FORT BENNING, Ga. - - Medical Soldiers from Fort Benning recently learned how to improve the long-range care casualties receive before they can be evacuated to appropriate medical facilities. The Soldiers completed the Delayed Evacuation Casualty Management Course (DECM) on Fort Benning June 27- July 1, 2022 and July 25 –Aug. 5, 2022.
The DECM five-day courses covered instructional and hands-on training to mitigate the combat casualty lethal triad. The “lethal triad” is a combination of coagulopathy, acidosis and hypothermia. These things will lead to a fatality very fast.
This training provides our medics with “an opportunity to refine their tactical combat casualty care from point of injury to the stage of prolonged casualty care, said Maj. James D. Jones, Martin Army Community Hospital Physician and Medical Control Officer for the DECM training. “This is a continuum of care that can start as early as the first minutes to hours after point of injury care.”
The Army expects to change from insurgent-focused operations to large-scale combat operations with near-peer adversaries that may challenge the fast casualty evacuation abilities we have enjoyed during recent conflicts. In future conflicts, remote geography and low-tier medical facilities are expected to delay casualty evacuations. Army medics will need to expand their level of training to care for casualties for a longer time anticipating delays in movement of injured service members’ to higher-level care facilities.
“It’s intended to refine our care for casualties that are not evacuated within a 24-hour window”, Jones said.
The courses covered classes directed at mitigating the “lethal triad” in combat casualties.
The lethal triad is a combination of coagulopathy, acidosis and hypothermia. Failure to address the triad will quickly lead to increased mortality in a combat casualty. DECM training will help prevent fatalities. “The lethal triad encompasses both a reversible cause of increased mortality as well as possible iatrogenic or medic inflicted cause of further insult to the already injured patient", Jones said.
Treatments that DECM will enable are extended care that will go beyond the expected 20-minute evacuation time to 2-3 days, or more.
“There is a good chance [medics] will be with a patient for a long time; which means now you are going to have to consider much further beyond tourniquets and IVs”, said Sgt. Kayla-Ann L. Guevara, Consolidated Troop Medical Clinic and DECM Course Coordinator.
The DECM course allows Army medics to move beyond Tactical Combat Casualty Care into the realm of Nursing Care so that casualties have fewer long-term medical consequences and an increased chance of survival. During these courses, “we trained 23 medics for a total of over 700 continuing education hours”, Jones said.