Tactical Combat Casualty Care

For all preppers who feel that the end of the world is coming and want to prepare, you need to take a look at Tactical Combat Casualty Care. This is the care that you will need to administer to your family or group if you come under attack. This is the care that will help you keep someone alive when there are no hospitals or doctors around to treat you when the worse happens.

Tactical Combat Casualty Care (TCCC)

The only standard of care dually endorsed by both the American College of Surgeons, and the
National Association of EMT’s for Casualty Management in Tactical Environments.

The Evolution of Tactical Combat Casualty Care

The hard lessons learned over centuries of battlefield healthcare were all but ignored until a landmark paper appeared in a 1996 issue of Military Medicine. Previously, military guidelines for trauma management mirrored tactics used in the civilian sector. Initiated by the elements of the Special Operations Command, the new strategies outlined in 1996 were collectively referred to as Tactical Combat Casualty Care (TCCC).

90% of combat deaths occur on the battlefield before the casualty ever reaches a medical treatment facility – Col. Ron Bellamy

The hemorrhage that takes place when a main artery is divided is usually so rapid and so copious that the wounded man dies before help can reach him. – Col. H.M. Gray, 1919

Decrease Preventable Combat Death

TCCC launched a total reassessment of practices with one overarching goal:Decrease Preventable Combat Death at the point of wounding. These new strategies based on historical wounding patterns in combat also bear a particular relevance to the operators of Tactical Law Enforcement who share many operational parallels with their military counterparts.

Instead of the civilian-based approaches of the past, integrated strategies specific to combat realities continue to emerge. Compared to standard pre-hospital treatment modalities, which are fundamentally based on blunt trauma, TCCC distinguishes itself from the norm by focusing primarily on the intrinsic tactical variables of penetrating trauma compounded by prolonged evacuation times.

Today, TCCC is quickly becoming the standard of care for the tactical management of combat casualties within the Department of Defense and is the sole standard of care dually endorsed by both the American College of Surgeons and the National Association of EMT’s for casualty management in tactical environments.

TCCC is built around three definitive phases of casualty care:

Care Under Fire:

Care rendered at the scene of the injury while both the medic and the casualty are under hostile fire. Available medical equipment is limited to that carried by each operator and the medic.

Tactical Field Care:

Rendered once the casualty is no longer under hostile fire. Medical equipment is still limited to that carried into the field by mission personnel. Time prior to evacuation may range from a few minutes to many hours.

Tactical Evacuation Care (TACEVAC):

Rendered while the casualty is evacuated to a higher echelon of care. Any additional personnel and medical equipment pre-staged in these assets will be available during this phase.

A Tiered System for Medical Equipment

During all phases of care the principle mandate of TCCC is the critical execution of the right interventions at the right time. Particularly in the tactical environment, good medicine administered at the wrong time can often prove to be lethal. With this in mind Tactical Healthcare Professionals as well as Individual Warfighters/ Operators will both likely be involved in casualty care at some level and must be trained in and armed with the appropriate medical equipment and procedures corresponding to each level of care. As illustrated below, our macro strategy equips each tier with the critical equipment essential to managing trauma at each phase of casualty care. When employed with Tactical Combat Casualty Care (TCCC) training standards, this tiered approach can decrease Preventable Combat Death by as much as 90+%.

The Target: Preventable Combat Death

Col. Gray hit the nail on the head 85 years ago. Empirical research using data from World War II until today elicited the same conclusion. The overwhelming cause of preventable combat death continues to be extremity hemorrhage. However, until recently, neither warfighters nor tactical operators were trained or equipped to control the life threatening hemorrhage so common to both operational arenas.

The fate of the wounded lays with those who apply the first dressing. – Col. Nicholas Senn, 1844-1908

The TCCC Guidelines are best-practice trauma care guidelines customized for use on the battlefield. They are guidelines only – there are no rigid protocols in combat, including Tactical Combat Casualty Care. If the recommended TCCC combat trauma management plan doesn’t work for the specific tactical situation that a combat medic, corpsman, or PJ encounters, then care must be modified to best fit the tactical situation. Scenario-based planning is critical for success in TCCC.

The Committee on Tactical Combat Casualty Care develops recommendations that are submitted to the Defense Health Board for review and approval. If approved, the recommendations are sent to the Assistant Secretary of Defense (Health Affairs) (ASD(HA)) for consideration. Posting these recommendations on this website does not constitute endorsement by the ASD(HA). Subsequent TCCC guidelines and curricula have not been reviewed or endorsed by the ASD(HA) or the Defense Health Board.

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