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TCCC Protocols

Tactical Combat Casualty Care guidelines for medical treatment in combat environments

TCCC Core Principles

Fundamental guidelines that govern all tactical medical care decisions in combat environments.

Tactical Mission Priority

Mission accomplishment takes precedence over medical care

Prevent Additional Casualties

Do not create additional casualties during medical care

Evidence-Based Medicine

Base all interventions on proven battlefield medicine

Hemorrhage Control Priority

Massive bleeding is the leading cause of preventable death

Care Under Fire (CUF)

Active hostile fire
Seconds to minutes

Medical care while under hostile fire

Treatment Priorities

  • 1Return fire and gain fire superiority
  • 2Move casualty to cover
  • 3Control massive hemorrhage with tourniquet
  • 4Airway management generally not performed

Specific Interventions

  • Apply tourniquet if extremity bleeding visible
  • Direct casualty to move to cover if able
  • Direct casualty to return fire if able
  • Try to keep casualty from sustaining additional wounds
  • Casualty should remain engaged as fighter if appropriate

Required Equipment

Combat Application Tourniquet (CAT)
Weapon and ammunition
Communication devices

Limitations

  • Limited to life-threatening hemorrhage control
  • No airway procedures unless unconscious and no pulse
  • Speed and tactical situation priority over medical care
  • Minimal time available for medical intervention

Phase Timeline

Progression through TCCC phases based on tactical situation

1
Care Under Fire (CUF)
Seconds to minutes • Active hostile fire
2
Tactical Field Care (TFC)
Minutes to hours • Relatively safe area
3
Tactical Evacuation Care (TEC)
Transport time • During evacuation

Critical Decision Points

Transition Between Phases:

Base decisions on tactical situation, not arbitrary time limits. Safety of team and mission success are paramount.

Resource Management:

Use minimum effective interventions in each phase. Save resources and energy for when more comprehensive care is possible.

Casualty Assessment:

Rapidly determine if casualty can continue fighting, needs immediate evacuation, or can wait for evacuation.

Documentation:

Record interventions and casualty status when possible. Use standardized forms (DD Form 1380 or tactical versions).

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MARCH AlgorithmTECC Guidelines