Abstract
The Tactical Combat Casualty Care (TCCC) project begun by the Naval Special Warfare Command and continued by the U.S. Special Operations Command developed a set of tactically appropriate battlefield trauma care guidelines that were initially published in 1996. Transition of these guidelines into use throughout the Department of Defense has been ongoing since that time. The need for updates to the TCCC guidelines was recognized early on and has been carried out by the Committee on Tactical Combat Casualty Care established and operated by the Naval Operational Medicine Institute. The evolution of these guidelines from the 1996 recommendations to the present is described. Numerous reports in the medical literature and collected from combat first responders have documented that TCCC is saving lives on the battlefield and improving the tactical flow of missions on which casualties have occurred. Present challenges to the optimized implementation of TCCC in U.S. combat units include the need to expedite transition of new TCCC techniques and technologies to deploying units, to provide TCCC training for all U.S. combatants, and to ensure adequate funding for the Committee on TCCC.
Highlights
Prehospital trauma care as performed on the battlefield differs markedly from that performed in the civilian sector
The Tactical Combat Casualty Care (TCCC) project begun by the Naval Special Warfare Command in 1993 and later continued by the U.S Special Operations Command (USSOCOM) developed a set of tactically appropriate battlefield trauma care guidelines that were published as a special supplement to Military Medicine in 1996 (Butler et al, 1996)
Breathing Consider tension pneumothorax and decompress with needle thoracostomy if casualty has torso trauma and respiratory distress Consider chest tube insertion if no improvement and/or long transport anticipated Most combat casualties do not require oxygen, but administration of oxygen may be of benefit for the following types of casualties: low oxygen saturation by pulse oximetry, injuries associated with impaired oxygenation, unconscious patient, traumatic brain injury (TBI) patients Sucking chest wounds should be treated with a petroleum gauze applied during expiration, covering it with tape or a field dressing, placing the casualty in the sitting position, and monitoring for the development of a tension pneumothorax 3
Summary
Authors alone are responsible for opinions expressed in the contribution and for its clearance through their federal health agency, if required. Jr., MC USN (Ret.) Contributors: CAPT Frank K. The Tactical Combat Casualty Care (TCCC) project begun by the Naval Special Warfare Command and continued by the U.S Special Operations Command developed a set of tactically appropriate battlefield trauma care guidelines that were initially published in 1996 Transition of these guidelines into use throughout the Department of Defense has been ongoing since that time. The need for updates to the TCCC guidelines was recognized early on and has been carried out by the Committee on Tactical Combat Casualty Care established and operated by the Naval Operational Medicine Institute. The evolution of these guidelines from the 1996 recommendations to the present is described. Present challenges to the optimized implementation of TCCC in U.S combat units include the need to expedite transition of new TCCC techniques and technologies to deploying units, to provide TCCC training for all U.S combatants, and to ensure adequate funding for the Committee on TCCC
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