Evidence map›Paper›PMID 34746434›Full record

SynthesisTrauma surgery & acute care open2021

Evaluating the Tactical Combat Casualty Care principles in civilian and military settings: systematic review, knowledge gap analysis and recommendations for future research.

Rachel Strauss, Isabella Menchetti, Laure Perrier, Erik Blondal, Henry Peng, Wendy Sullivan-Kwantes, Homer Tien, Avery Nathens, Andrew Beckett, Jeannie Callum and 1 more

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in Trauma surgery & acute care open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.2field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 21 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 1 country.

Rachel Strauss *Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Isabella Menchetti *Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Laure PerrierDepartment of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Erik BlondalDepartment of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Henry PengDefence Research and Development Canada, Toronto Research Centre, Toronto, Ontario, Canada.
Wendy Sullivan-KwantesDefence Research and Development Canada, Toronto Research Centre, Toronto, Ontario, Canada.
Homer TienDepartment of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Avery NathensDepartment of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Andrew BeckettDepartment of Surgery, St Michael's Hospital, Toronto, Ontario, Canada.
Jeannie CallumLaboratory Medicine and Molecular Diagnostics, Kingston Health Sciences Centre, Kingston, Ontario, Canada.
Luis Teodoro da LuzDepartment of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Sunnybrook Health Science Centre · CADefence Research and Development Canada · CAHealth Sciences Centre · CAKingston Health Sciences Centre · CASt. Michael's Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe Tactical Combat Casualty Care (TCCC) guidelines detail resuscitation practices in prehospital and austere environments. We sought to review the content and quality of the current TCCC and civilian prehospital literature and characterize knowledge gaps to offer recommendations for future research.

methodsMEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials were searched for studies assessing intervention techniques and devices used in civilian and military prehospital settings that could be applied to TCCC guidelines. Screening and data extraction were performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Quality appraisal was conducted using appropriate tools.

resultsNinety-two percent (n=57) of studies were observational. Most randomized trials had low risk of bias, whereas observational studies had higher risk of bias. Interventions of massive hemorrhage control (n=17) were wound dressings and tourniquets, suggesting effective hemodynamic control. Airway management interventions (n=7) had high success rates with improved outcomes. Interventions of respiratory management (n=12) reported low success with needle decompression. Studies assessing circulation (n=18) had higher quality of evidence and suggested improved outcomes with component hemostatic therapy. Hypothermia prevention interventions (n=2) were generally effective. Other studies identified assessed the use of extended focused assessment with sonography in trauma (n=3) and mixed interventions (n=2).

conclusionsThe evidence was largely non-randomized with heterogeneous populations, interventions, and outcomes, precluding robust conclusions in most subjects addressed in the review. Knowledge gaps identified included the use of blood products and concentrate of clotting factors in the prehospital setting. LEVEL OF EVIDENCE: Systematic review, level III.

Indexed as

resuscitation

Identifiers

PMID34746434
PMCPMC8527149
OpenAlexW3205030591

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.