Tactical emergency casualty Care (TECC) -2 day / 16 hours

• Explain the differences between military tactical and civilian tactical prehospital trauma care. 
• Describe the key factors influencing casualty care.
• Discuss the impacts that threat, time, incident, location, and available resources have on the response and care of trauma patients
• Understand how TCCC and TECC were developed.
• Describe the phases of tactical casualty care.

• Define characteristics of a direct threat environment/hot zone.
• Discuss the rationale for limited medical interventions during a direct threat.
• Discuss how mission tempo and skill sets impact provider action during the direct threat phase.
• Identify drag and carry techniques. 
• Discuss military experience with tourniquets and review the mechanism of action, placement, and optimization techniques for tourniquet use in direct threat care. 

•  Define the characteristics of indirect threat care/warm zone. 
• Describe the need for weapon removal from casualties with altered mental status. 
• Identify steps in the MARCH assessment.
• Explain PACE methodology. 
• Demonstrate the most appropriate hemorrhage control method based on physical assessment and resources.
• Demonstrate safe and effective application of junctional tourniquets in anatomic locations not amenable to tourniquet placement.
• Demonstrate safe and effective application of pressure dressings and hemostatic dressings.

•  Discuss indications for surgical cricothyroidotomy.
• Discuss airway management modifications for pediatric casualties.

• Discuss the use of chest seals.
• Discuss the signs, symptoms, and management of tension pneumothorax.
• Discuss evidence-based changes in anatomic sites for needle decompression.
• Discuss special considerations for needle decompression for pediatric casualties.

• Discuss application of tourniquets during indirect threat care/warm zone. 
• Discuss safe and effective hemorrhage control for partial and complete amputations.
• Discuss types and application of pelvic binders.
• Describe basic shock assessment and treatment.
• Discuss safe and effective venous access.
• Describe use of tranexamic acid (TXA) in casualty care. 

• Understand the negative impact of hypothermia to a trauma patient.
• Describe current interventions for traumatic brain injury (TBI).
• Understand available monitoring devices and ways to reassess the patient.
• Discuss analgesia options. 
• Describe fire used as a weapon.
• Discuss the importance of eye protection and eye injury intervention.
• Understand available evacuation devices and methods of effective patient communication.
• Discuss CPR attempts in a multicausality event.
• Discuss the importance of documentation.

• Describe the differences between indirect threat care/warm zone and evacuation care/cold zone.
• Explore the multiple transport platforms available in a tactical event.
• Understand the need to transport the right patient, to the right place, at the right time
• Describe the additional medical resources available for use in evacuation care/cold zone.

•  Discuss the difference between primary and secondary triage.
• Identify the limitations to current triage algorithms.
• Explain how triage is impacted when resources are limited.

Mandatory

• Tourniquets
• Wound Packing
• Junctional Tourniquets
• Chest Seals
• Pressure Bandages
• Airway Management
• Drags and Carries

Optional

• Needle Thoracentesis
• Intravenous access
• Intraosseous access
• Cricothyroidotomy
• Medications

Rendering Aid

• Female with gunshot wound
• Male with traumatic brain injury
• Police officer with gunshot wound
• Male with burns
• Pediatric male with amputated leg
• Female with penetrating injury
• Male with gunshot wound

Tactics

• Searching for suspect or suspects
• Making contact with suspect
• Taking suspect into custody
• Dividing resources (Stopping the threat/Rendering Care

Complicating factors

• Multiple injuries
• Active threat vs no stimulus
• Non-Injured interfering with incident