Clinical Practice Guidelines (CPGs)

Clinical Practice Guidelines (CPGs) are the backbone of the JTS Performance Improvement program for combatant command trauma systems. The JTS remains committed to using the highest levels of analytical and statistical analysis in its CPG development process. The CPGs are compiled from DoD Trauma Registry data, health data abstracted from patient records and after action reports. The data are analyzed and distilled into guidelines to remove medical practice variations and save lives. The CPGs are used by military and civilian healthcare providers worldwide and are largely responsible for decreasing case fatality rates.

CPGs are evidence-based and developed with subject matter experts in the military and civilian communities, deployed clinicians, trauma care physicians, surgical consultants, and JTS leaders. The JTS CPG standards and recommendations have found their way into the civilian medical communities. CPGs are freely available for download.

Send suggestions for CPGs and differing viewpoint(s) to: dha.jbsa.healthcare-ops.list.jts-cpg@health.mil.

Guidelines

Video Tutorials

Podcasts

Pocket Guides

NEW CPGs:

Use of Traumatic Brain Injury Plasma Biomarkers after a Potentially Concussive Event, 14 Apr 2025

Vascular Injury, 09 Apr 2025

Mechanical Ventilation Basics, 09 Apr 2025

Drowning Management, 17 Mar 2025

Chemical, Biological, Radiological, and Nuclear (CBRN) Injury Response Part 4: General Approach to Biological Casualties, 27 Feb 2025

CPG by topic

CPG Index file | Complete Zip of Current JTS CPGs

Abdominal Injury

Blunt Abdominal Trauma, Splenectomy, and Post-Splenectomy Vaccination, 13 May 2020

Airway

Airway Management in Prolonged Field Care, 01 May 2020
Airway Management of Traumatic Injuries, 17 Jul 2017

Altitude

Altitude Emergencies Prehospital Environment, 05 Mar 2024

Antibiotics and Antifungals

Infection Prevention in Combat-Related Injuries, 27 Jan 2021
Invasive Fungal Infection in War Wounds, 17 Jul 2023
Sepsis Management in Prolonged Field Care, 28 Oct 2020
Ventilator Associated Pneumonia (VAP), 07 May 2020

Aural/Acoustic Injury (Hearing Loss)

Aural Blast Injury/Acoustic Trauma and Hearing Loss, 27 Jul 2018

Blood (Resuscitation)

(Prehospital) Blood Transfusion, 30 Oct 2020
Damage Control Resuscitation, 12 Jul 2019
Damage Control Resuscitation (DCR) in Prolonged Field Care, 01 Oct 2018
Frozen and Deglycerolized Red Blood Cells, 05 Aug 2024
Transfusion of Type A Whole Blood for the Role 3, 30 May 2025
Whole Blood Transfusion, 15 May 2018

Burns

Burn Care, 11 May 2016
Burn Wound Management in Prolonged Field Care, 13 Jan 2017

Cardiac

(Acute) Coronary Syndrome, 14 May 2021

CBRN – Chemical Biological Radiological and Nuclear Injury

Chest/Thorax

Emergent Resuscitative Thoracotomy (ERT), 18 Jul 2018
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Hemorrhagic Shock, 31 Mar 2020
(Wartime) Thoracic Injury, 26 Dec 2018

Cold/Hypothermia

Frostbite and Immersion Foot Care, 26 Jan 2017
Hypothermia Prevention, Monitoring, and Management, 7 Jun 2023

COVID

(Management of) COVID-19 in Austere Operational Environments, 23 Apr 2021

Documentation

CPG Development Process, 04 Oct 2024
Documentation in Prolonged Field Care, 13 Nov 2018
Documentation Requirements for Combat Casualty Care, 18 Sep 2020
JTS CPG Author Guidance, 28 Aug 2024

Drowning

Drowning Management, 17 Mar 2025

Envenomation

The Global Snake Envenomation Management CPG has been removed from the website while it undergoes a rapid update. We apologize for any inconvenience. It will be reposted as soon as the update is complete.

