MODULE 01: PRINCIPLES AND

APPLICATIONS OF TACTICAL COMBAT

CASUALTY CARE (TCCC)
TCCC TIER 1 TCCC TIER 2 TCCC TIER 3 TCCC TIER 4
All Service Members Combat Lifesaver Combat Medic/Corpsman Combat Paramedic/Provider
 TACTICAL COMBAT CASUALTY CARE (TCCC)
ROLE-BASED TRAINING SPECTRUM

ROLE 1 CARE
NONMEDICAL MEDICAL
PERSONNEL PERSONNEL

YOU ARE HERE

STANDARDIZED JOINT CURRICULUM

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 PRINCIPLES AND APPLICATIONS OF TCCC

TERMINAL LEARNING OBJECTIVES

01 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 Tactical Combat Casualty Care skills in a combat or noncombat scenario. (Comprehensive
01 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
03 Describe the TCCC Phases of Care, and how intervention priorities differ in each phase, in accordance with CoTCCC guidelines
04 Describe the application of TCCC in combat and noncombat settings across different environments
Describe the role and responsibilities of a nonmedical service member in rendering TCCC care in accordance with Joint
05 Publication (JP) 4-02, Health Services Support, p. 27 (II-1)
06 Identify the key factors influencing TCCC
07 Identify the importance of TCCC training
08 Identify three objectives (or goals) of TCCC

08 ENABLING LEARNING = Cognitive ELOs = Performance ELOs

OBJECTIVE (ELO) #TCCC-CLS-PP T-01 25 JAN 20 3

CONGRESSIONAL MANDATE FOR
STANDARDIZED TRAINING
DoDI 1322.24

 Standardizes Combat Casualty Care for

all Service members
 Covers the use of a standardized
trauma training platforms

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 YOUR ONLINE RESOURCE

This isn’t just your typical

first aid training

 Training & Education Resource

 ASM TCCC Curriculum and resources
 Updated videos, podcasts, and resources
 Download CPGs to your phone

www.deployedmedicine.com

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 COURSE CONTENTS

WHAT THIS COURSE CONTAINS

 Principles and Applications of TCCC  Hypothermia Prevention

 Medical Equipment  Head Injuries
 Care Under Fire  Eye Injuries
 Principles and Application of Tactical Field Care  Pain Medication and Antibiotic Administration
 Tactical Trauma Assessment  Wound Management
 Massive Hemorrhage Control  Burns
 Airway Management  Fractures
 Respiration Assessment and Management  Casualty Monitoring
 Circulation/Hemorrhage Control  Pre-evacuation Procedures
 Shock Recognition  Evacuation Procedures

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PRINCIPLES AND APPLICATIONS OF TCCC

Video can be found on DeployedMedicine.com

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 PRINCIPLES AND APPLICATIONS OF TCCC

ROLES AND RESPONSIBILITIES OF

COMBAT LIFESAVER (CLS)
In a CUF situation the CLS:
 Attention to suppression of hostile fire may
minimize the risk of injury to personnel and
minimize additional injury to previously
injured Service members
In TFC the CLS Service members:
 Must maintain security and situational
awareness while continuing the treatment of
casualties and preparation for evacuation

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 PRINCIPLES AND APPLICATIONS OF TCCC

ROLES AND RESPONSIBILITIES OF CLS

First Responder Care (Role 1)

The first medical care 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
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

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 PRINCIPLES AND APPLICATIONS OF TCCC

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

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 PRINCIPLES AND APPLICATIONS OF TCCC

IMPORTANCE OF TCCC TRAINING

TCCC focuses on identifying and
treating the causes of preventable Bleeding from arm and leg injuries
death on the battlefield Junctional bleeding where an arm or
leg joins the torso such groin
Non-compressible bleeding such as a
gunshot wound to the abdomen
Tension pneumothorax, and airway problems

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PRINCIPLES AND APPLICATIONS OF TCCC

THREE GOALS OF TCCC

Treat the Casualty

Prevent additional casualties

Complete the mission

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 ENTER THE
BATTLEFIELD

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

PHASE 1: CARE UNDER FIRE

RETURN FIRE DIRECT CASUALTY FIRE SUPERIORITY

AND TAKE COVER TO REMAIN ENGAGED HAS BEEN GAINED

Never attempt to APPLY SELF AID CLS MOVEMENT

rescue a casualty until AND MOVE TO COVER TO CASUALTY
hostile fire is suppressed (if able) (if casualty is unable
to move to cover)
Using available
resources, ensure
GAIN FIRE
scene safety SUPERIORITY

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 CARE UNDER FIRE

PHASE 1: CARE UNDER FIRE

APPLY TOURNIQUET FIRE SUPERIORITY IMPORTANT

TO CONTROL CONTINUES TO BE CONSIDERATIONS:
LIFE-THREATENING MAINTAINED
Constantly assess risks and
BLEEDING make a plan before moving
CASUALTY a casualty
For life-threatening MOVEMENT
bleeding, place a
tourniquet "high and
tight" above the wound

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 TACTICAL FIELD CARE
MARCH PAWS
LIFE-THREATENING AFTER LIFE-THREATENING

M MASSIVE BLEEDING #1 Priority

P PAIN
A AIRWAY
A ANTIBIOTICS

R RESPIRATION (Breathing)
WOUNDS
W
C CIRCULATION

HYPOTHERMIA /
S SPLINTING

H HEAD INJURIES
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 TACTICAL FIELD CARE

PHASE 2: OTHER CONSIDERATIONS OF

TACTICAL FIELD CARE
REMEMBER:
Always use the
casualty's JFAK first
Tactical Field Care can
turn into a Care Under
Fire unexpectedly
TACTICAL FIELD CARE (TFC)
Personnel should
The casualty and the LIMITED SUPPLIES maintain their situational
person rendering care are Medical equipment and supplies
not under direct fire awareness
are limited to what is carried into
Intervention priorities should the field by the combat lifesaver
follow MARCH PAWS and the individual service member

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 TACTICAL EVACUATION

PHASE 3: TACTICAL EVACUATION CARE

CASUALTY MONITORING Complete MIST report PRE-EVAC PROCEDURES
Continue to reassess and M Mechanism of injury Complete DD Form 1380
monitor casualty
I Injuries
EVAC REQUEST S Symptoms
Use 9-Line Format T Treatment

CASUALTY PREP
Prep Litter

Prep Evac Equipment

Pack Casualty
Secure Items
(Litter Transport)
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 IN SUMMARY

GOALS
Treat the Casualty Prevent additional casualties Complete the mission

Three PHASES of TCCC

1 CARE
UNDER FIRE 2
TACTICAL
FIELD CARE
3 TACTICAL
EVACUATION
RETURN FIRE
AND TAKE COVER
COVER AND
CONCEALMENT CARE
Quick decision-making: More deliberate assessment and
 Consider scene safety Basic Management Plan: treatment of unrecognized
 Maintain tactical situational life-threatening injuries
 Identify and control life-
awareness
threatening bleeding  Pre-evacuation procedures
 Move casualty to safety  Triage casualties as required
 MARCH-PAWS assessment  Continuation of documentation

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 CHECK ON LEARNING
What are factors that influence TCCC?
What are the phases of care in TCCC?
What is the most essential treatment task in Care Under Fire?
What is every first responder’s role in Care Under Fire?
What does MARCH-PAWS stand for?

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ANY QUESTIONS?

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