DoD Combat Casualty Care Prolonged Field Care Research Award | Apply Online

Frequently Asked Questions (FAQs): DoD Combat Casualty Care Prolonged Field Care Research Award (PFCRA)

1) What is the PFCRA grant opportunity?

The Combat Casualty Care Prolonged Field Care Research Award (PFCRA) is a Department of Defense (DoD) funding opportunity focused on improving care for severely injured casualties when evacuation to a surgical facility is delayed for many hours or even days. The goal is to produce research-based, practical solutions that help medical personnel keep patients alive and stable in austere, resource-limited settings (point of injury, remote environments, or during transport).

2) What problem is PFCRA trying to solve?

PFCRA targets scenarios where the normal military trauma system assumption (rapid evacuation to surgery) breaks down. In future conflicts or large-scale disasters, wounded patients may not reach definitive surgical care quickly, so care teams must manage hemorrhage, shock, brain injury, and other life-threatening problems for prolonged periods without full hospital resources.

3) What does Prolonged Field Care (PFC) mean in this program?

Within PFCRA, Prolonged Field Care (PFC) refers to extended medical care delivered in austere, resource-limited conditions when definitive care is delayed. It emphasizes keeping the patient alive and as physiologically stable as possible until evacuation and surgical/definitive treatment can occur.

4) What is prolonged Damage Control Resuscitation (pDCR) in this context?

Prolonged Damage Control Resuscitation (pDCR) involves sustaining and resuscitating critically injured patients when definitive surgical care is not immediately available. PFCRA highlights the need to understand the physiologic effects of prolonged resuscitation and delayed surgery and to develop ways to reduce harms that can accumulate during extended pre-surgical care.

5) Does PFCRA focus on trauma system redesign or patient-level care?

The program expects applicants to keep the trauma care continuum in mind (injury through evacuation and definitive treatment), but proposals must center on patient-level interventions and patient-level outcomes, not broad trauma system redesign.

6) What are the required focus areas for proposals?

To be considered, proposals must directly address at least one of three required focus areas:

• Focus Area 1: Understanding the clinical implications of PFC and pDCR.
• Focus Area 2: Next-generation resuscitation and stabilization methods for prolonged out-of-hospital care.
• Focus Area 3: Enhanced treatment of injuries during PFC and pDCR (including treatments, forward surgical approaches, and portable critical care capabilities).

7) What topics are included under Focus Area 1?

Focus Area 1 supports studies that improve understanding of what should be monitored and treated to reduce death and complications during the acute window (up to 72 hours), especially for traumatic brain injury (TBI). It also includes research on:

• Pathophysiology and mitigation of prolonged hypotension or hypotensive resuscitation lasting up to 72 hours
• Consequences and safe limits of using current prehospital hemostatic devices for prolonged durations (beyond roughly 2 to 4 hours)
• Barriers to providing organ support and critical care in field conditions
• How transport after prolonged field care affects physiology and clinically meaningful outcomes

8) What is the significance of the 72-hour time window mentioned in Focus Area 1?

The opportunity highlights an acute window of up to 72 hours for understanding and mitigating death and complications during prolonged care. This includes prolonged resuscitation and delayed surgery scenarios, with particular emphasis on conditions like TBI and prolonged hypotension.

9) What topics are included under Focus Area 2?

Focus Area 2 targets development of next-generation resuscitation and stabilization methods that work during prolonged out-of-hospital care. It includes:

• Improved or novel approaches for casualties with both hemorrhagic shock and acute TBI (with or without additional injuries)
• Point-of-injury or prehospital monitoring/stabilization for TBI to identify life-threatening deterioration earlier, speed decision-making, and slow or prevent progression of brain injury when evacuation is delayed
• Metabolic and tissue stabilization strategies to extend survivability and support organ function during prolonged prehospital and en route care
• New methods to improve oxygen delivery to tissues without relying on ventilators, especially during prolonged hypotension and polytrauma

10) What topics are included under Focus Area 3?

