210 likes | 515 Views
NMCP Combat Trauma Research Group. Lanny Littlejohn, MD CDR MC (FS/DMO) USN Research Director, CTRG Medical Director, TCCC NMCP 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
E N D
NMCP Combat Trauma Research Group Lanny Littlejohn, MD CDR MC (FS/DMO) USN Research Director, CTRGMedical Director, TCCC NMCP 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, MD LCDR MC (UMO/DMO) USN Emergency Medicine Resident NMCP Dept of Emergency Medicine
Design Timeline Baseline End of Training Field Test Training Day1 Day4 Day5 • Classroom Setting • Initial Briefing • Minimal Stress • Classroom Setting • Minimal Stress • Field Setting • High Stress • Obstacle Course • Care under Fire • Flak, Helmet, Mask • Randomized, Cross-Over Design • Each HM applied CAT and SoftT • At each Timepoint • Dependent Variables • Time • Pulse • Placement
Results - 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 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 here Your 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
Click to add text • Add text 1 • Add text 2 Your Text Your Text Your Text Your Text Your Text Your Text Your Text
Text Text Text Add Title Text Text Text
1 2 3 • Click to add text • Add text 1 • Add text 2 • Add text 3 • Add text 4 • Add text 5 • Click to add text • Add text 1 • Add text 2 • Add text 3 • Add text 4 • Add text 5 • Click to add text • Add text 1 • Add text 2 • Add text 3 • Add text 4 • Add text 5
1 1 1 1 Your Text here Your Text here Your Text here Your Text here Add Your Text here
Text 2 Text 3 Text 1 Text 4 Text 6 Text 5