UNITED STATES MARINE CORPS
Field Medical Training Battalion
Camp Lejeune
BLOCK 2 INTRODUCTION
1. Principles of
Tactical Combat Casualty Care (TCCC)
Chances are you’ve heard of
Tactical Combat Casualty Care (TCCC). If not, it is the pre-hospital care
rendered to a casualty in a tactical, combat environment. The principles of
TCCC 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 Committee on Tactical Combat Casualty Care
(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, fluid resuscitation, analgesia, and antibiotics
are important steps in providing the best possible care for our Marines and
Sailors in combat. TCCC was developed to emphasize the need for continued
improvement in combat pre-hospital care.
TCCC has one basic
principle: perform the correct intervention at the correct time.
2. PHASES OF TCCC
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:
Care Under Fire -
care rendered at the scene while both the Corpsman and the casualty are still
under effective hostile fire. The risk of additional injuries from hostile fire
at any moment is extremely high for both the casualty and the Corpsman.
Available medical equipment is limited to that carried by the Corpsman and
casualty.
Tactical Combat Care - care rendered
once the Corpsman and casualties are no longer under effective hostile fire.
This also applies to situations in which an injury has occurred on a mission,
but there has been no hostile fire. Available medical equipment is still
limited to that carried into the field by mission personnel. Time to evacuation
may vary from minutes to hours.
Casualty Evacuation (CASEVAC) Care
- care rendered while the casualty is being transported to a higher echelon of
care. Additional personnel and equipment may be available depending on the type
of vehicle being used (helicopter, ground ambulance, boat, etc.).
Throughout block 2, each lesson will reinforce
the principles of TCCC. At the end of each lesson you will find a gray box that
will highlight the critical task that you will be expected to perform during
your Casualty Assessment.
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