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 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.

Over 1,800 total slides ... Topics Covered: Point of Wounding Care Tactical Combat Casualty Care Advanced Airway Techniques Chest Trauma Management Hemorrhage Control Hypovolemic Shock Management Battlefield Casualty Evacuation Casualty Triage International Humanitarian Law and Geneva Conventions Airway Management Initiate and Manage an IV Battlefield Medications General Pharmacology Soldier Medic: Pharmacology for the Combat Medic Soldier Medic Nerve Agents Heat Injuries Communications and Documentation Initial Assessment and Management of the Combat Casualty Spinal Trauma Evacuation Request Procedures Perform Casualty Triage Evacuation Platforms Field Medical Card Tactical Combat Casualty Care Head and Spine Injuries (EMT-B) Airway Management Cardiovasclar Emergencies Baseline Vital Signs Obstetric and Gynecologic Emergencies Pediatric Assessment and Management Assessment and Management of Pediatric Emergencies (EMT-B)

This is an easy to read reference and practical guide to the management of combat extremity injuries, which account for a high percentage of the injuries sustained in recent and current conflicts. The surgical techniques appropriate to the full range of extremity injuries and some other frequent injuries, such as trauma to the spine and pelvis, are clearly described with the aid of helpful illustrations. In each chapter a “bottom line up front” approach is adopted, providing key messages first; a further important feature is the emphasis placed on case-based information and lessons learned from practice. Care has been taken to ensure that the advice provided is straightforward and in line with military clinical practice guidelines. This book, written by surgeons with experience in combat casualty care, will be relevant to all physicians working in forward surgical teams, combat surgical hospitals, or the “Charlie Med”.​

This book offers support and encouragement to all those interested in the development of cybertherapy systems. It provides evidence to build confidence in their effectiveness for detecting, monitoring and evaluating a number of important conditions and identifies and addresses the main barriers to their further development. It is divided into four main sections: critical reviews, evaluation studies, original research and clinical observations, tackling this complex subject by means of a clearly sequenced structure. --

Over 2,300 total pages ... OVERVIEW Tactical Combat Casualty Care (TCCC) was developed to emphasize the need for continued improvement in combat pre-hospital care. The Committee on Tactical Combat Casualty Care (CoTCCC) was established in 2001 and is part of the Defense Health Board. CoTCCC is a standing multi-service committee charged with monitoring medical developments in regards to practice, technology, pharmacology and doctrine. New concepts in hemorrhage control, airway management, fluid resuscitation, analgesia, antibiotics and other lifesaving techniques are important steps in providing the best possible care for our Marines and Sailors in combat. The TCCC guidelines are published every 4 years in the Prehospital Trauma Life Support manual. It has been recognized that TCCC guidelines and curriculum will need to change more often than the 4-year cycle of the PHTLS textbook publication. The National Association of Emergency Medical Technicians (NAEMT) will include the updated TCCC guidelines and curriculum on its website as they are approved as a way to help get this new information out to the combat medical personnel in the military that need it. PRINCIPLES OF TACTICAL COMBAT CASUALTY CARE (TCCC) The principles of Tactical Combat Casualty Care are fundamentally different from those of traditional civilian trauma care, where most medical providers and medics train. These differences are based on both the unique patterns and types of wounds that are suffered in combat and the tactical conditions medical personnel face in combat. Unique combat wounds and tactical conditions make it difficult to determine which intervention to perform at what time. Besides addressing a casualty’s medical condition, responding medical personnel must also address the tactical problems faced while providing care in combat. A medically correct intervention at the wrong time may lead to further casualties. Put another way, “good medicine may be a bad tactical decision” which can get the rescuer and the casualty killed. To successfully navigate these issues, medical providers must have skills and training oriented to combat trauma care, as opposed to civilian trauma care. The specifics of casualty care in the tactical setting will depend on the tactical situation, the injuries sustained by the casualty, the knowledge and skills of the first responder, and the medical equipment at hand. In contrast to a hospital Emergency Department setting where the patient IS the mission, on the battlefield, care of casualties sustained is only PART of the mission. TCCC recognizes this fact and structures its guidelines to accomplish three primary goals: 1. Treat the casualty 2. Prevent additional casualties 3. Complete the mission In thinking about the management of combat casualties, it is helpful to divide care into three distinct phases, each with its own characteristics and limitations.

As societies become more complex and interconnected, the global risk for catastrophic disasters is increasing. Demand for expertise to mitigate the human suffering and damage these events cause is also high. A new field of disaster medicine is emerging, offering innovative approaches to optimize disaster management. Much of the information needed to create the foundation for this growing specialty is not objectively described or is scattered among multiple different sources. Now, for the first time, a coherent and comprehensive collection of scientific observations and evidence-based recommendations with expert contributors from around the globe is available in Koenig and Schultz's Disaster Medicine: Comprehensive Principles and Practices. This definitive work on disaster medicine identifies essential subject matter, clarifies nomenclature, and outlines necessary areas of proficiency for healthcare professionals handling mass casualty crises. It also describes in-depth strategies for the rapid diagnosis and treatment of victims suffering from blast injuries or exposure to chemical, biological, and radiological agents.