STP / DCR
Mission
The Shock Trauma Platoon (STP) delivers Damage Control Resuscitation (DCR) — control of life-threatening hemorrhage, balanced blood-product resuscitation, hypothermia prevention, and stabilization for transport — to casualties prior to surgery or in lieu of surgery for non-surgical injuries. DCR philosophy: get the casualty to the operating table or to evacuation in physiological condition that survives the next step.
Personnel & Task Organization
STP is a small, role-clear team. Cross-training is essential: every member should be able to manage airway under direction, run blood products, and document the resuscitation.
The team operates in resuscitation bays. Each bay has a defined provider lead and corpsman support. CRM applies — closed-loop callouts, time hacks, structured handoffs.
Equipment & Logistics
Blood and resuscitation:
- Cold-stored Low-Titer O Whole Blood (LTOWB) where available.
- Component therapy (PRBC, FFP, platelets) per current allowance.
- Walking Blood Bank activation capability for surge or sustainment.
- Rapid infuser capability.
- Tranexamic Acid (TXA) per JTS CPG.
Airway and ventilation:
- Standard intubation kits with backups.
- Cricothyrotomy kits accessible.
- Ventilator capability.
- End-tidal CO2 monitoring.
Diagnostics:
- Point-of-care ultrasound with FAST exam capability.
- Point-of-care laboratory (lactate, hemoglobin, blood gas) per allowance.
Hemorrhage control:
- Tourniquets, pressure dressings, hemostatic dressings.
- Pelvic binders.
- Junctional tourniquets.
Hypothermia prevention:
- Warming devices (active and passive).
- Warmed IV fluids.
AMAL:
Doctrinal References
- MCRP 4-11.1G, Health Service Support TTPs
- JTS CPG: Damage Control Resuscitation (12 Jul 2019)
- JTS CPG: Pre-Hospital Blood Transfusion (30 Oct 2020)
- JTS CPG: Walking Blood Bank
- JTS CPG: Massive Transfusion
- JTS CPG: TXA in Combat Casualty Care
- JTS CPG: Hypothermia Prevention and Management (07 Jun 2023)
- JTS CPG: REBOA for Hemorrhagic Shock (where applicable and within local scope of practice)
Clinical Practice Guidelines
The DCR bundle anchors practice at this node. Familiarity with each CPG is expected; printed quick-reference cards or laminated job aids should be physically present.
Decision Points
| Decision | Trigger | Outcome |
|---|---|---|
| Initiate massive transfusion | Hemodynamic instability with anatomic source; ABC score or clinical judgment | MTP per JTS CPG; balanced ratios |
| TXA administration | Penetrating trauma, hemodynamic instability, within 3 hours of injury | 1g IV per CPG |
| Surgical referral | Surgically-correctable hemorrhage; hollow viscus injury; clear surgical indication | Move to FRSS/DCS |
| Direct to Holding | Resuscitation complete; no surgical indication; stable for monitoring | STP → Holding |
| Direct to EVAC | Stable; capability needed exceeds Role 2 | STP → EVAC |
| Expectant management | Catastrophic injury; not survivable with available resources; MASCAL conditions | T4 disposition; comfort care; document |
| Airway escalation | Inability to maintain airway by less invasive means | Cricothyrotomy per CPG |
| ROSC management | Return of spontaneous circulation after arrest | Per current resuscitation guidance; consider survivability |
Linked ELOs
| TLO | ELO | Primary or Secondary |
|---|---|---|
| Clinical Ops | CO-10 (blood management) | Primary |
| Clinical Ops | CO-14 (clinical decision-making) | Primary |
| Clinical Ops | CO-7 (equipment familiarization) | Primary |
| Team Development | TD-1 (CPG analysis) | Primary |
| Team Development | TD-2 (cross-training) | Primary |
| Team Development | TD-4 (CRM in resuscitation) | Primary |
| Team Development | TD-9 (task org STP) | Primary |
| Trauma Integration | TI-5 (documentation/reporting) | Primary |
Forms & Documentation
- TCCC card / DD 1380.
- Trauma Flow Sheet (JTS-sanctioned).
- Transfusion record with product unit IDs.
- DoDTR data fields captured at this stage.
Reference Imagery
Last reviewed: • OPSEC reviewed: