1. NMCP Combat Trauma Research Group
Lanny Littlejohn, MD
CDR MC (FS/DMO) USN
Research Director, CTRG Medical Director, TCCC
NMCP Dept of Emergency Medicine

2. 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.

3. 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

4. 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)

5. The Effectiveness of Navy Hospital Corpsman in Applying TCCC Recommended Prehospital Tourniquets under Simulated Combat Stress (CIP # )
Richard H. Schreckengaust, MD
LCDR MC (UMO/DMO) USN
Emergency Medicine Resident
NMCP Dept of Emergency Medicine

6. Design Timeline Baseline End of Training Field Test Training Day1 Day4
Classroom Setting
Initial Briefing
Minimal Stress
Classroom Setting
Minimal Stress
Field Setting
High Stress
Obstacle Course
Care under Fire
Flak, Helmet, Mask
Study timeline
Subjects served as their own control in a cross over design
Randomized, Cross-Over Design
Each HM applied CAT and SoftT
At each Timepoint
Dependent Variables
Time
Pulse
Placement

7. Results - Pulse CAT v SOFT-T* 30% diff (2x rate) Training Effect*
15% improvement
Care Under Fire
5% decrement
(*p < .05)

8. Questions?

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