Casualty evacuation in arctic and extreme cold environments: A paradigm shift for traumatic hypothermia management in tactical combat casualty care

ABSTRACTIn Arctic or extreme cold environments of Alaska, trauma care is complicated by large expanses of geography and lack of forward-positioned resources. This paper presents four hypothetical vignettes highlighting austere cold medical priorities: (1) traumatic hypothermia management as part of...

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Bibliographic Details
Published in:International Journal of Circumpolar Health
Main Author: Titus J. Rund
Format: Article in Journal/Newspaper
Language:English
Published: Taylor & Francis Group 2023
Subjects:
CASEVAC Ecosystem
Tactical Combat Casualty Care (TCCC)
Triad of death
MARCH change to MhARCH
Casualty Protection Unit (CPU) & Casualty Collection Point (CCP)
Traumatic hypothermia
Arctic medicine. Tropical medicine
RC955-962
Arctic
Circumpolar Health
International Journal of Circumpolar Health
Alaska
Online Access:https://doi.org/10.1080/22423982.2023.2196047
https://doaj.org/article/2369fd41915b4cf1b11a8d2a01bb20f2
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Summary:ABSTRACTIn Arctic or extreme cold environments of Alaska, trauma care is complicated by large expanses of geography and lack of forward-positioned resources. This paper presents four hypothetical vignettes highlighting austere cold medical priorities: (1) traumatic hypothermia management as part of Tactical Combat Casualty Care (TCCC) is clinically and tactically important and hypothermia needs to be reprioritized in the MARCH algorithm to MhARCH; (2) at present it is unknown which TCCC recommended medical equipment/supplies will function as designed in the extreme cold; (3) ensuring advanced resuscitative care measures are available serves as a temporal bridge until casualties can receive damage control resuscitation (DCR); and (4) current systems for managing traumatic hypothermia in TCCC and casualty evacuation (CASEVAC) are insufficient. In conclusion, numerous assessments recognise the DoD’s current solutions for employing medical forces in Arctic operations are not optimally postured to save lives. There should be a joint standard for fielding an arctic supplement to current medical equipment sets. A new way of thinking in terms of an “ecosystem” approach of immediate casualty protection and movement in CASEVAC doctrine is needed to optimise these “Golden Minutes.”

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