Focus Area 3 emphasizes enhanced treatment of injuries during PFC and pDCR, including tangible treatments, forward surgical approaches, and portable critical care capabilities. This includes:

• TBI therapies (drugs, devices, or cellular therapies) intended to reduce death and disability and improve near-term and longer-term outcomes
• Forward surgical techniques and enabling technologies to stabilize life- and limb-threatening injuries outside traditional hospitals
• Advanced hemostatic approaches and intravascular methods such as REBOA (resuscitative endovascular balloon occlusion of the aorta)
• Simplified portable organ support technologies and interventions to prevent or treat organ failure and perfusion/reperfusion injury linked to prolonged resuscitation and delayed definitive care
• Methods to stabilize and treat complex tissue injuries (burns, facial trauma, chest wall crush injuries, pelvic fractures, spinal and extremity fractures, large soft-tissue defects) to prevent infection, limit tissue loss, protect exposed structures, reduce pain and secondary injury, and enable safer transport

11) Is traumatic brain injury (TBI) a priority area in PFCRA?

Yes. TBI is emphasized across the focus areas, including monitoring and treatment during the acute period (up to 72 hours), improved prehospital monitoring and stabilization, and development of therapies (including drugs, devices, or cellular therapies) intended to improve outcomes.

12) Are both materiel and non-materiel deliverables allowed?

Yes. PFCRA recognizes both materiel outputs (such as tools, devices, and technologies) and non-materiel outputs. It explicitly allows "knowledge products" as deliverables.

13) What are "knowledge products" under PFCRA?

"Knowledge products" are non-materiel deliverables intended to close gaps in the trauma care continuum by improving information, awareness, procedures, clinical practice guidance, training recommendations, and the effective use of existing drugs, devices, and equipment. This means proposals do not have to invent a new device to be responsive, as long as the output is evidence-backed and improves prolonged field care practice.

14) What types of research can PFCRA support?

PFCRA can support preclinical studies, clinical research, and early clinical trials or testing.

15) Are Phase II or Phase III clinical trials allowed?

No. Phase II and Phase III clinical trials intended to support FDA licensure for drugs, or pivotal/definitive testing for FDA device clearance, are not allowed under this announcement.

16) What funding mechanisms are used for PFCRA awards?

The funding mechanism types listed include grants and cooperative agreements.

17) Who is eligible to apply?

Eligibility is listed as unrestricted, meaning it is open to any entity type, subject to any additional eligibility notes in the full announcement.

18) What agency is associated with this opportunity?

The opportunity is associated with the Department of Defense (DOD-AMRAA).

19) What is the CFDA number for this opportunity?

The listing identifies CFDA 12.420.

20) When was the opportunity posted and when did it close?

It was posted on March 24, 2016, and the application closing date was August 4, 2016.

21) How many awards were expected?

The listing indicates an expected 31 awards.

22) What is the award ceiling?

The award ceiling is shown as 0. This typically signals that applicants should refer to the full announcement for detailed budget constraints or that ceilings may vary by project type.

23) What kinds of settings is PFCRA most concerned with?

PFCRA is oriented toward austere, resource-limited settings such as the point of injury, remote environments, and prolonged transport scenarios where evacuation is delayed and surgical care is not immediately available.

24) What outcomes does the program emphasize?

The program emphasizes patient-level outcomes, including survival and improved clinically meaningful outcomes during prolonged pre-surgical care, as well as near-term and longer-term outcomes for injuries such as TBI.

25) Does PFCRA address complications from prolonged use of current field devices?

Yes. Focus Area 1 specifically calls for research on the consequences and safe limits of using current prehospital hemostatic devices for prolonged durations (beyond roughly 2 to 4 hours).

26) Does PFCRA include organ support and critical care considerations in the field?

Yes. Focus Area 1 includes identifying barriers to providing organ support and critical care in field conditions, and Focus Area 3 includes simplified portable organ support technologies and interventions to prevent or treat organ failure and perfusion/reperfusion injury.

27) Does PFCRA include research related to oxygen delivery without ventilators?

Yes. Focus Area 2 includes developing new ways to improve oxygen delivery to tissues without relying on ventilators, particularly in scenarios involving prolonged hypotension and polytrauma.

28) Are forward surgical approaches and techniques like REBOA included?

Yes. Focus Area 3 supports forward surgical techniques and enabling technologies, including intravascular methods such as resuscitative endovascular balloon occlusion of the aorta (REBOA).

29) Does the opportunity address transport after prolonged field care?

Yes. Focus Area 1 includes studying how transport after prolonged field care affects physiology and clinically meaningful outcomes.

30) What is the overall intent of PFCRA across the trauma care continuum?

While keeping the entire continuum in mind (injury, prolonged care, evacuation, definitive treatment), PFCRA is aimed at accelerating actionable science and translational solutions that improve survival and outcomes when casualties must be managed longer than normal before surgical hemorrhage control and contamination control can occur.