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Deployed Trauma System

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The effect of a golden hour policy on the morbidity and mortality of combat casualties.
Kotwal RS, Howard JT, Orman JA, Tarpey BW, Bailey JA, Champion HR, Mabry RL, Holcomb JB, Gross KR.
JAMA Surg. 2016 Jan;151(1):15-24.

Rationale for inclusion: Although only cited 8 times, this is a relatively recent paper and addressed a controversial topic of the "Golden Hour." This study presents data accrued before and after the mandate in 2009 for transport to surgical care within 60 minutes.

Citations - 53 (as of July 2017)

Death on the battlefield (2001-2011): Implications for the future of combat casualty care.
Eastridge BJ, Mabry RL, Seguin P, Cantrell J, Tops T, Uribe P, Mallett O, Zubko T, Oetjen-Gerdes L, Rasmussen TE, Butler FK, Kotwal RS, Holcomb JB, Wade C, Champion H, Lawnick M, Moores L, Blackbourne LH.
J Trauma Acute Care Surg. 2012 Dec;73(6 Suppl 5):S431-7.

Rationale for inclusion:  This was a large analysis of pre-medical treatment facility (MTF) deaths. This study identified that the vast majority of potentially surviveable pre-MTF deaths were due to hemorrhage and further classified the site of the lethal hemorrhage.

Citations - 581 (as of July 2017)

Evaluation of military trauma system practices related to damage-control resuscitation.
Palm K, Apodaca A, Spencer D, Costanzo G, Bailey J, Blackbourne LH, Spott MA, Eastridge BJ.
J Trauma Acute Care Surg. 2012 Dec;73(6 Suppl 5):S459-64.

Rationale for inclusion:  This is a pre-post analysis study on the implemenation of the damage control resusctitation guideline implementation in the joint theater trauma system. Effective implementation and adherence is of the guideline is associated with improved compliance with balanced component transfusion and decreased practice variability.

Citations - 32 (as of July 2017)

Eliminating preventable death on the battlefield.
Kotwal RS, Montgomery HR, Kotwal BM, Champion HR, Butler FK Jr, Mabry RL, Cain JS, Blackbourne LH, Mechler KK, Holcomb JB.
Arch Surg. 2011 Dec;146(12):1350-8.

Rationale for inclusion: This is the first review of command driven TCCC guidelines and a prehospital trauma registry and has resulted in unprecedented reduction in preventable combat deaths. This is now the model for combat casualty care on the battlefield.

Citations - 218 (as of July 2017)

An analysis of in-hospital deaths at a modern combat support hospital.
Martin M, Oh J, Currier H, Tai N, Beekley A, Eckert M, Holcomb J.
J Trauma. 2009 Apr;66(4 Suppl):S51-60; discussion S60-1.

Rationale for inclusion: This review of a CSH experience for potentially preventable deaths identified areas for improvement to include delays in prehospital care and in hospital hemorrhage control.

Citations - 92 (as of July 2017)

Joint theater trauma system implementation of burn resuscitation guidelines improves outcomes in severely burned military casualties.
Ennis JL, Chung KK, Renz EM, Barillo DJ, Albrecht MC, Jones JA, Blackbourne LH, Cancio LC, Eastridge BJ, Flaherty SF, Dorlac WC, Kelleher KS, Wade CE, Wolf SE, Jenkins DH, Holcomb JB.
J Trauma. 2008 Feb;64(2 Suppl):S146-51; discussion S151-2.

Rationale for inclusion:  Prospectively collected data on burn casualties was compared to patients treated in theater prior to the Burn Resusciation Guidelines. This paper demonstrated the improved mortality associated with implementation of the guidelines, but more importantly it highlighted the implementation and effectiveness of the Clinical Practice Guidelines.

Citations - 113 (as of July 2017)

Tactical combat casualty care 2007: evolving concepts and battlefield experience.
Butler FK Jr, Holcomb JB, Giebner SD, McSwain NE, Bagian J.
Mil Med. 2007 Nov;172(11 Suppl):1-19.

Rationale for inclusion: This review describes the development and evolution of the TCCC guidelines from inception in 1996 through continuous updates organized by the Committee on TCCC. 

Citations - 194 (as of July 2017)

Causes of death in U.S. Special Operations Forces in the global war on terrorism: 2001-2004.
Holcomb JB, McMullin NR, Pearse L, Caruso J, Wade CE, Oetjen-Gerdes L, Champion HR, Lawnick M, Farr W, Rodriguez S, Butler FK.
Ann Surg. 2007 Jun;245(6):986-91.

Rationale for inclusion: This is the initial paper on modern battlefield deaths. It not only describes the mechanism of injury but also discussed the causes of potentially surviveable deaths. 

Citations - 510 (as of July 2017)

Trauma system development in a theater of war: experiences from Operation Iraqi Freedom and Operation Enduring Freedom.
Eastridge BJ, Jenkins D, Flaherty S, Schiller H, Holcomb JB.
J Trauma. 2006 Dec;61(6):1366-72; discussion 1372-3.

Rationale for inclusion: This is the first detailed description of the implementaion of the Joint Theater Trauma System. The implementation of the system helped identify multiple systems issues for the improvement of patient care including patient transfer to the appropriate level of care, the development of a trauma registry and performance improvement.

Citations - 277 (as of July 2017)

The impact of hypothermia on trauma care at the 31st combat support hospital.
Arthurs Z1, Cuadrado D, Beekley A, Grathwohl K, Perkins J, Rush R, Sebesta J.
Am J Surg. 2006 May;191(5):610-4.

Rationale for inclusion: This study represented a large cohort of patients (2848) who presented to a CSH over a 12 month period. 18% were hypothermic on presentation, and hypothermia was an independent predictor of damage control laparotomy and mortality.

Citations - 107 (as of July 2017)

Combat trauma experience with the United States Army 102nd Forward Surgical Team in Afghanistan.
Beekley AC, Watts DM.
Am J Surg. 2004 May;187(5):652-4.

Rationale for inclusion: This retrospective review of the FST is an account of the initial set up and experience in the forward setting and ausetere environment.

Citations - 141 (as of July 2017)

Tactical combat casualty care in special operations.
Butler FK Jr, Hagmann J, Butler EG.
Mil Med. 1996 Aug;161 Suppl:3-16.

Rationale for inclusion: This paper presents the results of a study that evaluated the appropriateness of the measures used by combat medics. A new basic management protocol was proposd that organized combat casualty care into 3 phases with appropriate measures. 

Citations - 334 (as of July 2017)

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