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Related Experiment Videos

Clinical practice guideline adherence during Operation Inherent Resolve.

Timothy P Plackett1, Darren C Cherry, Gerald Delk

  • 1Womack Army Medical Center (T.P.P.), Fort Bragg, North Carolina; Robert E. Bush Naval Hospital (D.C.C.), Naval Medical Center Portsmouth, Portsmouth, Virginia; Cedar Park Medical Center (G.D.), Austin, Texas; Bassett Army Community Hospital (S.S.), Fort Wainwright, Arkansas; Tripler Army Medical Center (J.T.), Honolulu, Hawaii; William Beaumont Army Medical Center (D.M.), Fort Bliss, Texas; Martin Army Community Hospital (J.M.), Fort Benning, GA; and Joint Trauma System (S.A.S.), Fort Sam Houston, Texas.

The Journal of Trauma and Acute Care Surgery
|April 7, 2017
PubMed
Summary

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Military trauma guidelines show significant adherence gaps in current operations. This study highlights variability in following clinical practice guidelines (CPGs) for battlefield injuries, impacting care consistency.

Area of Science:

  • Military Medicine
  • Trauma Surgery
  • Public Health

Background:

  • Joint Trauma System (JTS) clinical practice guidelines (CPGs) have reduced battlefield mortality.
  • Adherence to these CPGs in current military operations remains largely unassessed.

Purpose of the Study:

  • To evaluate the adherence to JTS CPGs in a deployed military medical setting.
  • To identify variations in the application of battlefield trauma care recommendations.

Main Methods:

  • Retrospective review of 114 trauma patient records from US Army Role II facilities during Operation Inherent Resolve.
  • Assessment of patient demographics, clinical care, outcomes, and compliance with JTS CPGs and Tactical Combat Casualty Care (TCCC) recommendations.

Main Results:

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  • High adherence (97%) to hypothermia treatment recommendations.
  • Low adherence for initial resuscitative fluid (41%), antibiotic prophylaxis (40% intra-abdominal), and calcium administration (40%).
  • Significant variability in guideline adherence was observed among individual surgeons.

Conclusions:

  • There is substantial deviation from established clinical practice guidelines in current military trauma care.
  • Variability in adherence suggests a need for improved implementation and consistent application of battlefield trauma protocols.