By William Sallette, Tripler Army Medical CenterMay 15, 2017
HONOLULU-- (May 12, 2017) When it comes to treating a patient that has received a traumatic injury on the battlefield, timing really does matter. What is commonly referred to as the 'Golden Hour', is the short amount of time immediately following a traumatic injury in which medical treatment is most effective to prevent irreversible internal damage and optimize the chance of survival.
For years the idea of 'load-and-go' was the best method to ensure the chances of survival. This means that the patient would be evacuated immediately. However, land operations in an unknown battlefield may require field care for hours or even days. This is why Tripler Army Medical Center has instituted training for Delayed Evacuation Casualty Management course (DECM).
"In the last eight years I have been deployed to places such as Columbia and central and west Africa where air evacuation was not readily available and Soldiers sustained severe injuries and many needed whole blood products to sustain life," said Command Sgt. Maj. Uriah S. Popp, United States Army Medical and Dental Activity Alaska Command Sgt. Maj. and creator of the course. "These injuries required immediate care, but evacuation was extended to 12 or more hours in many cases. This is where training like this comes in to play."
The course is designed to extend the life of a patient on the battlefield by up to 90 hours. This is extremely important as Soldiers are often in places where evacuation may not always be readily available or possible.
"This is incredible training for our Medics who must be able to sustain life on the battlefield far past the 'Golden Hour'," said TAMC Command Sgt. Maj. Timothy Sloan. "Command Sgt. Maj. Popp and his outstanding noncommissioned officers have developed a comprehensive program that takes our current annual medic training requirements and expands on those skills exponentially."
The course focuses on training Combat Medics and Practical Nursing Specialist on life saving techniques such as working with ventilators, whole blood transfusions, long term pain management and tele-health.
The intent of DECM is not to change current Army doctrine or current treatment procedures, but to provide combat medics and practical nurses with critical care concepts that prepare them to stabilize and sustain a casualty in an extended care scenario before casualty evacuation.
"We have to be proactive in our training," said Popp. "With today's current deployment environment and our activities in overseas contingency operations where immediate evacuation may not be readily available, it's necessary for our Soldiers to be trained to take care of a patient for an extended amount of time."
This type of care is not a new concept. The Special Operations Forces community has already developed many similar procedures for prolonged care and much of the DECM course was based on the special operations Tactical Trauma Medical Emergency Protocols, evidenced based nursing care practices and a result of the best practices developed by the Special Operations Command (SOCOM) Prolonged Filed Care (PFC).
"Our end goal is to develop Army Medics who possess the critical thinking skills and technical knowledge to sustain life in austere environments with minimal resources over an extended period of time when evacuation platforms are not available," said Sloan.