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Prehospital Interventions During Mass-Casualty Events in Afghanistan: A Case Analysis

  • Steven G. Schauer (a1) (a2), Michael D. April (a2), Erica Simon (a2), Joseph K. Maddry (a2) (a3), Robert Carter (a1) and Robert A. Delorenzo (a4)...
Abstract
Background

Mass-casualty (MASCAL) events are known to occur in the combat setting. There are very limited data at this time from the Joint Theater (Iraq and Afghanistan) wars specific to MASCAL events. The purpose of this report was to provide preliminary data for the development of prehospital planning and guidelines.

Methods

Cases were identified using the Department of Defense (DoD; Virginia USA) Trauma Registry (DoDTR) and the Prehospital Trauma Registry (PHTR). These cases were identified as part of a research study evaluating Tactical Combat Casualty Care (TCCC) guidelines. Cases that were designated as or associated with denoted MASCAL events were included.

Data

Fifty subjects were identified during the course of this project. Explosives were the most common cause of injuries. There was a wide range of vital signs. Tourniquet placement and pressure dressings were the most common interventions, followed by analgesia administration. Oral transmucosal fentanyl citrate (OTFC) was the most common parenteral analgesic drug administered. Most were evacuated as “routine.” Follow-up data were available for 36 of the subjects and 97% were discharged alive.

Conclusions

The most common prehospital interventions were tourniquet and pressure dressing hemorrhage control, along with pain medication administration. Larger data sets are needed to guide development of MASCAL in-theater clinical practice guidelines.

Schauer SG , April MD , Simon E , Maddry JK , Carter R III , Delorenzo RA . Prehospital Interventions During Mass-Casualty Events in Afghanistan: A Case Analysis. Prehosp Disaster Med. 2017;32(4):465468.

Copyright
Corresponding author
Correspondence: Steven G. Schauer, DO, RDMS 3698 Chambers Pass Road Fort Sam Houston, Texas 78234 USA E-mail: steven.g.schauer.mil@mail.mil
Footnotes
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Conflicts of interest/disclaimer: Opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Air Force (Washington, DC USA), the Department of the Army (Carlisle, Pennsylvania), or the Department of Defense (Virginia USA).

Footnotes
References
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Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
  • URL: /core/journals/prehospital-and-disaster-medicine
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