Besides developing best-practice clinical practice recommendations for prehospital trauma care, another primary mission of the K9 TECC working group is to identify operational gaps that exist in OpK9 prehospital trauma care during high-risk operations.
Over the past 20 years, out-of-hospital trauma care for the civilian tactical or high-threat environment has undergone a dramatic transformation. The formation of Tactical Emergency Medical Services (TEMS) along with the development of Tactical Emergency Casualty Care (TECC) best practice recommendations have fostered improved tactics, techniques, and procedures (TTPs) that have greatly enhanced the capability of first responders as well as a prehospital care environment with an improved chance of patient survival. Although much time and research has been placed into improving EMS TTPs for the human casualty, very little time, funding or scientific efforts have been placed into enhancing out-of-hospital trauma care for the elite OpK9.
The fact remains that as a veterinary and medical community, there is very little scientific data and / or evidence-based medicine to support what TTPs are most advantageous for treating this special population of elite K9s. Most of the information the veterinary community uses to guide veterinary care for OpK9s is based mostly off anecdotal clinical experience, retrospective analyses of MWDs in combat, or extrapolated from experimental animal models or human observational studies.
It seems obvious that veterinary and EMS communities need to partner together to fund and pursue more scientific-based, prospective clinical trials related to prehospital care for the OpK9. Many governmental agencies (e.g., DHS, TSA, CIA, FBI, USMS, USCBP, USAR, etc.) utilize OpK9s to successfully accomplish their mission; therefore, these agencies have a vested interest in ensuring their K9s receive the best medical care possible. As such, many of these organizations would hopefully be open to supporting efforts towards improving prehospital care through scientific research. Considering the large population of K9s these organizations have at their disposal, they serve a viable source for acquiring a sample size that provides adequate power. With these facts in mind, it seems prudent for the veterinary community to establish a partnership and liaison with these organizations to foster and pursue avenues for clinical research.
Some of the prehospital trauma care topics that are currently lacking evidence-based medicine for the OpK9 include the following. This list is not all inclusive and will remain an active document as research is completed and new areas lacking data are identified. Until data can be developed, existing standards and recommendations shall remain unchanged. The identified areas of research serves as a call to scientific and academic communities to focus funding and efforts to provide solid data on which to build the TECC Guidelines:
1. Fluid resuscitation (e.g., Scoop and Run, hypotensive resuscitation, etc.)
2. Appropriate field analgesia and sedation
3. Treatment relevant to heat-related injuries
4. Effectiveness of CPR (CAB vs. ABC, use of AEDs, etc.)
5. Novel hemostatic agents (e.g., Vetigel®), etc)
6. Prehospital Antifibriniolytics (e.g., TXA, EACA)
7. Advanced airway techniques (e.g., cricothyrotomy, BIAD, etc.)
8. Junctional Tourniquets
9. High-altitude injuries and treatment
10. Field Monitoring device
11. PTSD in the OpK9
12. Effect of obesity on K9 TECC equipment and Guidelines
13. Prevlance of OpK9 deaths and injuries during high risk operations
14. Complicatios of Needle Decompression when performed by untrained first responders
15. GDV treatment - Outcome of performing Gastric Decompression prior to or in absence of Fluid resuscitation