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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.

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CPG by topic

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

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

• Altitude Emergencies Prehospital Environment, 05 Mar 2024

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

• (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
• Whole Blood Transfusion, 15 May 2018

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

• (Acute) Coronary Syndrome, 14 May 2021

• Chemical, Biological, Radiological and Nuclear (CBRN) Injury Part I: Initial Response to CBRN Agents, 01 May 2018
• Chemical, Biological, Radiological and Nuclear (CBRN) Injury Response Part 2: Medical Management of Chemical Agent Exposure, 23 Mar 2022
• Chemical, Biological, Radiological and Nuclear (CBRN) Injury Response Part 3: Medical Management of Radiation Exposure and Nuclear Events, 20 Aug 2024
• Suspected Radio Frequency Electromagnetic Field Overexposure, 12 July 2024

• 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

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

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

• 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 Management, 27 Oct 2017

• (Global) Snake Envenomation Management, 30 Jun 2020
• (Global) Spider and Scorpion Envenomation, 09 Feb 2021

• Genitourinary (GU) Injury Trauma Management, 29 Mar 2024

• (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 and Dialysis in the Deployed Setting, 25 Apr 2022

• 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

• 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, 16 Aug 2021

• Nursing Intervention in Prolonged Field Care, 22 Jul 2018

• Nutritional Support Using Enteral and Parenteral Methods, 04 Aug 2016

• 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

• 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

• 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 Guidelines, 21 Dec 2021

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

• Inhalation Injury and Toxic Industrial Chemical Exposure, 25 Jul 2016
• Mechanical Ventilation Basics CPG, 27 Dec 2021
• (Acute) Respiratory Failure, 23 Jan 2017

• 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, 12 Aug 2016

• Tactical Combat Casualty Care Guidelines, 25 Jan 2024

• Telemedicine in the Deployed Setting, 19 Sep 2023

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

• Unexploded Ordnance (UXO) Management, 14 Mar 2017

• Vascular Injury, 12 Aug 2016

• Prevention of Venous Thromboembolism, 29 Mar 2024

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

• i-STAT Portable Blood Analyzer Austere Locations - CCAT, 29 Jan 2020
• Mechanical Ventilation during Critical Care Air Transport, 14 Dec 2021
• Negative Pressure Wound Therapy - CCAT, 11 Feb 2020
• Transcutaneous Temporary Transvenous Pacing - CCAT, 30 Jan 2020

• Military Working Dogs Clinical Management, 12 Dec 2018
• Canine Tactical Combat Casualty Care Guidelines, 2023
• Transfusion for MWD, 10 Dec 2019

• (Guideline for Forward Management of) Acute Behavioral Health Conditions by Non-specialty Medical Personnel
• (Acute) Concussion Management and Progressive Return to Activity, Jan 2021
• (Management of) Exertional Rhabdomyolysis in Warfighters 2020
• Naval Aviation Medical Treatment Protocols, Apr 2019
• Prevention, Diagnosis and Management of Exertional Heat Illness
• Standard Medical Operating Guideline (SMOG), 19 July 2024 revision
• (Management of) Stroke and Cerebrovascular Emergencies in the Deployed Setting, 03 July 2024
• Treatment of Ocular Trauma and Vision-threatening Conditions by Deployed Ophthalmologists (Eye Surgeons)
• U.S. Army Aeromedical Evacuation Supplemental Handbook for the Standard Medical Operating Guidelines (SMOG)
• (How to Manage) Ventilation When Using the Universal Portable Anesthesia Complete Vaporizer Guide, 26 Dec 2021