Tactical combat casualty care

Basic Management Plan for Care Under Fire

1. Return fire and take cover.
2. Direct or expect casualty to remain engaged as a combatant if appropriate.
3. Direct casualty to move to cover and apply self-aid if able.
4. Try to keep the casualty from sustaining additional wounds.
5. Casualties should be extricated from burning vehicles or buildings and moved to places of relative safety. Do what is necessary to stop the burning process.
6. Airway management is generally best deferred until the Tactical Field Care phase.
7. Stop life-threatening external hemorrhage if tactically feasible:
   • Direct casualty to control hemorrhage by self-aid if able.
   • Use a CoTCCC-recommended tourniquet for hemorrhage that is anatomically amenable to tourniquet application.
   • Apply the tourniquet proximal to the bleeding site, over the uniform, tighten, and move the casualty to cover.

References

Tactical Combat Casualty Care Guidelines 2 June 2014

• All changes to the guidelines made since those published in the 2010 Seventh

Edition of the PHTLS Manual are shown in bold text. The most recent changes are shown in red text.

• These recommendations are intended to be guidelines only and are not a

substitute for clinical judgment.