Post on 28-Dec-2015
NMCP Combat Trauma Research Group
Lanny Littlejohn, MDCDR MC (FS/DMO) USNResearch Director, CTRGMedical Director, TCCCNMCP Dept of Emergency Medicine
Group Structure and Mission
• Composed of 3-4 staff EM physicians– 1-2 deployed or in fellowship at any given time
• Residents interested in contributing to preclinical literature
• Three areas of focus– Prehospital and early resuscitative phase– Bridging between preclinical and clinical via
protocols with fidelity to actual casualty Tx– Support the mission of the residency program
• Wide range of research questions so less expertise in any one area.
Recent and upcoming protocols• 4 hemostatic agent studies completed
– Henao– Kozen– Devlin– Littlejohn
• 1 hemostatic agent study planned (May 2012)• Supraglottic airway and TQ study just completed in
TCCC class• Vented Chest Seals• HBOC/HTS ongoing• Arginine Vasopressin
• Tranexamic Acid
Hemostatic Agents
• Experience primarily in the Alam model WRT injury
• Open and limited access models– CELOX equal efficacy (QC and Hemcon) open
model– All agents similar if pressure dressing
appropriately used– Kerlix effective in small wounds with firm
packing
• Adopted Kheirabadi model after standardization meeting (upcoming protocol)
The Effectiveness of Navy Hospital Corpsman in Applying TCCC Recommended Prehospital Tourniquets under Simulated Combat Stress(CIP # 2011-0074)
Richard H. Schreckengaust, MDLCDR MC (UMO/DMO) USNEmergency Medicine ResidentNMCP Dept of Emergency Medicine
Design TimelineDesign Timeline
Day1 Day4 Day5
Baseline End of Training Field Test
Randomized, Cross-Over Design• Each HM applied CAT and SoftT
• At each Timepoint
Training
Classroom Setting •Initial Briefing•Minimal Stress
Classroom Setting •Minimal Stress
Field Setting•High Stress
•Obstacle Course•Care under Fire•Flak, Helmet, Mask
Dependent Variables•Time•Pulse•Placement
Results - PulseResults - Pulse
• CAT v SOFT-T*• 30% diff (2x
rate)• Training Effect*
– 15% improvement• Care Under Fire
– 5% decrement
(*p < .05)
Your Text here
Your Text here
Your Text hereYour Text here
Your Text here
Your Text here
Your Text here
Your Text here
Your Text here
Your Text here
Your Text here Your Text here Your Text here
Your Text here
Your Text here
Your Text here
Your Text here
Text
Your Text here Your Text here Your Text here
Your Text here Your Text hereYour Text here
Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore eu feugiat nulla facilisis .
Your Text here
Your Text here
Your Text here
Your Text
Click to add text
•Add text 1•Add text 2
Your Text
Your Text
Your Text
Your Text
Your Text
Your Text
Add Title
TextText
TextText
TextText
TextText
TextText
TextText
Text 1 Text 2 Text 3 Text 4 Text 5 Text 6
Add text 1
Add text 2
Add text 3
Add text 4
Add text 5
1Click to add text
•Add text 1•Add text 2•Add text 3•Add text 4•Add text 5
2Click to add text
•Add text 1•Add text 2•Add text 3•Add text 4•Add text 5
3Click to add text
•Add text 1•Add text 2•Add text 3•Add text 4•Add text 5
12
34
5
88
30
10
30
20
30 6
523
25
33
0
20
40
60
80
100
120
A B
1
Your Text here
1
Your Text here
1
Your Text here
1Y
our Text here
Add Your Text here
Text 1
Text 2
Text 3
Text 4
Text 6Text 5