"Optimizing Combat Casualty Care"

Joint Trauma System

The Department of Defense Center of Excellence for Trauma


The mission of the Joint Trauma System (JTS) is to provide evidence-based process improvement of trauma and combat casualty care, to drive morbidity and mortality to the lowest possible levels, and to provide evidence-based recommendations on trauma care and trauma systems across the Department of Defense (DoD).

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.

DoDTR Trauma Registry

The JTS efforts are supported by the concurrent collection and analysis of data maintained in the Department of Defense Trauma Registry (DoDTR), formerly Joint Theater Trauma Registry (JTTR). The DoDTR is the data repository for DoD trauma-related injuries. The goal of this registry is to document, in electronic format, information about the demographics, injury-producing incident, diagnosis and treatment, and outcome of injuries sustained by US/Non-US military and US/Non-US civilian personnel in wartime and peacetime from the point of wounding to final disposition.


The DoDTR supports US military performance improvement initiatives with global-wide collection and aggregation of combat casualty care epidemiology, treatments and outcomes. DoDTR data enables JTS to conduct performance improvement studies and gap analyses for medical capabilities to direct ongoing and future combat casualty care research, trauma skills training, and direct combat casualty care. DoDTR data analysis was instrumental in proving the Golden Hour evacuation policy saves lives. DoDTR data also provided the supporting evidence to prompt a doctrinal change of Army flight medics from EMT-Basic to an EMT-Paramedic to improve the survivability of combat casualties. JTS is the first to create integrated multi-specialty registries. These registries are:

  • Acoustic: Collects data related to acoustic trauma injuries to the inner ear. The registry tracks the patient’s acoustic injury, evaluation results, and care management that is not included in initiating DoDTR trauma record.
  • Infectious Disease (ID): Collects trauma-related ID epidemiology; a central repository for bacteria isolates infecting war wounded.
  • Military En Route Care Registry (MERCuRY): Collects data about treatment during medical evacuation (MEDEVAC) and Casualty evacuation (CASEVAC).
  • Military Orthopaedic Trauma Registry (MOTR): A registry of military orthopaedic injuries designed to augment the DoDTR for specific orthopaedic information such as injury patterns, fracture characteristics, treatment and complications associated with combat extremity injuries.
  • Pre-Hospital Trauma Registry (PHTR): Captures never before attainable prehospital trauma care information provided on the ground at the point of injury by all combat forces.
  • Outcomes (Recovery and Rehabilitation): Collects data about a patient’s recovery and rehabilitation after he/she leaves the treatment facilities.
  • Traumatic Brain Injury (TBI): Collects data related to patients with TBI injuries, ranging from mild concussion to a penetrating head injury.
  • Vision: Collects ocular clinical data, from injury to treatment to vision recovery.


    • DATA ACQUISITION: Mines the medical records to abstract, code, and enters critical trauma data into the DoDTR database for use in support of the JTS mission.

    • DATA ANALYSIS: Develops queries and provides data from the DoDTR in response to requests for information. Conducts classified and non-classified data analysis.

    • DATA AUTOMATION: Supports the information technology for the DoDTR and data-related special projects. Designs and implements special-project database applications, related architecture, and documentation. Handles documentation needs for JTS to maintain Program compliance with the Defense Health Agency.

    • PERFORMANCE IMPROVEMENT: Coordinates performance improvement (PI) activities across the spectrum of trauma care. Participates in the development, maintenance, and adherence to Clinical Practice Guidelines. Develops PI course content and training, and resolves trauma system patient care issues.

    • EDUCATION: Develops and conducts pre-deployment training of the CENTCOM Joint Theater Trauma System (JTTS) teams, DoDTR user training, and JTS staff training. Develops educational products for COCOM trauma system development. Secures continuing education credits and coordinates performance improvement and other trauma related courses.


    Note: The DoDTR is a population of trauma patients and includes selected data elements. It is not the patient record. While a query of the DoDTR can identify a population and provide data elements, the investigator may have to conduct a chart review to collect additional for their protocol. JTS does not assist with access to chart review.

    The DoDTR data requestor must be a member of the US Military or Government or sponsored by a US Military or Government entity. The party will accept responsibility for safeguarding the data set and ensure that all applicable DoD and Federal requirements are met by the non-Federal requestor. JTS does not assist non-Federal requestors in finding DoD sponsors.

    In most cases, a Memorandum of Understanding is required between the US Army Institute of Surgical Research and the requester's organization.

    The issuance of identifiable data/information for research purposes is subject to oversight by the Institutional Review Board (IRB). The requester's IRB reviews and approves the protocol specifying the conditions under which data may be requested from the DoDTR. The IRB ensures that adequate provisions to protect the privacy of subjects and maintain the confidentiality of data exist. Requesters must comply with the HIPAA Privacy Rules when preparing the research protocol or for the IRB. The DoDTR is in compliance with Army, Defense Health Agency and federal Information Assurance regulations. JTS is under no obligation to accept the requestor’s IRB determination or scientific review, and reviews all proposed studies for appropriate methodology and scientific validity.

    To submit questions or contact JTS, click here