Tactical Combat Casualty Care Tccc Tc3 Presentation

Tactical Combat Casualty Care Guidelines 28 October 2013 * All changes to the guidelines made since those published in the 2010 Seventh Edition of the PHTLS Manual are shown in bold text. The most recent changes are shown in red text. * These recommendations are intended to be guidelines only and are not a substitute for clinical judgment. Basic Management Plan for Care Under Fire 1. Return fire and take cover. 2. Direct or expect casualty to remain engaged as a combatant if appropriate. 3. Direct casualty to move to cover and apply self-aid if able. 4. Try to keep the casualty from sustaining additional wounds. 5. Casualties should be extricated from burning vehicles or buildings and moved to places of relative safety. Do what is necessary to stop the burning process. 6. Airway management is generally best deferred until the Tactical Field Care phase. 7. Stop life-threatening external hemorrhage if tactically feasible: - Direct casualty to control hemorrhage by self-aid if able. - Use a CoTCCC-recommended tourniquet for hemorrhage that is anatomically amenable to tourniquet application. - Apply the tourniquet proximal to the bleeding site, over the uniform, tighten, and move the casualty to cover.

Tactical Combat Casualty Care (TCCC) has saved hundreds of lives during our nation's conflicts in Iraq and Afghanistan. Nearly 90 percent of combat fatalities occur before a casualty reaches a medical treatment facility. Therefore, the prehospital phase of care is needed to focus on reducing the number of combat deaths. However, few military physicians have had training in this area and, at the onset of hostilities, most combat medics, corpsmen, and pararescue personnel in the U.S. military have been trained to perform battlefield trauma care through civilian-based trauma courses. These courses are not designed for the prehospital combat environment and do not reflect current practices in the area of prehospital care. TCCC was created to train Soldiers and medical personnel on current best practices for medical treatment from the point of injury to evacuation to Role 3 facilities

A decade of intense combat in two theaters has taught us many lessons about what works and what does not in the effort to accomplish thatall-important mission of saving lives in battle. A severely injured Soldier today has about twice the likelihood of surviving his wounds compared to Soldiers in wars as recent as Vietnam. That progress is the result of many things: better tactics and weapons, better body armor and helmets, better trained and fitter Soldiers. But, the introduction of Tactical Combat Casualty Care (TCCC) throughout the Army has certainly been an important part of that improvement.TCCC is fundamentally different from civilian care. It is the thoughtful integration of tactics and medicine, but to make it work takes a different set of skills and equipment, and every Soldier and leader needs to understand it and practice it.This handbook is the result of years of careful study of the care of wounded Soldiers, painstaking research by medics and physicians, and the abilityof leaders at all levels to see and understand the lessons being learned and the willingness to make the changes in equipment, training, and doctrine needed to improve the performance of the Army Health System. It is the best guidance we have at the time of publication, but new information, new techniques, or new equipment will drive changes in the future. Be assured that these performance improvement efforts will continue as long as American Soldiers go in harm's way.

INTRODUCTION: What is TCCC and Why Do I Need to Learn about it?? 1. Coalition forces presently have the best casualty treatment and evacuation system in history. 2. TCCC is what will keep you alive long enough to benefit from it. 3. Originally a Special Operations research effort Trauma management plans that take into account the unique challenges faced by combat medical personnel Now used throughout U.S. military and by most allied countries TCCC has helped U.S. combat forces to achieve the highest casualty survival rate in history. TCCC Approach: 1. Identify the causes of preventable death on the battlefield 2. Address them aggressively 3. Combine good medicine with good tactics Phases of Care in TCCC: 1. Care Under Fire Care under fire is the care rendered by the first responder or combatant at the scene of the injury while he and the casualty are still under effective hostile fire. Available medical equipment is limited to that carried by the individual or by the medical provider in his or her aid bag. 2. Tactical Field Care Tactical Field Care is the care rendered by the first responder or combatant once he and the casualty are no longer under effective hostile fire. It also applies to situations in which an injury has occurred, but there has been no hostile fire. Available medical equipment is still limited to that carried into the field by unit personnel. Time to evacuation to a medical treatment facility may vary considerably. 3. 3. Tactical Evacuation Care Tactical Evacuation Care is the care rendered once the casualty has been picked up by an aircraft, vehicle or boat. Additional medical personnel and equipment that may have been pre-staged should be available in this phase of casualty management.

Tactical Combat Casualty Care (TCCC) has saved hundreds of lives during our nation's conflicts in Iraq and Afghanistan. Nearly 90 percent of combat fatalities occur before a casualty reaches a medical treatment facility. Therefore, the prehospital phase of care is needed to focus on reducing the number of combat deaths. However, few military physicians have had training in this area and, at the onset of hostilities, most combat medics, corpsmen, and pararescue personnel in the U.S. military have been trained to perform battlefield trauma care through civilian-based trauma courses. These courses are not designed for the prehospital combat environment and do not reflect current practices in the area of prehospital care. TCCC was created to train Soldiers and medical personnel on current best practices for medical treatment from the point of injury to evacuation to Role 3 facilities.

