Addressing evacuation delay: the critical role of the core region of combat trauma concept in future warfare.

Abstract

With the transition to large-scale combat operations (LSCOs) and distributed warfare in theatre, medical evacuation times could be a lot longer, which challenges the "golden hour". In response to this challenge, the paper presents the "Core Region of Combat Trauma (CRCT)" as a novel framework for directing care in the Prolonged Casualty Care (PCC) phase when evacuation is prolonged. The CRCT is the site of injuries which are among the leading causes of potentially preventable deaths following Tactical Combat Casualty Care (TCCC). The care of CRCT located in the transitional phase between TCCC and damage control surgery. The guiding principle of CRCT management is damage control and physiological maintenance. This methodology facilitates the transition of casualties from a state where evacuation is not feasible to one where evacuation is tolerable.