What is the TCCC ?

Tactical Combat Casualty Care (TCCC) is a set of guidelines and protocols developed by the military to provide prehospital trauma care in tactical combat environments. It focuses on treating the most preventable causes of death on the battlefield, known as the "Big Three": severe bleeding, airway obstruction, and tension pneumothorax (a type of collapsed lung).

TCCC, also known as TC3, is the concept and practice of providing medical care under enemy fire during combat. Its focus is on reducing the mortality rate of frontline soldiers, maintaining combat effectiveness, and facilitating the completion of mission tasks by subsequent combat forces. The U.S. military has integrated recent combat experience to redefine the procedures and methods of casualty care under enemy fire. The goal of combat units is to complete mission tasks while ensuring the safety of casualties and ensuring the smooth operation of casualty evacuation. In conflicts, both sides will inevitably suffer casualties. Therefore, in addition to enhancing the combat effectiveness of troops to address the challenges of advanced technology and enemy tactical strategies, it is also necessary to enhance the medical capabilities of frontline medical personnel to effectively support combat operations.

Characteristics of Modern Combat Wounds and Development of Medical Care

1.Characteristics of Modern Combat Wounds and Development of Medical Care

Modern Combat Wounds and Their Characteristics
War wounds refer to injuries to the body and limbs of soldiers (including hired personnel) caused by lethal weapons or the war environment during combat, such as body trauma caused by bullets penetrating the body, trenches, or collapsing buildings. Analysis of recent military operations such as the 1989 Panama Operation and the 1993 Somalia Mission has revealed the following characteristics of modern combat wounds:

Short warning time
Intense attack power (wide area of effect)
Strong lethality and destructiveness (severe, lethal injuries)
Large number of personnel casualties (high number of casualties)
Complex and diverse injuries (mainly involving trauma, wounds, and burns)

Therefore, in modern combat environments, how medical, nursing, and emergency personnel provide effective medical support to various grassroots units and adjust the methods of treating combat wounds to meet battlefield needs are crucial. This ensures that injured soldiers receive care as quickly as possible, thereby increasing the survival rate of combatants.

2.Development of Medical Care

Recent international literature reveals that the development of Tactical Combat Casualty Care (TCCC) began with the United States Navy Special Operations Command and was later promoted by the U.S. Special Forces Command. The first version of the combat casualty care guidelines was published in 1996 and was incorporated into the military version of the prehospital emergency care manual in 2003, becoming the current standard of care for battlefield trauma first aid. It is widely used in the U.S. Army, Navy, Air Force, Coast Guard, Marine Corps, and even in defense forces around the world.

Researcher Kelly conducted an analysis and study of 232 casualties in the battles of Iraq and Afghanistan. The study found that 75% of preventable causes of death were due to bleeding, 13% to airway obstruction, and 8% to central nervous system damage. Among the bleeding cases, 31% were controllable, such as limb bleeding, while 69% were uncontrollable, such as head, neck, and torso bleeding. Currently, the main cause of combat deaths on the battlefield is bleeding from limb injuries. Past combat experience shows that 20% of severe bleeding injuries could have been prevented if appropriate medication or equipment for controlling bleeding had been available on-site, potentially increasing survival rates.

In addition to hemorrhage control, the approach to fluid resuscitation for severe bleeding injuries has also differed from past concepts. Due to the downsizing of combat units, the availability of emergency medical supplies is limited. Therefore, research has focused on how to provide emergency medical care with limited resources on the battlefield. This includes using small-volume fluid resuscitation for severe bleeding injuries and administering fluid resuscitation orally to burn injury patients, which are areas of recent intensive research by the U.S. military.

The military has integrated recent combat experience to develop tactical combat casualty care, with the most important principle being to provide timely and accurate medical care under sustained combat conditions. Providing medical assistance at the wrong time could potentially result in more casualties. The three main goals of tactical combat casualty care are to treat casualties, prevent further casualties, and complete the mission. The most important aspect is to protect and treat casualties while ensuring the completion of the mission. Failure to complete the tactical mission could result in catastrophic consequences.

BACK