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CONTENTS: 1. U.S. ARMY MEDEVAC CRITICAL CARE FLIGHT PARAMEDIC STANDARD MEDICAL OPERATING GUIDELINES 2. Tactical Evacuation After Action Report & Patient Care Record 3. INSTRUCTIONS: DA Form 4700 OP4, Tactical Evacuation (TACEVAC) After Action Report (AAR) and Patient Care Record (PCR) [MEDICAL RECORD-SUPPLEMENTAL MEDICAL DATA] 4. DD Form 1380 TACTICAL COMBAT CASUALTY CARE (TCCC) CARD 5. JOINT TRAUMA SYSTEM DEVELOPMENT, CONCEPTUAL FRAMEWORK, AND OPTIMAL ELEMENTS 6. The United States Military Joint Trauma System Assessment: A Report Commissioned by the US Central Command Surgeon Sponsored by Air Force Central Command A Strategic Document to Provide a Platform for Tactical Development (2018) INTRODUCTION This current set of medical guidelines has gone through some significant improvements since the original release in 2014 and were developed through a collaboration of Emergency Medicine professionals, experienced Flight Medics, Aeromedical Physician Assistants, Critical Care Nurses, and Flight Surgeons. There has been close coordination in the development of these guidelines by the Joint Trauma System, Committee of En Route Combat Casualty Care and the Committee of Tactical Combat Casualty Care. Our shared goal is to ensure excellent en route care that is standard across all evacuation and emergency medical pre-hospital units. It is our vision that all of these enhancements and improvements will advance en route care across the services and the Department of Defense. The CCFP Program Office facilitates appropriate training and medical education to the CCFP providers. The CCFP program of instruction ensures the appropriate skills and knowledge required for CCFPs to apply these medical guidelines during aeromedical evacuation. Unit medical trainers and medical directors should evaluate CCFPs ability to follow and execute the medical instructions herein. These medical guidelines are intended to guide Critical Care Flight Paramedics (CCFP) and prehospital professionals in the response and management of emergencies and the care and treatment of patients in both garrison and theater of war environments. Unit medical providers are not expected to employ these guidelines blindly. Unit medical providers are expected to manipulate and adjust these guidelines to their unit’s mission and medical air crew training / experience. Medical directors or designated supervising physicians should endorse these guidelines as a baseline, appropriately adjust components as needed, and responsibly manage individual unit medical missions within the scope of practice of their Critical Care Flight Paramedics, Enroute Critical Care Nurses, and advanced practice aeromedical providers.
CONTENTS: 1. U.S. ARMY MEDEVAC CRITICAL CARE FLIGHT PARAMEDIC STANDARD MEDICAL OPERATING GUIDELINES - CY20 Version Published January 2020, 278 pages 2. TCCC Guidelines for Medical Personnel - 1 August 2019, 24 pages 3. Joint Trauma System Clinical Practice Guideline Special Edition v2.0 - Management of COVID-19 in Austere Operational Environments (Prehospital & Prolonged Field Care) - 28 May 2020, 40 pages 4. DoD C-19 PRACTICE MANAGEMENT GUIDE - Clinical Management of COVID-19, 124 pages 5. COVID-19 Considerations in the Deployed Setting (Presentation) - 27 May 2020, 35 pages INTRODUCTION The STANDARD MEDICAL OPERATING GUIDELINES (SMOG) continues to go through significant improvements with each release as a result of the collaboration of Emergency Medicine professionals, experienced Flight Medics, Aeromedical Physician Assistants, Critical Care Nurses, and Flight Surgeons. There has been close coordination in the development of these guidelines by the Joint Trauma System, and the Defense Committees on Trauma. Our shared goal is to ensure the highest quality en route care possible and to standardize care across all evacuation and emergency medical pre-hospital units. It is our vision that all of these enhancements and improvements will advance en route care across the services and the Department of Defense. Unit medical trainers and medical directors should evaluate Critical Care Flight Paramedics (CCFP) ability to follow and execute the medical instructions herein. These medical guidelines are intended to guide CCFPs and prehospital professionals in the response and management of emergencies and the care and treatment of patients in both garrison and combat theater environments. Unit medical providers are not expected to employ these guidelines blindly. Unit medical providers are expected to manipulate and adjust these guidelines to their unit’s mission and medical air crew training / experience. Medical directors or designated supervising physicians should endorse these guidelines as a baseline, appropriately adjust components as needed, and responsibly manage individual unit medical missions within the scope of practice of their Critical Care Flight Paramedics, Enroute Critical Care Nurses, and advanced practice aeromedical providers. The medication section of this manual is provided for information purposes only. CCFPs may administer medications only as listed in the guidelines unless their medical director (supervising physician) orders a deviation. Other medications may be added, so long as the unit supervising physician and/or medical director approves them. This manual also serves as a reference for physicians providing medical direction and clinical oversight to the CCFP. Treatment direction, which is more appropriate to the patient’s condition than the guideline, should be provided by the physician as long as the CCFP scope of practice is not exceeded. Any medical guideline that is out of date or has been found to cause further harm will be updated or deleted immediately. The Medical Evacuation Concepts and Capabilities Division (MECCD) serves as the managing editor of the SMOG and are responsible for content updates, managing the formal review process, and identifying review committee members for the annual review. The Standard Medical Operating Guidelines are intended to provide medical procedural guidance and is in compliment to other Department of Defense and Department of the Army policies, regulatory and doctrinal guidance. Nothing herein overrides or supersedes laws, rules, regulation or policies of the United States, DoD or DA.
