CLS ■ I l/IBAT

TCCC ESAVER DHA

DEFENSE HEALTH AGENCY

TACTICAL COMBAT
CASUALTY CARE
COURSE
MODULE 01: PRINCIPLES AND
APPLICATIONS OF TACTICAL COMBAT Committee on
Tactical Combat

CASUALTY CARE (TCCC)

Casualty Care
(CoTCCC)

TCCC TIER 1 TCCC TIER 2 TCCC TIER 3 TCCC TIER 4

All Service Combat Lifesaver Combat Medic/Corpsman Combat Paramedic/Provider
Members
 TACTICAL COMBAT CASUALTY CARE (TCCC)
ROLE-BASED TRAINING SPECTRUM DEFENSE HEALTH AGENCY

- ROLE 1 CARE
NONMEDICAL MEDICAL
PERSONNEL PERSONNE
L

CLS A YOU ARE HERE

STANDARDIZED JOINT CURRICULUM

#TCCC-CLS-PPT-01 25 JAN 20 2
 PRINCIPLES AND APPLICATIONS OF TCCC DHP
DEFENSE HEALTH AGENCY

TERMINAL LEARNING OBJECTIVES

\
Q^ Given a combat or noncombat scenario, perform Tactical Combat Casualty Care (TCCC) in accordance with the Committee on
Tactical Combat Casualty Care (CoTCCC) Guidelines
Demonstrate the application of TCCC skills in a combat or noncombat scenario.
(Comprehensive Module Practical Exercise)

02 Describe the practice of TCCC in accordance with CoTCCC Guidelines

Identify the leading causes of preventable death due to traumatic injuries, and the corresponding interventions to help

• 02 increase chances of survival

Describe the TCCC Phases of Care, and how intervention priorities differ in each phase, in accordance with CoTCCC
• guidelines Describe the application of TCCC in combat and noncombat settings across different environments
03 Describe the role and responsibilities of a nonmedical service member in rendering TCCC care in accordance with Joint
Publication (JP) 4-02, Health Services Support, p. 27 (11-1)
•
Identify the key factors influencing TCCC
04 Identify the importance of TCCC training
• Identify three objectives (or goals) of TCCC
V /
05 ENABLING LEARNING = Cognitive ELOs = Performance ELOs

• OBJECTIVES (ELOs) #TCCC-CLS-PPT-01 25 JAN 20 3

 CONGRESSIONAL MANDATE FOR
STANDARDIZED TRAINING DEFENSE HEALTH AGENCY

DoDI 1322.24

■
I
Standardizes Combat Casualty
Care for all Service members
DoD INSTRUCTION 1322.24 Covers the use of standardized
MEDICAL READINESS TRAINING
trauma training platforms
(MRT)
Originating Component: Office of the Under Secretary ofDefense for Personnel and Readiness

Effective: March 16, 2018

Reusability: Cleared for public release. Available on the DoD Issuances Website at
http://www.esd.whs.mil/DD/.
Reissues and Cancels: DoD Instruction 1322.24, “Medical Readiness
Training,” October 6, 2011
Approved by: Robert L. Wilkie, Under Secretary ofDefense forPersonnel and
Readiness * •

Purpose: This issuance:

•

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a #TCCC-CLS-PPT-01 25 JAN 20 4
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STANDARDIZED TCCC TRAINING ACROSS

THE ENTIRE U.S. MILITARY

MEDICINE BEGINNING WITH THE TCCC ALL SERVICE MEMBERS COURSE

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| ASM TCCC curriculum and resources

| Updated videos, podcasts, and resources ALL ^
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downloadable COURSE ]
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#TCCC-CLS-PPT-01 25 JAN 20 5
 COURSE CONTENTS
WHAT THIS COURSE CONTAINS
| Principles and Applications of TCCC |
Medical Equipment | Care Under Fire
Principles and Application of
Tactical Field Care Tactical Trauma
Assessment Massive Hemorrhage
Control Airway Management
Respiration Assessment and
Management
Circulation/Hemorrhage Control
Shock Recognition
DEFENSE HEALTH AGENCY
| Hypothermia Prevention |
Head Injuries | Eye
Injuries
| Pain Medication and
Antibiotic Administration |
Wound Management |
Burns | Fractures |
Casualty Monitoring | Pre-
evacuation Procedures
Evacuation Procedures
#TCCC-CLS-PPT-01 25 JAN 20 6
PRINCIPLES AND APPLICATIONS OF TCCC
TACTICAL COMBAT
CASUALTY CARE j