This handbook was previously distributed as a supplement to the Journal of Special Operations Medicine. The realm of special operations forces (SOF) medicine is a unique and ever-changing one that demands specialized training for our joint SOF. Managing trauma on today’s battlefield presents a dynamic array of challenges where limited resources can be rapidly overwhelmed. An austere environment, hostile gunfire, and delays in casualty evacuation (CASEVAC) are the norms for the special operations medic. The material in this handbook was gleaned from special operations medics operating in the Global War on Terrorism and other operational environments. It should not be viewed as a substitute for the professional training and judgment of special operations medics; rather, it is designed to be a hip-pocket reference on the tactics, techniques, and procedures (TTP) of SOF-relevant tactical combat casualty care. Key Lessons Ninety percent of combat loss of life occurs before casualties ever reach a military treatment facility (MTF); treatment prior to casualty evacuation is vital. Litter carries are fundamental for good patient care; they prevent further injury and get individuals off target as soon as possible. Rehearse manual carry methods prior to deployment. Every special operations warfighter should carry a tourniquet and be thoroughly familiar with its application. When managing multiple casualties, apply the principles of triage in classifying the priority of treatment and evacuation. Rehearse and employ all of the mechanics of CASEVAC from the point of injury to the handover at a MTF. This handbook provides a number of considerations when employing medical support to SOF in combat. The challenges are numerous, but the special operations medic must deliver medical care to save Soldiers’ lives. The collection of TTP in this handbook will enhance the medic’s ability to determine the optimum method to deliver casualty survival assistance.

"This book is designed to deliver combat casualty care information that will facilitate transition from a continental US or civilian practice to the combat care environment. Establishment of the Joint Theater Trauma System and the Joint Theater Trauma Registry, coupled with the efforts of the authors, has resulted in the creation of the most comprehensive, evidence-based depiction of the latest advances in combat casualty care. Lessons learned in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) have been fortified with evidence-based recommendations to improve casualty care. The educational curriculum was designed overall to address the leading causes of preventable death and disability in OEF and OIF. Specifically, the generalist combat casualty care provider is presented requisite information for optimal cae of US combat casualties in the first 72 to 96 hours after injury. The specialist provider is afforded similiar information, supplemented by lessons learned for definitive care of host nation patients."--

This is a complete reproduction of the revised Edition C of the Army's Combat Lifesaver course. The course contains information needed to pass the written, written performance, and performance examinations for combat lifesaver certification and recertification. All of the tasks contain important, lifesaving information. Terminal objectives are: Tactically manage a casualty. Given a casualty in a battlefield environment and a combat lifesaver medical equipment set. Applied the procedures given in this course so that the mission is not endangered and the risk of additional injury to the casualty is minimized. Evaluate and treat a casualty. Given a combat lifesaver medical equipment set and a casualty with one or more of the following problems: blocked airway, no respiration, bleeding from an extremity, amputation of an extremity, hypovolemic shock, or open chest wound. Performed needed procedures in accordance with the procedures given in this course and documented the treatment on a U.S. Field Medical Card or Tactical Combat Casualty Care Card, as appropriate. Prepare and transmit a request for medical evacuation. Given a writing instrument, a MEDEVAC worksheet, needed information, and a transmitting device. Prepared a MEDEVAC request in correct format and transmitted the request following the rules for proper transmission. Transport a casualty. Given a casualty in need of evacuation, drag equipment (such as a Dragon Harness or SLICK litter), a SKED litter, a Talon litter, materials for improvising a litter (if used), and assistant(s) (if needed). Prepared the SKED litter, Talon litter, improvised litter, or other equipment (if used) and evacuated the casualty using a drag, manual carry, or litter in accordance with the procedures given in this subcourse. Combat Lifesaver * Lesson 1 - INTRODUCTION TO THE COMBAT LIFESAVER AND TACTICAL COMBAT CASUALTY CARE * Lesson 2 - CARE UNDER FIRE * Lesson 3 - TACTICAL FIELD CARE * Lesson 4 - CONTROLLING BLEEDING * Lesson 5 - OPENING AND MANAGING A CASUALTY'S AIRWAY * Lesson 6 - TREATING PENETRATING CHEST TRAUMA * Lesson 7 - INITIATING A FIELD MEDICAL CARD OR TCCC CARD * Lesson 8 - REQUESTING MEDICAL EVACUATION * Lesson 9 - TACTICAL CASUALTY MOVEMENT * Lesson 10 - EVACUATING A CASUALTY USING A LITTER * Appendix A - COMBAT LIFESAVER MEDICAL EQUIPMENT SET * Appendix B - HAWES CARRY