View source for Tactical combat casualty care

==Background==
*Tactical Combat Casualty Care (TCCC) is a set of evidence-based guidelines for trauma care in a tactical or combat environment.
*Developed and updated by the Committee on Tactical Combat Casualty Care (CoTCCC), a division of the US Department of Defense Joint Trauma System (JTS).
*Goal is to reduce preventable combat deaths.
*Guidelines are divided into three "phases of care".

==Phases of Care==
*[[Care under fire]]
*[[Tactical field care]]
*[[Tactical evacuation care]]

==Assessment and Triage==
*Rather than typical "ABC" approach to trauma assessment, TCCC prioritizes massive hemorrhage
*MARCH acronym is used to prioritize treatment:
**'''M''' - Massive hemorrhage
***Emphasize early recognition of significant bleeding. Apply limb [[tourniquet]]s high, tight, and early. For junctional injuries, utilize direct pressure or hemostatic agents while waiting for OR. 
**'''A''' - Airway
***Consider triage given limited management resources. May require surgical airway if significant facial or oropharyngeal injuries are present. 
**'''R''' - Respiration
***Recognize and manage pneumothoraces with needle or chest tube thoracostomy. Consider chest seals for chest cavity wounds. 
**'''C''' - Circulation
***Reevaluate for peripheral pulses, [[tourniquet]]s that need to be replaced, and hemorrhage management deferred during "M." Consider eFAST exam. 
**'''H''' - Head/Hypothermia
***Evaluate for head injury, including mental status and GCS. Treat hypothermia.

==See Also==
*[[Combat triage]]
*[[Nine line CASEVAC]]
*[[Military emergency medicine]]

==External Links==
*[http://cotccc.com/ Committee on Tactical Combat Casualty Care (CoTCCC)]

==References==
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[[Category:EMS]]
[[Category:Military]]