COMBAT
INTRO TO TACT CAL
CASUALTY CARE (TCCC)
Tactical Combat Casualty Care

Video can be found on DeployedMedicine.com

#TCCC-CLS-PPT-01 25 JAN 20 7
 PRINCIPLES AND APPLICATIONS OF TCCC DEFENSE HEALTH AGENCY

ROLES AND RESPONSIBILITIES OF

I
THE COMBAT LIFESAVER
In a Care Under Fire situation the CLS:
Must respond to suppression of hostile fire to
minimize the risk of injury to personnel and
minimize additional injury to previously injured

I
Service members
In Tactical Field Care the CLS Service members:
Must maintain security and situational
awareness while continuing to tend to casualties
and prepare for evacuation

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 PRINCIPLES AND APPLICATIONS OF TCCC DEFENSE HEALTH AGENCY

ROLES AND RESPONSIBILITIES OF CLS

First Responder Care (Role 1)

The first medical care that military personnel receive is
provided at Role 1 (also referred to as unit-level
medical care or self-aid, buddy aid, combat lifesaver,
and/or medic care). This role of care includes:
Immediate lifesaving measures and treatment for
disease and non-battle injury (DNBI) or
degradation of functional capability sustained by
personnel and caused by factors other than those
directly attributed to enemy action

#TCCC-CLS-PPT-01 25 JAN 20 9
 PRINCIPLES AND APPLICATIONS OF TCCC DHA^
DEFENSE HEALTH AGENCY

THE KEY FACTORS INFLUENCING TCCC

| Hostile fire
| Tactical considerations | Environmental
considerations | Wounding patterns | Equipment
constraints | Delays in reaching higher levels of
care | Level of first responder training and
experience

#TCCC-CLS-PPT-01 25 JAN 20 10
 mm
PRINCIPLES AND APPLICATIONS OF TCCC DEFENSE HEALTH AGENCY

IMPORTANCE OF TCCC TRAINING

TCCC focuses on identifying and
treating the causes of preventable
death on the battlefield
I
I Bleeding from arm and leg injuries
Junctional bleeding where an arm or

I
leg joins the torso such as the groin
Noncompressible bleeding such as a
gunshot wound to the abdomen
I Tension pneumothorax (air trapped in 1
the chest that prevents breathing and
lation), and airway problems

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PRINCIPLES AND APPLICATIONS OF TCCC DHflP
DEFENSE HEALTH AGENCY

THREE GOALS OF TCCC

| Treat the casualty

| Prevent additional casualties

| Complete the mission

#TCCC-CLS-PPT-01 25 JAN 20 \2
CLS
DHK
DEFENSE HEALTH AGENCY

ENTER THE
BATTLEFIELD

#TCCC-CLS-PPT-01 25 JAN 20

Three PHASES of TCCC
CARE UNDER
FIRE
RETURN FIRE AND TAKE
COVER
Quick decision-making:
I
Consider scene safety
Identify and control life-
threatening bleeding
Move casualty to safety
DEFENSE HEALTH AGENCY
2 TACTICAL 3 TACTICAL
FIELD CARE EVACUATION
COVER AND
CONCEALMENT
CARE (TACEVAC)
More deliberate assessment and
treatment of unrecognized life-
Basic Management Plan:
threatening injuries
Maintain tactical situational
awareness Pre-evacuation procedures
Triage casualties as Continuation of documentation
required MARCH PAWS
assessment
NOTE: This is covered in more
advanced TCCC training!
#TCCC-CLS-PPT-01 25 JAN 20
 CARE UNDER FIRE
DEFENSE HEALTH AGENCY

