Citation

Rund TJ. Int. J. Circumpolar Health. 2023; 82(1): e2196047.

Copyright

(Copyright © 2023, International Union for Circumpolar Health, Publisher Informa - Taylor and Francis Group)

DOI

10.1080/22423982.2023.2196047

PMID

37161378

Abstract

In 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."

Language: en

Keywords

Humans; Alaska; *Extreme Cold Weather; *Hypothermia/therapy; Advanced resuscitative care; CASEVAC Ecosystem; Casualty Protection Unit (CPU) & Casualty Collection Point (CCP); Class VIII Medical Supplies & Logistics; Cold Soak & Thermal Cycle; Dietary Supplements; Ecosystem; Golden hour; MARCH change to MhARCH; Tactical Combat Casualty Care (TCCC); Traumatic hypothermia; Triad of death