CONTENTS: 1. U.S. ARMY AEROMEDICAL EVACUATION CRITICAL CARE FLIGHT PARAMEDIC STANDARD MEDICAL OPERATING GUIDELINES - CY23 Version Published January 2023, 318 pages 2. TCCC Guidelines for Medical Personnel - 15 December 2021, 19 pages 3. JTS Clinical Practice Guidelines, 2,260 total pages - current as of 19 September 2023: INTRODUCTION The SMOG continues to go through significant improvements with each release as a result of the collaboration of Emergency Medicine professionals, experienced Flight Medics, Aeromedical Physician Assistants, Critical Care Nurses, and Flight Surgeons. There has been close coordination in the development of these guidelines by the Joint Trauma System, and the Defense Committees on Trauma. Our shared goal is to ensure the highest quality en route care possible and to standardize care across all evacuation and emergency medical pre-hospital units. It is our vision that all of these enhancements and improvements will advance en route care across the services and the Department of Defense. Unit medical trainers and medical directors should evaluate Critical Care Flight Paramedics (CCFP) ability to follow and execute the medical instructions herein. These medical guidelines are intended to guide CCFPs and prehospital professionals in the response and management of emergencies and the care and treatment of patients in both garrison and combat theater environments. Unit medical providers are not expected to employ these guidelines blindly. Unit medical providers are expected to manipulate and adjust these guidelines to their unit’s mission and medical air crew training / experience. Medical directors or designated supervising physicians should endorse these guidelines as a baseline, appropriately adjust components as needed, and responsibly manage individual unit medical missions within the scope of practice of their Critical Care Flight Paramedics, Enroute Critical Care Nurses, and advanced practice aeromedical providers. The medication section of this manual is provided for information purposes only. CCFPs may administer medications only as listed in the guidelines unless their medical director and/or supervising physician orders a deviation. Other medications may be added, so long as the unit supervising physician and/or medical director approves them. This manual also serves as a reference for physicians providing medical direction and clinical oversight to the CCFP. Treatment direction, which is more appropriate to the patient’s condition than the guideline, should be provided by the physician as long as the CCFP scope of practice is not exceeded. Any medical guideline that is out of date or has been found to cause further harm will be updated or deleted immediately. The Medical Evacuation Concepts and Capabilities Division (MECCD) serves as the managing editor of the SMOG and are responsible for content updates, managing the formal review process, and identifying review committee members for the annual review. The Standard Medical Operating Guidelines are intended to provide medical procedural guidance and is in compliment to other Department of Defense and Department of the Army policies, regulatory and doctrinal guidance. Nothing herein overrides or supersedes laws, rules, regulation or policies of the United States, DoD or DA.
The definitive treatment on the medical evacuation and management of injured patients in both peace- and wartime. Edited by eminent experts in the field, this text brings together medical specialists from all four branches of the armed services. It discusses the history of aeromedical evacuation, triage and staging of the injured patient, evacuation from site of injury to medical facility, air-frame capabilities, medical capabilities in-flight, response to in-flight emergencies, and mass emergency evacuation. Specific medical conditions are addressed in detail, including such general surgical casualties as abdominal wounds and soft tissue, vascular, maxillofacial, head and spinal cord injuries, ophthalmologic, orthopaedic, pediatric, obstetric-gynecologic casualties, burns, and more. Over 80 illustrations provide a review of transport equipment and both medical and surgical treatment. A must-have reference for all armed forced physicians and flight surgeons, for general and trauma surgeons, internists, intensive care specialists, orthopaedic surgeons, and public health service physicians.
