Tactical Combat Casualty Care (TCCC)


A decade of intense combat in Iraq and Afghanistan theaters has taught us many lessons about what works and what does not in the effort to accomplish that all-important mission of saving lives in battle.

A severely injured Soldier today has about twice the likelihood of surviving his wounds compared to Soldiers in wars as recent as Vietnam. That progress is the result of many things:

Originally a Special Operations research effort, now the introduction of Tactical Combat Casualty Care (TCCC) throughout the U.S. Military has certainly been an important part of that improvement. TCCC has helped U.S. combat forces to achieve the highest casualty survival rate in history.


TCCC (Tactical Combat Casualty Care) was developed in 1996 by the Naval Special Warfare Command. These guidelines dealt with battlefield trauma care and aimed at eliminating preventable loss of life on the battlefield. The TCCC guidelines were approved by the American College of Surgeons (ACS) and the National Association of Emergency Medical Technicians (NAEMT). They were soon adopted by the U.S. Special Operations Command (USSOCOM). TCCC was then implemented across all services, and this has been identified as one of the major factors resulting in the highest combat casualty survival rates in history.

Causes of preventable death on the battlefield today:

Potentially Preventable Deaths (232) Early in OIF and OEF

Potentially Preventable Deaths

Cause of Death

What is TCCC

Tactical Combat Casualty Care (TCCC) 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 situation faced while providing casualty care in combat. A medically correct intervention performed at the wrong time may lead to further casualties. Put another way, "good medicine may be bad tactics," which can get the rescuer and 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.

Casualties and Wounds

On the battlefield, the pre-hospital period is the most important time to care for any combat casualty. In previous wars, up to 90 percent of combat deaths occurred before a casualty reached a medical treatment facility. This highlights the primary importance of treating battlefield casualties at the point of injury, prior to casualty evacuation and arrival at a treatment facility.

TCCC Goals

TCCC presents a system to manage combat casualties that considers the issues discussed above. An important guiding principle of TCCC is performing the correct intervention at the correct time in the continuum of field care. To this end, TCCC is structured to meet three important goals:

Stages of Care

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:

Course Scope

This course trains the student in skills necessary to become an effective medical care provider and Soldier. The student receives training in pre-hospital emergency care, evacuation, deployable medical systems, aircraft and ground evacuation, and casualty triage and processing. The students will learn to integrate tactical and technical skills during rigorous scenario training. TCCC course length is one week and is open to all personnel irrespective of medical training and back ground. TCCC is currently part of each U.S. Commanders essential mission task list for his men prior to entering a combat zone. One cannot pass basic training without this certification or enter into an active area of operations without it.

TCCC certification has been proven time and again to not only increase the survival of the injured but also has a large impact on morale since each personnel can save the life of the other without being a combat medic.

Courses Offered by Our Cadre:

Tactical Combat Casualty Care (TCCC) for all personnel (1 week)

Tactical Combat Casualty Care (TCCC) for medical personnel (2 weeks)

Basic Combat Medic Certification (68W)* (20 weeks)
Train the Trainer Course (TCCC) – TCCC Instructor

Advanced Combat Medic Training (68W1)* (44 weeks)
Train the Trainer Course – 68W Instructor

Advanced Combat Medic Training (18D)* (on request)

Prolonged Field Care (PFC) (5 weeks – TCCC+PFC)