation pathway for all patients. Separate Traumatic Brain Injury (TBI) algorithm not required. Recommendations for pediatric airway management and intubation Team approach to trauma airway management Always find the latest on combat casualty care at www.deployedmedicine.com   This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. For more information, please visit https://creativecommons.org/.

Listen to LtCol Ian Stewart, USAF, MC, Associate Professor of Medicine at the Uniformed Services University of the Health Sciences and a practicing Nephrologist at the David Grant United Airforce Medical Center explain the “Hyperkalemia and Dialysis in a Deployed Setting” Clinical Practice Guideline (CPG).  The following topics are discussed by LtCol Stewart in this podcast: Primary causes of Acute Kidney Injury (AKI) & Hyperkalemia in the deployed setting Risk factors for AKI and Hyperkalemia in combat casualties Rhabdomyolysis Use of Renal Replacement Therapy prior to transport to a higher echelon of care Monitoring practices in casualties with AKI Criteria for transfer to a higher echelon of care for casualties with AKI Current Research on AKI Initial Treatments for AKI and hyperkalemia Acute Peritoneal Dialysis Methods available for Renal Replacement Therapy at different echelons of care NxStage® System One TM Renal Replacement Therapy system Catheter placement Replacement fluids and rates UltraFiltration Difference between NxStage® System One TM and peritoneal dialysis Performance improvement monitoring   This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.  For more information, please visit https://creativecommons.org/.

This podcast is a discussion with LTC Mario A. Rivera of the Army Nurse Corps and COL Jennifer Gurney from the U.S. Army Institute of Surgical Research (USAISR).  COL Gurney is a critical care trauma surgeon at USAISR and Chief of Trauma Systems Development with the Joint Trauma System. Learn more on the following topics as you listen to LTC Rivera and COL Gurney discuss the Burn Care Clinical Practice Guideline. Burn Injury Assessment Resuscitation Wound Care Scenarios including chemical and electrical injuries This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.  For more information, please visit https://creativecommons.org/.

This podcast is a discussion with LTC Benjamin K. Potter, Chief of Orthopedics at Walter Reed National Military Medical Center. Learn more on the following topics as you listen to LTC Potter share his experience as the chief orthopedic surgeon for the amputee care program. Indications for amputation / Amputation criteria Classifications of Amputations Trauma assessment and prioritization of care in the context of amputation Amputation vs. limb salvage decisions in the OR Preparing the limb for amputation Ipsilateral fractures and amputations Skin and tissue flap challenges Amputations near joints Open initial wound management Postoperative care of amputations Negative pressure wound therapy Always find the latest at www/deployedmedicine.com This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.  For more information, please visit https://creativecommons.org/.

This podcast is a discussion with Lt Col Jason Paisley MD, USAF, the director of Physician Education at the Center for Sustainment of Trauma and Readiness Skills (CSTARS). The podcast reviews the updated Clinical Practice Guideline (CPG) on REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta) for advanced providers. Specifically, it addresses the newer equipment that allows for easier insertion and talks about the way REBOA is being used in various clinical scenarios that may have otherwise required more invasive methods. Always find the latest on Combat Casualty Care at: www/deployedmedicine.com or download the mobile app “Deployed Medicine”.  

A discussion with Dr Don Marion about the Neurosurgery and Severe Head Injury Clinical Practice Guideline (CPG) from the Joint Trauma System (JTS).  Dr Marion is the Senior Clinical Consultant, Clinical Affairs Division of Defense and Veterans Brain Injury Center. For more information about the JTS, check out www.deployedmedicine.com or http://jts.amedd.army.mil/ This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.  For more information, please visit https://creativecommons.org/.

A discussion with Col Stacy Shackelford, MD about the Committee on SURGICAL Combat Casualty Care (CoSCCC), a new component of the Joint Trauma System (JTS). Listen to it here, through your podcast service or download our app “Deployed Medicine” The Joint Trauma System (JTS) is the Department of Defense Center of Excellence for Trauma providing...