Accepted for Publication: April 25, 2011.
Published Online: August 15, 2011. doi:10.1001/archsurg.2011.213
Author Contributions: Study concept and design: R. S. Kotwal, Cain, and Mechler. Acquisition of data: R. S. Kotwal, Montgomery, B. M. Kotwal, and Cain. Analysis and interpretation of data: R. S. Kotwal, Montgomery, Champion, Butler, Mabry, Blackbourne, and Holcomb. Drafting of the manuscript: R. S. Kotwal, B. M. Kotwal, Champion, Mabry, and Blackbourne. Critical revision of the manuscript for important intellectual content: R. S. Kotwal, Montgomery, Champion, Butler, Cain, Blackbourne, Mechler, and Holcomb. Statistical analysis: R. S. Kotwal. Administrative, technical, and material support: R. S. Kotwal, Montgomery, B. M. Kotwal, Butler, Mabry, and Blackbourne. Study supervision: R. S. Kotwal, Montgomery, Blackbourne, and Holcomb.
Financial Disclosure: None reported.
Disclaimer: The views, opinions, and findings contained in this report are those of the authors and should not be construed as official or reflecting the views of the DoD unless otherwise stated. Citations of commercial products or organizations do not constitute an official DoD endorsement or approval of the products or services of these organizations. This report was approved for public release by the US Army Special Operations Command Operational Security Office and the Public Affairs Office on October 8, 2010.
Previous Presentation: The abstract was presented at the 2011 Combat Trauma Innovation Conference; January 18, 2011; London, England.
Additional Information: This article is dedicated to SFC Marcus V. Muralles, a former 75th Ranger Regiment Special Operations Combat Medic who was killed in action while serving with the 160th Special Operations Aviation Regiment in Afghanistan on June 28, 2005, and SGT Jonathan K. Peney, a Special Operations Combat Medic who was killed in action while serving with the 75th Ranger Regiment in Afghanistan on June 1, 2010.
Additional Contributions: We acknowledge the Texas A&M Health Science Center Rural and Community Health Institute for their collaboration on the PHTR; the JTTR and the Armed Forces Institute of Pathology for providing casualty outcome data; and all senior Ranger Special Operations Combat Medics whose practical experiences and perspectives contributed immeasurably to the development and implementation of Ranger medical training programs and the PHTR. Most importantly, we especially recognize the sacrifices of the casualties depicted in this article as well as their fellow Rangers who provided care to them.