Additional Reading

The crisis of today’s global war on terrorism and the rash of domestic tragedies nationwide continue to challenge virtually all aspects of our emergency response models. This level of violence targeting the civilian community is unprecedented in its encroachment upon our culture–from co-workers and teachers to law enforcement and first responders. This brutal reality is no longer a distant headline from a foreign battlefield or large urban area. It is a growing danger in our own backyard. We hope to empower you to confront the challenge by building this online archive of White Papers, Overviews and Case Studies. Please click the title to download the specific literature.

White Papers

Who Are We Failing?

As tactics pertaining to terrorism response, active shooters and counter-narcotics operations continue to evolve, the techniques of “casualty extraction” remain somewhat nonproductive and stagnant. Many of our teams, if called upon to save one of our own, would probably utilize traditional carries, tactics and movements which are proving to be ineffective and unrealistic, and may actually increase the risk of unnecessary operator injury and/or death.

SALT Triage System

It is recognized that there is a need for a national standard for mass casualty triage, as disasters frequently cross jurisdictional lines involving responders from multiple agencies. After reviewing all of the existing triage systems a consensus review panel found that there was insufficient evidence to support one system over the others. Using aspects of the existing systems and based on best evidence, SALT (Sort –Assess - Life Saving Interventions - Treatment and/or transport) was developed as a national all-hazards mass casualty initial triage standard for all patients (e.g., adults, children, special populations).

Rescue Human Factors™

The physiological and psychological demand placed on combatant and rescue personnel is typically unappreciated. Simple tasks can become both difficult and in some instances impossible to perform under survival stress.

Tactical Combat Casualty Care

TCCC launched a total reassessment of practices with one overarching goal: decrease preventable combat death at the point of wounding. These evolving strategies based on historical wounding patterns in combat also bear a particular relevance to the operators of Tactical Law Enforcement who share many operational parallels with their military counterparts. Instead of the civilian-based approaches of the past, integrated strategies specific to combat realities continue to emerge.

Overviews

Trauma Management: The Cold Facts of Secondary Hypothermia

Secondary hypothermia in trauma patients with a core temperature below 95°F is considered a poor prognostic sign... if under 89.6°F it is linked to 100% mortality.

Hemorrhage Control: What Makes an Effective Prehospital Emergency Tourniquet?

Temporary prehospital emergency tourniquets are life-saving devices that rarely cause complications when appropriately trained rescuers apply the devices correctly. Although the total time that a tourniquet remains in place is a major determinant of potential injury, an often-overlooked aspect is the design of the device itself. To understand why the C-A-T® (Combat Application Tourniquet®) by North American Rescue represents the optimal design for a temporary emergency tourniquet, one must understand how this device works...

Extraction: The Physics of Extraction

Traditionally, many rescuers attempt to “snatch and grab” a casualty in order to move them to a position of cover. Using this technique, a negative cascade of events is likely to occur.

Case Studies

Size Matters: High performance, low cube tools for emergency airway management

Since the first priority in emergency medicine is indeed airway management, airway tools should be at the top of the list for evaluation. In the case of pre-hospital trauma care, a unique set of variables must be addressed...

Post-Injury Hypothermia in Trauma: A Chilling Reality

Hypothermia is widely recognized as a lifethreatening complication, particularly in situations involving traumatic injury. Characterized by the decrease of core body temperature, it is progressive in nature and profoundly affects every system in the wounded patient.

Evidence Based Medicine: From the streets of Baghdad to the streets of our cities ...what can we learn?

The crisis of today's global realities has invoked revolutionary challenges in virtually every aspect of modern life. Never has this truth been more self evident than in the case of First Responders...

Tourniquets: A paramedic's tale of two treatment modalities

Like many whose career track and passion are in emergency medicine, the seasoned paramedic in this story leads a double life. As a Tactical Medic serving in the Special Operations Division of his State Police Department, he is no stranger to strategies that increase survivability in the tactical arena...

High Threat Extraction: Excerpts from an interview with Gunnery Sergeant Ryan P. Shane

 

TCCC: What's in this for me? A civilian case for the relevance of Tactical Combat Casualty Care.

The crisis of today's global realities continue to challenge virtually every aspect of modern life. The violence directed at civilians, law enforcement and even emergency responders exposes a brutal threat that is no longer a distant headline from a foreign battlefield but a viable danger lurking in our own back yard...

Vascular Access: Compromised Peripheral Vasculature & the Pre-hospital Setting

To improve first attempt IV success in all patients, North American Rescue has developed the patented BOA™ Constricting IV Band. This easy to use and quick to apply device provides circumferential pressure on either of the upper extremities for the purpose of obtaining peripheral venous access in patients. The BOA™ is a revolutionary device that can also be used on those patients with little or no peripheral perfusion or poor peripheral vasculature.

Hemorrhage Control: “To Bleed, or Not to Bleed, That is The Question!”

Pre-hospital health care providers are called upon to address and treat many different types of traumatic injuries. From minor abrasions, as seen on the child patient who fell off of their skateboard, to the complex, multisystem injuries of the victim struck by a car while walking across the street. Each of these traumatic injuries has unique and specific treatment modalities.

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