nmcp combat trauma research group lanny littlejohn, md cdr mc (fs/dmo) usn research director, ctrg...
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NMCP Combat Trauma Research Group
Lanny Littlejohn, MDCDR MC (FS/DMO) USNResearch Director, CTRGMedical Director, TCCCNMCP Dept of Emergency Medicine
Group Structure and Mission
• Composed of 3-4 staff EM physicians– 1-2 deployed or in fellowship at any given time
• Residents interested in contributing to preclinical literature
• Three areas of focus– Prehospital and early resuscitative phase– Bridging between preclinical and clinical via
protocols with fidelity to actual casualty Tx– Support the mission of the residency program
• Wide range of research questions so less expertise in any one area.
Recent and upcoming protocols• 4 hemostatic agent studies completed
– Henao– Kozen– Devlin– Littlejohn
• 1 hemostatic agent study planned (May 2012)• Supraglottic airway and TQ study just completed in
TCCC class• Vented Chest Seals• HBOC/HTS ongoing• Arginine Vasopressin
• Tranexamic Acid
Hemostatic Agents
• Experience primarily in the Alam model WRT injury
• Open and limited access models– CELOX equal efficacy (QC and Hemcon) open
model– All agents similar if pressure dressing
appropriately used– Kerlix effective in small wounds with firm
packing
• Adopted Kheirabadi model after standardization meeting (upcoming protocol)
The Effectiveness of Navy Hospital Corpsman in Applying TCCC Recommended Prehospital Tourniquets under Simulated Combat Stress(CIP # 2011-0074)
Richard H. Schreckengaust, MDLCDR MC (UMO/DMO) USNEmergency Medicine ResidentNMCP Dept of Emergency Medicine
Design TimelineDesign Timeline
Day1 Day4 Day5
Baseline End of Training Field Test
Randomized, Cross-Over Design• Each HM applied CAT and SoftT
• At each Timepoint
Training
Classroom Setting •Initial Briefing•Minimal Stress
Classroom Setting •Minimal Stress
Field Setting•High Stress
•Obstacle Course•Care under Fire•Flak, Helmet, Mask
Dependent Variables•Time•Pulse•Placement
Results - PulseResults - Pulse
• CAT v SOFT-T*• 30% diff (2x
rate)• Training Effect*
– 15% improvement• Care Under Fire
– 5% decrement
(*p < .05)
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