Combat & Casualty Care

Q1 2016

Military Magazines in the United States and Canada, Covering Combat and Casualty Care, first responders, rescue and medical products programs and news\Tactical Defense Media

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Page 29 of 35 28 | Combat & Casualty Care | Spring 2016 Med Device Betterment The National Center for Medical Readiness (NCMR) has played an integral role in tactical combat casualty care, with a keen focus on the use of tourniquets for battlefeld use. By COL (Ret.) Douglas "Boots" Hodge, Associate Director, Operational and Disaster Medicine, NCMR, Wright State Research Institute (WSRI) A s Associate Director of Operational and Disaster Medicine, my job is to continually perform research and keep up-to-date information on trauma and disaster medicine which the National Center for Medical Readiness (NCMR) uses to perform: education and training; modeling and simulation; consulting and management; and research, testing and evaluation. My primary focus is research and training in trauma care in the field medicine, pre-hospital care and en route care. I have has several areas of interest in medicine: How do we determine medical competency and how do we measure skill degradation in a perishable skill areas? I continue to work issues for counterfeit medical devices. NCMR is part of Wright State Research Institute (WSRI). It offers a realistic research and training environment set on over 50 acres in Fairborn, Ohio that uses unique props and realistic settings to duplicate the full range of hazardous materials, confined spaces, and civilian and military transportation-oriented wreckage for any potential emergency response personnel – from community groups and healthcare providers to law enforcement agencies and combat medics. NCMR also serves an applied research platform as well as a test bed for industry development and commercialization of disaster preparedness-related equipment and materials. NCMR provides a unique capability of curriculum development and delivery across the spectrum of adult learning. Distinct efforts are made to provide highest quality models and simulations. Tourniquet Evolution Prior to Sept 11th, military and civilian tourniquets were very limited and remained unchanged for about 40 years. They were generally not recommended except in last ditch efforts. While tourniquets have been around for centuries, the greatest breakthrough has been in the last 10 years with the introduction of the CAT and SOFT-T tourniquets. These revolutionary changes were the result of recognition that U.S. casualties and death during combat where tied to extremity hemorrhage. The end customers, Special Forces, developed their own designs, which eventually were supported by DoD R&D for improvements. They continued to evolve, making improvements in the windlass, widening the actual tourniquet material, sewing and catches. However, they are not foolproof. We continue to see failures when over- tightened, or not applied as recommended. The biggest problem today with quality is the continued introduction of counterfeit tourniquets that are intended to look exactly like the original ones. They were developed for the Air Soft Market, but rapidly were adopted by medics because they look identical to the original devices. Side by side most people can't tell the difference except for an expert and even then some can't tell them apart. The problem is counterfeit tourniquets break during actual use. There have been multiple reports in AHEAD OF THE CARE CURVE

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