Tactical combat casualty care: Difference between revisions

Latest revision as of 22:15, 16 February 2018

Background

Tactical Combat Casualty Care (TCCC) is a set of evidence-based guidelines for trauma care in a tactical or combat environment.
Developed and updated by the Committee on Tactical Combat Casualty Care (CoTCCC), a division of the US Department of Defense Joint Trauma System (JTS).
Goal is to reduce preventable combat deaths.
Guidelines are divided into three "phases of care".

Phases of Care

Assessment and Triage

Rather than typical "ABC" approach to trauma assessment, TCCC prioritizes massive hemorrhage
MARCH acronym is used to prioritize treatment:
- M - Massive hemorrhage
  - Emphasize early recognition of significant bleeding. Apply limb tourniquets high, tight, and early. For junctional injuries, utilize direct pressure or hemostatic agents while waiting for OR.
- A - Airway
  - Consider triage given limited management resources. May require surgical airway if significant facial or oropharyngeal injuries are present.
- R - Respiration
  - Recognize and manage pneumothoraces with needle or chest tube thoracostomy. Consider chest seals for chest cavity wounds.
- C - Circulation
  - Reevaluate for peripheral pulses, tourniquets that need to be replaced, and hemorrhage management deferred during "M." Consider eFAST exam.
- H - Head/Hypothermia
  - Evaluate for head injury, including mental status and GCS. Treat hypothermia.

External Links

Committee on Tactical Combat Casualty Care (CoTCCC)

References

Authors:

@@ Line 1: / Line 1: @@
-===Basic Management Plan for Care Under Fire===
+==Background==
-#Return fire and take cover.
+*Tactical Combat Casualty Care (TCCC) is a set of evidence-based guidelines for trauma care in a tactical or combat environment.
-#Direct or expect casualty to remain engaged as a combatant if appropriate.
+*Developed and updated by the Committee on Tactical Combat Casualty Care (CoTCCC), a division of the US Department of Defense Joint Trauma System (JTS).
-#Direct casualty to move to cover and apply self-aid if able.
+*Goal is to reduce preventable combat deaths.
-#Try to keep the casualty from sustaining additional wounds.
+*Guidelines are divided into three "phases of care".
-#Casualties should be extricated from burning vehicles or buildings and moved to places of relative safety. Do what is necessary to stop the burning process.
-#Airway management is generally best deferred until the Tactical Field Care phase.
+==Phases of Care==
-#Stop life-threatening external hemorrhage if tactically feasible:
+*[[Care under fire]]
-#*Direct casualty to control hemorrhage by self-aid if able.
+*[[Tactical field care]]
-#*Use a CoTCCC-recommended tourniquet for hemorrhage that is anatomically amenable to tourniquet application.
+*[[Tactical evacuation care]]
-#*Apply the tourniquet proximal to the bleeding site, over the uniform, tighten, and move the casualty to cover.
+==Assessment and Triage==
+*Rather than typical "ABC" approach to trauma assessment, TCCC prioritizes massive hemorrhage
+*MARCH acronym is used to prioritize treatment:
+**'''M''' - Massive hemorrhage
+***Emphasize early recognition of significant bleeding. Apply limb [[tourniquet]]s high, tight, and early. For junctional injuries, utilize direct pressure or hemostatic agents while waiting for OR.
+**'''A''' - Airway
+***Consider triage given limited management resources. May require surgical airway if significant facial or oropharyngeal injuries are present.
+**'''R''' - Respiration
+***Recognize and manage pneumothoraces with needle or chest tube thoracostomy. Consider chest seals for chest cavity wounds.
+**'''C''' - Circulation
+***Reevaluate for peripheral pulses, [[tourniquet]]s that need to be replaced, and hemorrhage management deferred during "M." Consider eFAST exam.
+**'''H''' - Head/Hypothermia
+***Evaluate for head injury, including mental status and GCS. Treat hypothermia.
 ==See Also==
+*[[Combat triage]]
+*[[Nine line CASEVAC]]
+*[[Military emergency medicine]]
+==External Links==
+*[http://cotccc.com/ Committee on Tactical Combat Casualty Care (CoTCCC)]
 ==References==
-Tactical Combat Casualty Care
+<references/>
-Guidelines
-June 2014
-* All changes to the guidelines made since those published in the 2010 Seventh
-Edition of the PHTLS Manual are shown in bold text. The most recent changes
-are shown in red text.
-* These recommendations are intended to be guidelines only and are not a
-substitute for clinical judgment.
 [[Category:EMS]]
-[[Category:Mil]]
+[[Category:Military]]