The new reckoning: The Combat Casualty Care Research Program responds to real and present challenges in military operational projections

This issue of the Journal of Trauma and Acute Care Surgery features topics from the 2017 Military Health System Research Symposium and starts a second decade of partnership between the Combat Casualty Care Research Program (CCCRP) and the journal. This publication comes at a time of significant change for the CCCRP, as it responds to military planning for the future multidomain battlefield (MDB). The projected MDB portends markedly different operational scenarios than those conducted over the past 17 years. Emerging threats around the globe have the Department of Defense preparing for more complex battlefields that are larger in size and scope and which pit the United States against better equipped and more sophisticated adversaries. As the CCCRP navigates this new reckoning associated with trauma care on the MDB, its research investments will need to be robust and enabled to plan, program, and budget for agile and closer-term solutions. To accomplish this, the program will need to expand on its strong foundation of lessons learned and assets developed over the past 20 years.

The National Trauma Research Repository: Ushering in a New ERA of trauma research (Commentary)

Despite being the leading cause of death in the United States for individuals 46 years and younger and the primary cause of death among military service members, trauma care research has been underfunded for the last 50 years. Sustained federal funding for a coordinated national trauma clinical research program is required to advance the science of caring for the injured. The Department of Defense is committed to funding studies with military relevance; therefore, it cannot fund pediatric or geriatric trauma clinical trials. Currently, trauma clinical trials are often performed within a single site or a small group of trauma hospitals, and research data are not available for secondary analysis or sharing across studies. Data-sharing platforms encourage transfer of research data and knowledge between civilian and military researchers, reduce redundancy, and maximize limited research funding. In collaboration with the Department of Defense, trauma researchers formed the Coalition for National Trauma Research (CNTR) in 2014 to advance trauma research in a coordinated effort. CNTR's member organizations are the American Association for the Surgery of Trauma (AAST), the American College of Surgeons Committee on Trauma (ACS COT), the Eastern Association for the Surgery of Trauma (EAST), the Western Trauma Association (WTA), and the National Trauma Institute (NTI). CNTR advocates for sustained federal funding for a multidisciplinary national trauma research program to be conducted through a large clinical trials network and a national trauma research repository. The initial advocacy and research activities underway to accomplish these goals are presented.

The medical response to the Boston Marathon bombings: an analysis of social media commentary and professional opinion

OBJECTIVES

To explore the differences in perception of the medical response to the victims of the 2013 Boston Marathon bombings between laypeople and healthcare professionals.

METHODS

Commentary accessible and available on Internet discussion websites by non-medically trained persons and in the academic literature by healthcare professionals was analysed qualitatively.

RESULTS

Major themes were found relating to both the pre-hospital and hospital-based phases of the medical response to the disaster. Laypeople focused more on pre-hospital care and the actions of specific bystanders, while healthcare professionals focused on hospital care, the importance of a disaster plan, and frequent training for the success of the response.

CONCLUSION

Laypeople and healthcare professionals have positive but differing perceptions of the medical response to the victims of the bombings. This may have implications for future funding and implementation of disaster preparedness.