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A National Trauma Care System Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths After Injury (2016) / Chapter Skim
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Appendix B: Committee Collective Analysis of Case Studies
Pages 429-436

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From page 429...
... -- that include the implementation of lessons learned from previous conflicts and high-performing civilian trauma systems, digital data capture, performance improvement, requirements-driven research, and the dissemination of best practices. One cross-cutting theme evident throughout the case studies is the extent to which the military's trauma care system adapted to the difficult conditions, austere environments, and high burden of injury that characterized U.S.
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From page 430...
... : The electronic medical the Trauma Patient Mortality Trauma Registry enabled record Theater Medical Data Store Care Experience preventable death studies. was developed.
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From page 431...
... : Registry analysis Strength(s) : DoDTR data Resuscitation Decision Support confirmed provider reports of indicated poor outcomes System (BRDSS)
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From page 432...
... Similarly, JTS CPGs on burn care and severe traumatic brain injury (TBI) are based on registry data and retrospective analyses and, in the case of pediatric burn care, even "rules of thumb." A crucial feature of focused empiricism is the continuous refinement and improvement of CPGs until high-quality data can be generated.
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From page 433...
... The damage control resuscitation approach utilized in the DCBI case, for example, was continuously refined over time and later validated through prospective research undertaken with civilian collaborators. Similarly, although the use of tranexamic acid is included in military prehospital guidelines, the U.S.
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From page 434...
... The committee has identified patient-centered trauma care as one of the critical components of a learning trauma care system. The coordinated and comprehensive care received by the soldier in the DCBI case, including efforts to provide early pain control, reflects positively on the military and its progress in improving communication, patient transfers, and holistic care that includes psychological and spiritual support.
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From page 435...
... A notable example is the civilian sector's widespread adoption of a 1:1:1 transfusion ratio, which mimics the military whole blood transfusion paradigm and has been shown to decrease trauma-induced coagulopathy, total blood use, and exsanguination. While the civilian sector's implementation of best practices regarding tourniquet use has lagged behind that of the military, the successful use of tourniquets on the battlefield has translated to their incorporation into civilian prehospital care.
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Key Terms

  • national trauma
  • trauma registry
  • learning trauma
  • brain injury
  • civilian sector

  • registry data
  • civilian trauma
  • performance improvement
  • blast injury
  • clinical practice

  • focused empiricism
  • severe traumatic
  • trauma data
  • blood transfusion
  • dodtr data

  • data bank
  • widespread adoption
  • cpg compliance
  • burn care
  • blunt trauma

  • tactical combat
  • retrospective analysis
  • practice guidelines
  • decision support
  • resuscitation decision

  • dismounted complex
  • invasive fungal
  • prospective research
  • combat casualty
  • tranexamic acid


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