TY - JOUR
T1 - Management of Hypothermia in Tactical Combat Casualty Care
T2 - TCCC Guideline Proposed Change 20-01 (June 2020)
AU - Bennett, Brad L.
AU - Giesbrect, Gordon
AU - Zafren, Ken
AU - Christensen, Ryan
AU - Littlejohn, Lanny F.
AU - Drew, Brendon
AU - Cap, Andrew P.
AU - Miles, Ethan A.
AU - Butler, Frank K.
AU - Holcomb, John B.
AU - Shackelford, Stacy A.
N1 - Publisher Copyright:
2020.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - As an outcome of combat injury and hemorrhagic shock, trauma-induced hypothermia (TIH) and the associated coagulopathy and acidosis result in significantly increased risk for death. In an effort to manage TIH, the Hypothermia Prevention and Management Kit™ (HPMK) was implemented in 2006 for battlefield casualties. Recent feedback from operational forces indicates that limitations exist in the HPMK to maintain thermal balance in cold environments, due to the lack of insulation. Consequently, based on lessons learned, some US Special Operations Forces are now upgrading the HPMK after short-term use (60 minutes) by adding insulation around the casualty during training in cold environments. Furthermore, new research indicates that the current HPMK, although better than no hypothermia protection, was ranked last in objective and subjective measures in volunteers when compared with commercial and user-assembled external warming enclosure systems. On the basis of these observations and research findings, the Committee on Tactical Combat Casualty Care decided to review the hypothermia prevention and management guidelines in 2018 and to update them on the basis of these facts and that no update has occurred in 14 years. Recommendations are made for minimal costs, low cube and weight solutions to create an insulated HPMK, or when the HPMK is not readily available, to create an improvised hypothermia (insulated) enclosure system.
AB - As an outcome of combat injury and hemorrhagic shock, trauma-induced hypothermia (TIH) and the associated coagulopathy and acidosis result in significantly increased risk for death. In an effort to manage TIH, the Hypothermia Prevention and Management Kit™ (HPMK) was implemented in 2006 for battlefield casualties. Recent feedback from operational forces indicates that limitations exist in the HPMK to maintain thermal balance in cold environments, due to the lack of insulation. Consequently, based on lessons learned, some US Special Operations Forces are now upgrading the HPMK after short-term use (60 minutes) by adding insulation around the casualty during training in cold environments. Furthermore, new research indicates that the current HPMK, although better than no hypothermia protection, was ranked last in objective and subjective measures in volunteers when compared with commercial and user-assembled external warming enclosure systems. On the basis of these observations and research findings, the Committee on Tactical Combat Casualty Care decided to review the hypothermia prevention and management guidelines in 2018 and to update them on the basis of these facts and that no update has occurred in 14 years. Recommendations are made for minimal costs, low cube and weight solutions to create an insulated HPMK, or when the HPMK is not readily available, to create an improvised hypothermia (insulated) enclosure system.
UR - http://www.scopus.com/inward/record.url?scp=85091551032&partnerID=8YFLogxK
M3 - Review article
C2 - 32969001
AN - SCOPUS:85091551032
SN - 1553-9768
VL - 20
SP - 21
EP - 35
JO - Journal of special operations medicine : a peer reviewed journal for SOF medical professionals
JF - Journal of special operations medicine : a peer reviewed journal for SOF medical professionals
IS - 3
ER -