LUNG SUPPORT
Extracorporeal (i.e., outside the body) membrane oxygenation (ECMO) technology provides a circuit to replace lung function in severely injured casualties, such as the one shown here. ECMO support machines exist or are being developed through combat casualty care research. Older versions of these artificial organ support machines were much larger and more invasive, and required more personnel to operate them. Discovery and innovation in this area of research will support the use of even smaller, more autonomous units in forward, out- of-hospital environments, including field and en-route care. (Photo by Lt Col Jeremy Cannon, M.D., U.S. Air Force Medical Corps)
T
he burden of injury among U.S. service personnel during the wars in Afghanistan and Iraq confirmed the benefit of requirements-driven medical research aimed at reducing combat-related mortality and
improving survival. While elements of trauma research existed before these wars, they were small, service-focused and not fully coordinated. Te wars also exposed the often overlooked fact that, unlike research in the areas of cancer, cardiovascular dis- ease and behavioral health, the nation has no federal institutes or private foundations dedicated to funding trauma research. Te sacrifices of our men and women in uniform have re-emphasized the lesson that combat casualty care research is a military-spe- cific imperative; there is no safety net in this endeavor.
With this in mind, the U.S. Combat Casualty Care Research Program (CCCRP) is charged with driving innovation in trauma care to support Force 2025 and Beyond. Central to this effort is a reappraisal of the time between injury and life- sustaining medi- cal treatment—known as the “golden hour” standard. In the past, the end of the golden hour was marked by the time a patient arrived at a fixed facility or traditional echelon of care. Now that advanced resuscitative capability can be pushed closer to the point of injury, regardless of setting or location, we must redefine the golden hour end point. (See Figure 1 on Page 82.)
CCCRP PS AND QS Te CCCRP guides the nation’s rejuvenated investment in requirements-driven military trauma research. Te program, co-located at Fort Detrick, MD, and the Defense Health Headquarters, Falls Church, VA, plans, programs, budgets and oversees the execution of approximately $300 million in requirements-driven research aimed at producing knowledge and materiel solutions for the full spectrum of military trauma care, including at the point of injury, en route in rotary and fixed-wing transport, and in Level II through Level V facilities.
Te CCCRP’s primary task is the oversight and management of science and technology elements of funding. However, its staff and processes are integral to the life cycle of research, includ- ing the advanced development and acquisition of knowledge and materiel and their relevant implementation in the prac- tice of combat casualty care. Te mission of the CCCRP is to produce solutions that improve survival and recovery from combat-related injury, and thereby empower and sustain the fighting force.
Te program staff resides within the Research Area Directorate – 2 (RAD-2) of the U.S. Army Medical Research and Materiel Command (USAMRMC) and the Research, Development and Acquisition Directorate of the Defense Health Agency (DHA).
ASC.ARMY.MIL 81
SCIENCE & TECHNOLOGY
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