Cerebral blood flow changes during palpation of external airway structures in healthy volunteers.

Introduction: Previous studies demonstrate increased intracranial pressure (ICP) during direct laryngoscopy in patients with traumatic brain injury (TBI). Worse outcomes in TBI have been associated with increased ICP. It remains unclear if the same effect occurs during cricothyrotomy.

Battlefield Analgesia: Adherence to Tactical Combat Casualty Care Guidelines.

Background: Low rates of prehospital analgesia, as recommended by Tactical Combat Casualty Care (TCCC) guidelines, have been demonstrated in the Joint Theaters combat setting. The reasons for this remain unclear. This study expands on previous reports by evaluating a larger prehospital dataset for determinants of analgesia administration.

The Prehospital Trauma Registry Experience With Intraosseous Access.

Background: Peripheral intravenous (IV) cannulation is often difficult to obtain in a patient with hemorrhagic shock, delaying the appropriate resuscitation of critically ill patients. Intraosseous (IO) access is an alternative method. To date, few data exist on use of this procedure by ground forces in Afghanistan.

Prehospital Resuscitation Performed on Hypotensive Trauma Patients in Afghanistan: The Prehospital Trauma Registry Experience.

Introduction: Hemorrhage is the leading cause of potentially preventable death on the battlefield. Hypotension in the setting of trauma portends a higher rate of mortality. We describe the interventions for trauma-related hypotension performed in the prehospital combat setting in accordance with Tactical Combat Casualty Care (TCCC) guidelines.

Prehospital Administration of Antibiotic Prophylaxis for Open Combat Wounds in Afghanistan: 2013-2014.

Background: Military operations place injured Servicemembers at high risk for open wounds. Austere environments and initial wound contamination increase the risk for infection. Wound infections continue to cause significant morbidity among injured Servicemembers.

A randomized cross-over study comparing surgical cricothyrotomy techniques by combat medics using a synthetic cadaver model.

Objective: Cricothyrotomy is a complex procedure with a high rate of complications including failure to cannulate and injury to adjacent anatomy. The Control-Cric™ System and QuickTrach II™ represent two novel devices designed to optimize success and minimize complications with this procedure. This study compares these two devices against a standard open surgical technique.

Chest Seal Placement for Penetrating Chest Wounds by Prehospital Ground Forces in Afghanistan.

Background: Thoracic trauma represents 5% of all battlefield injuries. Communicating pneumothoraces resulting in tension physiology remain an important etiology of prehospital mortality. In addressing penetrating chest trauma, current Tactical Combat Casualty Care (TCCC) guidelines advocate the immediate placement of a vented chest seal device.

QuikClot® Combat Gauze® Use by Ground Forces in Afghanistan The Prehospital Trauma Registry Experience.

Background: QuikClot® Combat Gauze® (QCCG) was fielded in 2008 to replace previous generations of hemostatic products. To the best of our knowledge, despite nearly a decade of use, there are no published data on use among US combatant forces. We describe the use of QCCG by ground forces in Afghanistan and compare patients who received QCCG compared with the remaining population in the database who did not receive QCCG.

Effect of pain and analgesia on compensatory reserve.

Background: The measurement of the body's capacity to compensate for reduced blood volume can be assessed with a compensatory reserve measurement (CRM). The CRM, which is calculated from changes in features of the arterial waveform, represents the integration of compensatory mechanisms during states of low tissue perfusion and oxygenation, such as hemorrhage. This study was designed to test the hypothesis that pain which activates compensatory mechanisms and analgesia that result in reduced blood pressure are associated with lower compensatory reserve.