This book provides a comprehensive overview of damage control resuscitation (DCR), an evidence-based approach to the resuscitation of patients with severe life-threatening hemorrhage (LTH). It focuses on both civilian and military applications as DCR is utilized in civilian trauma situations as well as combat casualty care settings. The book covers the history of fluid resuscitation for bleeding, epidemiology of severe traumatic injuries, prediction of life-threatening hemorrhage, pathophysiology and diagnosis of blood failure, and permissive hypotension. Chapters provide in-depth detail on hemostatic resuscitation principles, dried plasma, dried platelet surrogates, and recent developments in frozen red blood cells and oxygen carriers. The book also discusses how DCR principles can be used in a variety of situations such as when there are large numbers of patients with hemorrhagic lesions, non-trauma scenarios, and on distinct populations such as children. Finally, it concludes with a discussion of training and education methods for the implementation of DCR and remote DCR principles as well as learning healthcare system principles to facilitate the implementation of DCR and ultimately improve outcomes for patients with life-threatening hemorrhage. Damage Control Resuscitation: Identification and Treatment of Life-Threatening Hemorrhage is an essential resource for physicians and related professionals, residents, nurses and medical students in emergency medicine, anesthesia, surgery, and critical care, as well as civilian and military EMS providers.
This book provides a systemic approach to acute trauma care in line with the ABCDE paradigm and up-to-date information on assessing and managing major trauma from the pre-hospital to the rehabilitation phase. The book's early sections are dedicated to identifying and managing pathology caused by massive haemorrhage, airway, breathing, circulation or neurological trauma and examining the current evidence base relating to their management. The book then builds from fundamental skills to advanced interventions so that each level of responder can identify and implement aspects of clinical practice that will be of benefit to them at their stage. This approach also explains advanced interventions that may be executed subsequently, explaining how each phase of care sits together. This has a further benefit of producing seamless care for patients by practitioners of different levels using this book as a reference point. Later sections deal with specifics of in-hospital trauma care by speciality, including the explanation of decision making processes by specialities, use of diagnostic and interventional radiology, rehabilitation and psychological aspects of trauma care. The Textbook of Acute Trauma Care also focuses on non-clinical issues relevant to trauma such as training and logistics of retrieval and repatriation, aviation considerations in HEMS, legal and forensic evidence considerations and ethical issues dealing with trauma patients. In addition, the book contains chapters from international experts on cognitive and human factors relating to healthcare and suggests strategies for training and minimising errors. This book is an essential resource for all grades of practitioner, from first responders to Consultant/Attending Physician level providers.
The purpose of the handbook is to provide these medical professionals a printed resource that outlines the latest techniques and procedures used by the US Army Medevac and critical care flight paramedic communities.
ADP 3-0, Operations, constitutes the Army's view of how to conduct prompt and sustained operations across multiple domains, and it sets the foundation for developing other principles, tactics, techniques, and procedures detailed in subordinate doctrine publications. It articulates the Army's operational doctrine for unified land operations. ADP 3-0 accounts for the uncertainty of operations and recognizes that a military operation is a human undertaking. Additionally, this publication is the foundation for training and Army education system curricula related to unified land operations. The principal audience for ADP 3-0 is all members of the profession of arms. Commanders and staffs of Army headquarters serving as joint task force (JTF) or multinational headquarters should also refer to applicable joint or multinational doctrine concerning the range of military operations and joint or multinational forces. Trainers and educators throughout the Army will use this publication as well.
A story of equipment failures, bad luck, poor planning and unbelievable courage written 25 years after the battle, this new book by Leigh Neville reveals the hard-hitting truth of what happened minute by minute in the dusty streets of Mogadishu. On October 3, 1993, Task Force Ranger was dispatched to seize two high-profile lieutenants of a Somali warlord. Special Forces troops were transported by ground vehicles and helicopters, and the mission was meant to be over within the hour. They quickly found themselves under heavy fire, and two Black Hawk helicopters were shot down. With a hastily organized relief column many hours away, the American troops faced a desperate battle for survival. Focusing on the stories of the soldiers on the ground, and in the air, Day of the Rangers reveals the experiences and recollections of the Special Forces units, including the Rangers, Delta operators and Nightstalker crews who fought in the battle of Mogadishu. Published to mark the battle's 25th anniversary and using recently declassified documents and new interviews with many of the participants, Day of the Rangers is a fascinating and revealing new history of a battle that would influence American Special Forces for decades to come.