Initial Care of Blast Injury: TCCC and TECC

  • Babak Sarani
  • Geoffrey L. Shapiro
  • James J. Geracci
  • E. Reed Smith


The key principles and tactics of addressing severely wounded persons in battle are delineated in Tactical Combat Casualty Care (TCCC). However, whereas the military setting affords a mostly homogenous group of patients within a very unique care environment, the civilian sector is comprised of a wide array of patient demographics with disparate mechanisms of injury. Thus, the principles of TCCC have been translated for the civilian sector as delineated in the Tactical Emergency Casualty Care (TECC) guidelines. TECC takes into account the skill level of the provider – ranging from the bystander to the surgeon – the environment of care, and threat level associated with it and addresses all causes of potentially preventable death, including hemorrhage, pneumothorax, and loss of airway. It stresses that the greatest opportunity to mitigate preventable death is rapid extrication of the wounded to a facility able to provide definitive care.


Tactical Emergency Casualty Care Tactical Combat Casualty Care Preventable death 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Babak Sarani
    • 1
  • Geoffrey L. Shapiro
    • 2
  • James J. Geracci
    • 3
  • E. Reed Smith
    • 4
  1. 1.Center for Trauma and Critical CareGeorge Washington UniversityWashington, DCUSA
  2. 2.Emergency Medical Services ProgramGeorge Washington UniversityWashington, DCUSA
  3. 3.US Army III Corps (Armored), Fort HoodKilleenUSA
  4. 4.Arlington County Emergency Medical ServicesGeorge Washington UniversityArlingtonUSA

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