Using the Joint Trauma System, Clinical Practice Guideline titled Use of TBI Biomarkers After a Potentially Concussive Event, here is a detailed list of medical materiel needed to implement this guideline, assuming care at Role of Care 1–3 levels where biomarker use is feasible.

1. Biomarker Testing Equipment & Supplies

These enable objective assessment of brain injury severity via blood-based biomarkers (e.g., GFAP and UCH-L1).

A. Biomarker Platform (Abbott i-STAT TBI Whole Blood test)

  • FDA-cleared TBI biomarker system (analyzer device)
  • Test cartridges specific for GFAP and UCH-L1
  • External control/test calibration kits (if applicable)
  • Maintenance kit for analyzer (cleaning solutions, swabs)
  • Device software update instructions
    • Accessing device software and update procedures are located in section 1 and Appendix D of the ATBI Technical Manual, TM 8-6630-261-12&P accessed on the Army Publishing Directorate here: https://armypubs.army.mil.

B. Blood Collection Supplies

  • Venipuncture supplies:
    • Tourniquets
    • Alcohol/iodine prep pads
    • Vacutainer tubes (EDTA or heparin, depending on platform)
    • Butterfly needles or standard needles
    • Collection tube holders
    • Bandages or gauze + tape
  • Biohazard disposal container (sharps)
  • Cold chain storage

2. Neurological & Cognitive Assessment Tools

Used for screening, documentation, and clinical decision-making alongside biomarkers.

  • MACE 2 (Military Acute Concussion Evaluation Version 2) cards or digital tool
  • Neurologic exam checklist or reference card
  • Glasgow Coma Scale (GCS) reference card
  • Pupillary light reflex pen (penlight)
  • Stopwatch or timer
  • Blood pressure cuff & stethoscope (for baseline vitals)
  • Pulse oximeter
  • Thermometer (to rule out confounding febrile causes)
  • Basic neurologic exam kit:
    • Reflex hammer
    • Tuning fork
    • Visual acuity chart

3. Documentation & Reporting Tools

Ensure proper capture of data for medical and operational purposes.

  • DD Form 1380 Tactical Combat Casualty Care Card
  • Electronic Health Record (EHR) system if applicable
  • Printed or digital algorithm from the CPG
  • Biomarker test logbook or quality control record
  • Patient information leaflets on TBI/concussion (if available)

4. Storage, Packaging & Transport

Supports safe and effective use in deployed settings.

  • Ruggedized carrying case for biomarker device
  • Refrigeration/cooler for samples, TBI Whole Blood Cartridges, Control Level 1 and 2, and Calibration/Verification Cartridges
  • Power adapters for POC analyzer

5. Additional Medical Supplies

  • Personal Protective Equipment (PPE): gloves, masks, goggles
  • Disinfectants for cleaning equipment
  • Eye protection (if working in austere environments)
  • Hand sanitizer and cleaning wipes

References for Use

  • JTS CPG: Use of TBI Biomarkers After a Potentially Concussive Event (latest edition)
  • ATBI Technical Manual TM 8-6630-261-12&P (Accessed on the Army Publishing Directorate at https://armypubs.army.mil)
  • DoD Quick Reference Guide and Troubleshooting Procedures (Included in the Deployment Kit and Appendix F of the ATBI Technical Manual)
  • DHA Procedural Instructions for neurotrauma/TBI documentation
  • MACE-2 & ACE (Acute Concussion Evaluation) instructions

For additional information refer to:

 

DISCLAIMER: This is not an exhaustive list. These are items identified to be important for the care of combat casualties.