The mission of the Joint Trauma System (JTS) is to improve trauma readiness and outcomes through evidence-driven performance improvement. And the vision of the Joint Trauma System is that every Soldier, Sailor, Airman, and Marine injured on the battlefield or in any theater of operations will be provided with the optimum chance for survival and maximum potential for functional recovery.42

Military trauma system deficiencies were noted in reports from Operation Desert Shield and Desert Storm in 1992.43 Then, after the terrorist attacks of September 11, 2001, the increase in armed conflict and subsequent battlefield injuries again raised questions about how to improve the military trauma response, as the absence of trauma experts and a trauma system was glaring.44

COL John Holcomb, MD, was deployed to examine the trauma system and make recommendations for improvement. The result was a Central Command Joint Theater Trauma System (JTTS), which later became the Joint Trauma System in 2006.45,46 After several organizational changes, it has been designated as the lead agency for trauma in DoD with authority to establish and assure best-practice trauma care guidelines.47

The JTS consists of six principal entities:48

- DOD Trauma Registry Management
- Defense Committee on Trauma
- Performance Improvement
- Combatant Command Trauma System Management
- Joint Trauma Education and Training
- Defense Medical Readiness Institute

The Committee on Tactical Combat Casualty Care is a committee under the Defense Committee on Trauma, along with the Committee on En Route Combat Casualty Care and the Committee on Surgical Combat Casualty Care.

Several key JTS functions play roles in combat casualty care at the unit level:

- Developing and maintaining evidence-supported clinical practice guidelines (CPGs) – supporting the unit medics with concise and subject matter expert-vetted TCCC Guidelines and other CPGs.
- Recommending combat casualty care training requirements – providing resources and training recommendations for unit personnel, both medical and nonmedical.
- Evaluating and recommending new equipment or medical supplies – providing units with well-researched objective advice on equipment and supplies so that they do not need to do independent research.
- Facilitating medical performance improvement by promoting real-time, data-driven clinical process improvements and improved outcomes – providing units with up-to-date information to help tailor unit training and procedures more rapidly than in prior years.
- Improving communication and facilitating movement, collection, and sharing of theater combat casualty data across all roles of care and all the Military Services – supporting the key roles of communication and documentation at a unit level, in addition to higher levels.
- Maintaining the Department of Defense Trauma Registry (DoDTR) on DoD injury demographics, care provided, and outcomes – supporting communication with unit leadership and identifying any unit-specific trends.
- Improving the organization and delivery of trauma care – helping unit medics to organize, train and equip in support of their leadership and unit personnel. The JTS website has many documents and other information that can answer trauma-related questions and help you manage unit TCCC training. Additionally, their contact information has different links for the various JTS functions that you might need to access at a unit level.