TCCC for you and me?
It’s a scary of world out there folks. From terrorist’s bombings to active shooters, people driving trucks through crowds and even mass casualty knife attacks the world appears to be taking a turn towards the apocalypse . With the uptick in violent, mass casualty events what skills can we rely on to protect ourselves, and the ones we care about?
TCCC or Tactical Combat Casualty Care
TCCC or Tactical Combat Casualty Care was developed in the mid 90’s as a way to effectively deal with combat wounds while still allowing a unit to compete its mission and provide the best possible care for the injured. It was originally developed for special operations but is now the standard of care for all DOD personnel as well as many of our NATO allies. TCCC is broken into three phases of patient care: Care under fire, Tactical field care, and Tactical evacuation. Each of these phases looks to decrease preventable combat death and focusing on addressing the most common causes of combat related death. At this time those causes are:
1. Uncontrolled hemorrhage
2. Tension Pneumothorax
3. Airway obstruction
TCCC’s success is well documented and has proven to be effective in all arenas it has been implemented. The secret to TCCC’s success is its simplicity! It is no longer the responsibility of the medic to be the sole provider of care during combat. The skills and knowledge preached from the TCCC pulpit are those of straightforward, evidence –based, easily taught, and easily practiced medicine. And to prove that point and to drive it’s success, the DOD began teaching the curriculum to everyone being deployed to a combat zone, not just the medical providers.
As a result, preventable combat death has dropped from almost 16% during Viet Nam to 9% overall in OEF/OIF. In some units the rate dropped to below 3%. 75th Ranger Regiment hasn’t had a preventable combat death since 2001. This can be attributed to an aggressive effort to push effective trauma medicine down to the individual soldier.
So why is that a big deal to you? We know TCCC and its brother TECC (Tactical Emergency Casualty Care) are effective in dealing with combat and combat-like injuries. But, our chances of being in a combat-like environment are slim…very slim. But, the neat-o thing about TCCC is the principles don’t change based on how you get hurt. So the same way I stop bleeding from a gunshot wound is the same way I stop bleeding from a car accident, or a construction accident. It doesn’t matter if I stop breathing because of cardiac arrest or from being unresponsive after a bomb blast, managing an airway is, essentially, the same.
Today, the average time it takes for a first responder to get to you after you call 911 is 9 minutes. 9 mins on a sunny, not busy, fully staffed government agency day. The time it takes for you to bleed to death from an arterial bleed is about 3 mins. From the time you stop breathing until your brain dies is about 4 mins. So you’re dead and help is still 5 minutes away! Small, decisive, simple things can be done at the time of injury to sustain life until better equipped and higher trained rescuers arrive. Tourniquet application, airway management, chest seals, hypothermia prevention, etc are easy to learn and easy to do. These are small investment that pays big dividends.
If your mindset is bent towards preparedness or you care to be an asset versus a liability then we know that training is the key. Owning a guitar does not make you Eric Clapton. If you own a trauma kit the first thing that needs to go in it is training! Seek out the training in your area, vet your instructors, and dedicate some time to learning the skills that can make a difference.
In a perfect world we wouldn’t have to deal with these types of problems, in a slightly less perfect world everyone would be trained to deal with medical emergencies. We don’t live in either of those places. It’s up to you. Make a difference. Get training
TCCC/ TECC courses are widely available to anyone interested and are supported by the National Association of EMT’s (NAEMT). You can find courses through their site at NAEMT.org. If you are looking for a course or have other questions you can email me or visit my website at www.preparedmed.com
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