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Prehospital Interventions During Mass-Casualty Events in Afghanistan: A Case Analysis

Published online by Cambridge University Press:  03 May 2017

Steven G. Schauer Open the ORCID record for Steven G. Schauer [Opens in a new window] ,
Michael D. April ,
Erica Simon ,
Joseph K. Maddry ,
Robert Carter III  and
Robert A. Delorenzo
Steven G. Schauer*
Affiliation:
US Army Institute of Surgical Research, JBSA Fort Sam Houston, TexasUSA San Antonio Military Medical Center, JBSA Fort Sam Houston, TexasUSA
Michael D. April
Affiliation:
San Antonio Military Medical Center, JBSA Fort Sam Houston, TexasUSA
Erica Simon
Affiliation:
San Antonio Military Medical Center, JBSA Fort Sam Houston, TexasUSA
Joseph K. Maddry
Affiliation:
San Antonio Military Medical Center, JBSA Fort Sam Houston, TexasUSA US Air Force 59th Medical Wing, JBSA Fort Sam Houston, TexasUSA
Robert Carter III
Affiliation:
US Army Institute of Surgical Research, JBSA Fort Sam Houston, TexasUSA
Robert A. Delorenzo
Affiliation:
University of Texas Health Sciences Center at San Antonio, San Antonio, TexasUSA
*
Correspondence: Steven G. Schauer, DO, RDMS 3698 Chambers Pass Road Fort Sam Houston, Texas 78234 USA E-mail: [email protected]
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Abstract

Background

Mass-casualty (MASCAL) events are known to occur in the combat setting. There are very limited data at this time from the Joint Theater (Iraq and Afghanistan) wars specific to MASCAL events. The purpose of this report was to provide preliminary data for the development of prehospital planning and guidelines.

Methods

Cases were identified using the Department of Defense (DoD; Virginia USA) Trauma Registry (DoDTR) and the Prehospital Trauma Registry (PHTR). These cases were identified as part of a research study evaluating Tactical Combat Casualty Care (TCCC) guidelines. Cases that were designated as or associated with denoted MASCAL events were included.

Data

Fifty subjects were identified during the course of this project. Explosives were the most common cause of injuries. There was a wide range of vital signs. Tourniquet placement and pressure dressings were the most common interventions, followed by analgesia administration. Oral transmucosal fentanyl citrate (OTFC) was the most common parenteral analgesic drug administered. Most were evacuated as “routine.” Follow-up data were available for 36 of the subjects and 97% were discharged alive.

Conclusions

The most common prehospital interventions were tourniquet and pressure dressing hemorrhage control, along with pain medication administration. Larger data sets are needed to guide development of MASCAL in-theater clinical practice guidelines.

SchauerSG, AprilMD, SimonE, MaddryJK, CarterR III, DelorenzoRA. Prehospital Interventions During Mass-Casualty Events in Afghanistan: A Case Analysis. Prehosp Disaster Med. 2017;32(4):465–468.

Keywords

AfghanistancombatMASCALmass casualtymilitary
Type
Brief Report
Information
Prehospital and Disaster Medicine , Volume 32 , Issue 4 , August 2017 , pp. 465 - 468
Copyright
© World Association for Disaster and Emergency Medicine 2017 

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Footnotes

Conflicts of interest/disclaimer: Opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Air Force (Washington, DC USA), the Department of the Army (Carlisle, Pennsylvania), or the Department of Defense (Virginia USA).

References

1. Butler, FK Jr., Hagmann, J, Butler, EG. Tactical combat casualty care in special operations. Mil Med. 1996;161(Suppl):3-16.Google Scholar
2. Blackbourne, LH, Baer, DG, Eastridge, BJ, et al. Military medical revolution: prehospital combat casualty care. J Trauma Acute Care Surg. 2012;73(6 Suppl 5):S372-S377.CrossRefGoogle ScholarPubMed
3. El Sayed, M, Tamim, H, Mann, NC. Description of medication administration by Emergency Medical Services during mass-casualty incidents in the United States. Prehosp Disaster Med. 2016;31(2):141-149.Google Scholar
4. El Sayed, M, Tamim, H, Mann, NC. Description of procedures performed on patients by Emergency Medical Services during mass-casualty incidents in the United States. Am J Emerg Med. 2015;33(8):1030-1036.Google Scholar
5. Schenk, E, Wijetunge, G, Mann, NC, et al. Epidemiology of mass-casualty incidents in the United States. Prehosp Emerg Care. 2014;18(3):408-416.CrossRefGoogle ScholarPubMed
6. Repine, TB, Lisagor, P, Cohen, DJ. The dynamics and ethics of triage: rationing care in hard times. Mil Med. 2005;170(6):505-509.Google Scholar
7. Baker, MS. Creating order from chaos: Part I: triage, initial care, and tactical considerations in mass casualty and disaster response. Mil Med. 2007;172(3):232-236.CrossRefGoogle ScholarPubMed
8. Baker, MS. Creating order from chaos: Part II: tactical planning for mass casualty and disaster response at definitive care facilities. Mil Med. 2007;172(3):237-243.Google Scholar
9. Beekley, AC. Mass casualties in combat: lessons learned. J Trauma. 2007;62(6 Suppl):S39-S40.Google Scholar