PHASE 1: CARE UNDER FIRE

I RETURN FIRE I DIRECT CASUALTY TO I GAIN FIRE
AND TAKE COVER
I
REMAIN ENGAGED
APPLY SELF-AID AND
MOVE TO COVER
SUPERIORITY

MOVE TO CASUALTY
Never attempt to (if casualty is
rescue a casualty until (if able)
hostile fire is
unable to move to
suppressed cover)

A resources,
ensure scene
Using available
safety

#TCCC-CLS-PPT-01 25 JAN 20 15
 CARE UNDER FIRE
DEFENSE HEALTH AGENCY

I
PHASE 1: CARE UNDER FIRE
I APPLY TOURNIQUET CONTINUE TO
IMPORTANT

I
TO CONTROL LIFE- MAINTAIN FIRE
THREATENING SUPERIORITY CONSIDERATIONS:
Continuously assess
BLEEDING MOVE risks and make a plan
before moving a
CASUALTY casualty
For life-threatening
bleeding, place a
tourniquet "high
and
tight" above the wound

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 TACTICAL FIELD CARE

MARCH PAWS
DEFENSE HEALTH AGENCY

DURING LIFE-THREATENING AFTER LIFE-THREATENING

M MASSIVE BLEEDING #1 Priority

P PAIN A
A AIRWAY
ANTIBIOTICS

R RESPIRATION (Breathing) W WOUNDS S

C CIRCULATION SPLINTING

H HYPOTHERMIA / #TCCC-CLS-PPT-01 25 JAN 20 7


PHASE 2: OTHER CONSIDERATIONS OF
TACTICAL FIELD CARE
I
TFC
The casualty and the
I
person rendering care are not
under direct fire
Intervention priorities
should follow MARCH PAWS
mm
TACTICAL FIELD CARE DEFENSE HEALTH AGENCY
REMEMBER:
I Always use the
I I casualty’s Joint First
Aid Kit (JFAK) first
I
TFC can turn into a CUF
LIMITED SUPPLIES
Medical equipment and situation unexpectedly
Personnel should
supplies are limited to what is
carried into the field by the maintain their situational
combat lifesaver and the awareness
individual Service member
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 TACTICAL EVACUATION DHflP
DEFENSE HEALTH AGENCY

PHASE 3: TACTICAL EVACUATION CARE

CASUALTY MONITORING COMPLETE REPORT PRE-EVAC PROCEDURES
Continue to reassess and Complete DD Form 1380
monitor casualty Mechanism of
injury O Injuries
EVAC REQUEST
o Symptoms o
Use 9-Line Format
Treatment

CASUALTY PREP

Prep Litter

| Prep Evac Equipment

Pack Casualty
Secure Items (litter transport) #TCCC-CLS-PPT-01 25 JAN 20 19
 IN SUMMARY DEFENSE HEALTH AGENCY

GOALS
I Treat the casualty I Prevent additional casualties I Complete the mission

Three PHASES of TCCC

O CUF 0 TFC o TACEVAC
COVERAND CONCEALMENT
RETURN FIRE AND
TAKE COVER More deliberate assessment and
Basic management plan:
treatment of unrecognized life-

I
Quick decision-making: Maintain tactical situational
threatening injuries:

I
1 Consider scene safety awareness
Identify and control life- I Triage casualties as required I Pre-evacuation procedures
threatening bleeding I Conduct MARCH PAWS
Continuation of documentation
Move casualty to safety assessment

#TCCC-CLS-PPT-01 25 JAN 20 20
 DEFENSE HEALTH AGENCY

CHECK ON LEARNING

I What factors influence TCCC?

I What are the phases of care in TCCC?

What is the most essential treatment task in CUF?

I What is every first responder’s role in CUF?
I What does MARCH PAWS stand for?

#TCCC-CLS-PPT-01 25 JAN 20
 DEFENSE HEALTH AGENCY

ANY
QUE
STIO
NS?

#TCCC-CLS-PPT-01 25 JAN 20