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:

- National Stock Number (NSN) and ordering: Medical Electronic Catalogue (ECAT) https://www.medical.dla.mil/Portal/ECAT/EcatHome
- Technical Manual TM 8-6630-261-12&P: Army Publishing Directorate https://armypubs.army.mil
- ATBI capability and instructional information: Abbott Point of Care https://www.globalpointofcare.abbott/us/en/index.html

For additional information including National Stock Number (NSN), please contact dha.ncr.med-log.list.lpr-cps@health.mil

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