Leadership and a casualty response system for eliminating preventable death.

Combat casualties who die from their injuries do so primarily in the prehospital setting. Although most of these deaths result from injuries that are non-survivable, some are potentially survivable. Of injuries that are potentially survivable, most are from hemorrhage. Thus, military organizations should direct efforts toward prehospital care, particularly through early hemorrhage control and remote damage control resuscitation, in order to eliminate preventable death on the battlefield. A systems-based approach and priority of effort for institutionalizing such care was developed and maintained by medical personnel and command-directed by non-medical combatant leaders within the 75th Ranger Regiment, U.S. Army Special Operations Command. The objective of this manuscript is to describe the key components of this prehospital casualty response system; emphasize the importance of leadership; underscore the synergy achieved through collaboration between medical and non-medical leaders; and provide an example to other organizations and communities striving to achieve success in trauma as measured through improved casualty survival. (C) 2017 Lippincott Williams & Wilkins, Inc.

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