Abstract
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.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Butler FK Jr, Blackbourne LH. Battlefield trauma care then and now: a decade of Tactical Combat Casualty Care. J Trauma Acute Care Surg. 2012;73(6 Suppl 5):S395–402.
Eastridge BJ, Mabry RL, Seguin P, Cantrell J, Tops T, Uribe P, et al. Death on the battlefield (2001-2011): implications for the future of combat casualty care. J Trauma Acute Care Surg. 2012;73(6 Suppl 5):S431–7.
Champion HR, Bellamy RF, Roberts CP, Leppaniemi A. A profile of combat injury. J Trauma. 2003;54(5 Suppl):S13–9.
Schroeder E, Valdez C, Krauthamer A, Khati N, Rasmus J, Amdur R, et al. Average chest wall thickness at two anatomic locations in trauma patients. Injury. 2013;44(9):1183–5.
Smith ER, Shapiro G, Sarani B. The profile of wounding in civilian public mass shooting fatalities. J Trauma Acute Care Surg. 2016;81(1):86–92.
Smith R, Callaway DW. Tactical emergency casualty care. The need for & evolution of civilian high threat medical guidelines. JEMS. 2014;Suppl:10–5.
US Fire Administration. Fire/Emergency Medical Services Department operational considerations and guide for active shooter and mass casualty incidents. 2013 [cited 2015 2/9/2015]; Available from: https://www.usfa.fema.gov/downloads/pdf/publications/active_shooter_guide.pdf.
National tactical officers association. TEMS position statement. 2014 [cited 2015 2/9/2015]; Available from: https://ntoa.org/sections/tems/tems-position-statement/.
International association of firefighters. IAFF position statement: rescue task force training. 2014 [cited 2015 2/9/2015]; Available from: http://services.prod.iaff.org/ContentFile/Get/17073.
Jacobs LM, Wade DS, McSwain NE, Butler FK, Fabbri WP, Eastman AL, et al. The Hartford Consensus: THREAT, a medical disaster preparedness concept. J Am Coll Surg. 2013;217(5):947–53.
Sims K, Montgomery HR, Dituro P, Kheirabadi BS, Butler FK. Management of external hemorrhage in tactical combat casualty care: the adjunctive use of XStat compressed hemostatic sponges: TCCC guidelines change 15-03. J Spec Oper Med. 2016;16(1):19–28.
Jacobs LM, Rotondo M, McSwain N, Wade DS, Fabbri WP, Eastman A, et al. Joint committee to create a national policy to enhance survivability from mass casualty shooting events: Hartford Consensus II. Conn Med. 2014;78(1):5–8.
Pons PT, Jerome J, McMullen J, Manson J, Robinson J, Chapleau W. The Hartford Consensus on active shooters: implementing the continuum of prehospital trauma response. J Emerg Med. 2015;49(6):878–85.
Fisher AD, Miles EA, Cap AP, Strandenes G, Kane SF. Tactical damage control resuscitation. Mil Med. 2015;180(8):869–75.
Callaway D, Bobko J, Smith ER, Shapiro G, McKay S, Anderson K, et al. Building community resilience to dynamic mass casualty incidents: a multiagency white paper in support of the first care provider. J Trauma Acute Care Surg. 2016;80(4):665–9.
Fisher AD, Callaway DW, Robertson JN, Hardwick SA, Bobko JP, Kotwal RS. The ranger first responder program and tactical emergency casualty care implementation: a whole-community approach to reducing mortality from active violent incidents. J Spec Oper Med. 2015;15(3):46–53.
Callaway DW, Robertson J, Sztajnkrycer MD. Law enforcement-applied tourniquets: a case series of life-saving interventions. Prehosp Emerg Care. 2015;19(2):320–7.
Robertson J, McCahill P, Riddle A, Callaway D. Another civilian life saved by law enforcement-applied tourniquets. J Spec Oper Med. 2014;14(3):7–11.
Bobko JP, Callaway DW, Smith ER. Preparing for the unthinkable. Tactical emergency casualty care pediatric guidelines. JEMS. 2014;Suppl:28–32.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Sarani, B., Shapiro, G.L., Geracci, J.J., Smith, E.R. (2018). Initial Care of Blast Injury: TCCC and TECC. In: Galante, J., Martin, M., Rodriguez, C., Gordon, W. (eds) Managing Dismounted Complex Blast Injuries in Military & Civilian Settings. Springer, Cham. https://doi.org/10.1007/978-3-319-74672-2_3
Download citation
DOI: https://doi.org/10.1007/978-3-319-74672-2_3
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-74671-5
Online ISBN: 978-3-319-74672-2
eBook Packages: MedicineMedicine (R0)