Task Analysis Tool to Evaluate Tactical Combat Casualty Care in the Extreme Cold

Due to the evolving geopolitical strategy of near-peer nations, there has been a growing national interest in the Arctic region. However, Tactical Combat Casualty Care (TCCC) assessments and interventions have been shaped based on input from conflicts such as Iraq and Afghanistan. They do not consider the unique factors seen in extreme cold environments. Naval Medical Research Unit San Antonio has developed a task analysis tool, the Task Step Analysis Tool-Binary (TSAT-B), to evaluate the effects of extreme cold on tasks within the current TCCC protocols. The tool was pilot-tested using a trauma manikin in field environments in Alaska, with temperatures ranging from -2 to -35°C. As part of the TSAT-B, task steps are graded into three categories (provider, casualty, and procedure). Steps are timed, and hand temperature is measured before and after a task. Written and verbal feedback is used to enhance the binary (go/nogo) two-alternative forced-choice. The TSAT-B has proven to be a useful evaluation tool and is being offered to standardize how current TCCC protocols and proposed changes are evaluated.