(Global) Spider and Scorpion Envenomation, 09 Feb 2021

Genitourinary

Genitourinary (GU) Injury Trauma Management, 29 Mar 2024

Hemorrhage Control and Adjuncts

(High Bilateral) Amputations and Dismounted Complex Blast Injury, 05 Aug 2024
Emergent Resuscitative Thoracotomy (ERT), 18 Jul 2018
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Hemorrhagic Shock, 31 Mar 2020
Pelvic Fracture Care, 15 Mar 2017

Hyperkalemia

Hyperkalemia and Dialysis in the Deployed Setting, 25 Apr 2022

Infection Treatment

Infection Prevention in Combat-Related Injuries, 27 Jan 2021
Invasive Fungal Infection in War Wounds, 17 Jul 2023
Sepsis Management in Prolonged Field Care, 28 Oct 2020
Ventilator Associated Pneumonia (VAP), 07 May 2020
(War) Wounds: Wound Debridement and Irrigation, 27 Sep 2021
(Acute Traumatic) Wound Management in the Prolonged Field Care Setting, 24 Jul 2017

Neuro/Traumatic Brain Injury

Catastrophic Non-Survivable Brain Injury, 27 Feb 2017
Emergency Life-Saving Cranial Procedures by Non-Neurosurgeons in Deployed Setting, 23 Apr 2018
Traumatic Brain Injury and Neurosurgery in the Deployed Environment, 15 Sep 2023
Traumatic Brain Injury Management in Prolonged Field Care, 06 Dec 2017
(Use of) Traumatic Brain Injury Plasma Biomarkers after a Potentially Concussive Event, 14 Apr 2025

Nursing Care

Nursing Intervention in Prolonged Field Care, 22 Jul 2018

Nutrition

Nutritional Support Using Enteral and Parenteral Methods, 04 Aug 2016

Ophthalmology

Eye Trauma: Initial Care, 01 Jun 2021
Ocular Evaluation and Disposition after Suspected Laser Exposure, 14 Feb 2020
Ocular Injuries and Vision-Threatening Conditions in Prolonged Field Care, 01 Dec 2017

Orthopedic

Amputation: Evaluation and Treatment, 10 Oct 2024
(High Bilateral) Amputations and Dismounted Complex Blast Injury, 05 Aug 2024
Cervical and Thoracolumbar Spine Injury Evaluation, Transport and Surgery in the Deployed Setting, 19 Jun 2020
(Acute Extremity) Compartment Syndrome (CS) and the Role of Fasciotomy in Extremity War Wounds, 25 Jul 2016
Crush Syndrome - Prolonged Field Care, 28 Dec 2016
Orthopaedic Trauma: Extremity Fractures, 26 Feb 2020
Pelvic Fracture Care, 15 Mar 2017

Pain Control (Analgesia)

Analgesia and Sedation Management During Prolonged Field Care, 11 May 2017
Anesthesia for Trauma Patients, 05 Apr 2021
Pain, Anxiety and Delirium, 26 Apr 2021

Prolonged Casualty Care

Prolonged Casualty Care Guidelines, 21 Dec 2021

Radiology

Radiology: Imaging Trauma Patients in a Deployed Setting, 13 May 2017

Respiratory

Inhalation Injury and Toxic Industrial Chemical Exposure, 25 Jul 2016
Mechanical Ventilation Basics, 09 Apr 2025
(Acute) Respiratory Failure, 23 Jan 2017

Surgical Procedures

Emergency General Surgery in Deployed Locations, 01 Aug 2018
Emergent Resuscitative Thoracotomy (ERT), 18 Jul 2018
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Hemorrhagic Shock, 31 Mar 2020
(Austere) Resuscitative Surgical Care, 30 Oct 2019
Vascular Injury, 09 Apr 2025

Tactical Combat Casualty Care Guidelines

Tactical Combat Casualty Care Guidelines, 25 Jan 2024

Telemedicine

Telemedicine in the Deployed Setting, 19 Sep 2023

Transport

En Route Care Patient Packaging, 21 Aug 2024
Interfacility Transport of Patients Between Theater Medical Treatment Facilities, 24 Apr 2018

Unexploded Ordnance (UXO)

Unexploded Ordnance (UXO) Management, 14 Mar 2017

Vascular

Vascular Injury, 09 Apr 2025

Venous Thromboembolism

Prevention of Venous Thromboembolism, 29 Mar 2024

Wound Management

(War) Wounds: Wound Debridement and Irrigation, 27 Sep 2021
(Acute Traumatic) Wound Management in the Prolonged Field Care Setting, 24 Jul 2017

Critical Care Air Transport CPGs

i-STAT Portable Blood Analyzer in Austere Locations, 26 Feb 2025
Mechanical Ventilation during Critical Care Air Transport, 10 Mar 2025
Negative Pressure Wound Therapy, 26 Feb 2025
Transcutaneous Temporary Transvenous Pacing, 26 Jan 2025

Military Working Dog CPGs (Canine)

NOTE: The updated MWD CPGs are updated versions of the chapters featured in the MWD Clinical Management CPG, 12 Dec 2018.
The primary CPG no longer contains the chapters.