TCCC: A Highly Valuable Acronym

Tactical Combat Casualty Care or “Tee Triple See” (TCCC) is a term coined by the military and now being adopted by law enforcement to designate immediate medical care given to trauma victims, but doing so under fire.

Remembering that TCCC deals with treating casualties under fire, the acronym is different but the priorities remain (mostly) the same.  The new acronym I learned was M-A-R-C-H.  It stands for:

Massive Bleeding: This is the only thing we deal with in an unsecured area and even then we don’t touch it until the immediate threat has been neutralized.

Airway: The victim/patient HAS to be able to breath.  I’d had limited experience inserting an airway (nasal pharyngeal airway or NPA) but students in the class were able to do this on a training mannequin.

Respiration: Once the airway is clear then you check to see what the respiration rate is.  An accelerated respiration rate can be indicative of excessive bleeding and/or shock.  If you’ve controlled any massive bleeding that is externally visible, a higher respiration rate may indicate an internal bleed (from what I understood).

Circulation: Within the confines of whatever treatment you’ve provided (such as a tourniquet), you should be able to get a pulse if the patient’s blood pressure is sufficient.

Hypothermia / Head Injury: Something I hadn’t ever heard before but was taught in TCCC was that it’s vitally important to keep the patient’s core temperature up.  If it drops below 90 degrees Fahrenheit, a 100% mortality rate has been observed.  The last thing we’re checking for is head injury.

The course covered much more but there’s no way I can include it all here.  Students learned how to insert a needle into the thoracic cavity to relieve tension pneumothorax.  Students learned how to effectively apply a chest seal for entry and exit wounds due to gunshot or other penetrating wound.  Students learned how to quickly and efficiently look for bleeding injuries including gun shots from calibers small enough that the skin closed back up.  Students learned how to apply a cervical collar, load a patient onto a litter and methods for safely moving the litter away from the danger zone / farther into safe area or to the mode of transport.

The bottom line is that I feel much more confident, having had this training, than I did before taking it.  I also am more familiar with the most common medical challenges gunshot wounds to the torso can cause and how easily they can be remedied until such time as a surgeon can fix the problem long term.  As a person who carries a gun day in and day out, and being aware of the fact that trauma injuries can happen anywhere from a wide assortment of unexpected causes, I feel better prepared in my day for having successfully completed this training.

That said, the training is for naught if I don’t carry the necessary tools with which to deliver the skills I learned in this course.  That means that I should always have with me or immediately available my gun and extra magazine(s) FIRST and FOREMOST.  I also need to have a chest seal (or two), hemostatic gauze, a tourniquet, an appropriate needle for relieving tension pneumothorax, an NPA, gloves and a few other small items.  All of this can be carried in a pouch small enough to fit in a cargo pocket, briefcase, backpack, etc.  The key is HAVING it and knowing where it is when you need it.  Sound familiar?  It should. It’s the same rule that applies to carrying your gun.

The bottom line is that this type of course can prove invaluable at some unknown point in your future.  I highly encourage everyone to take such a course.  If you’re interested in taking the class from the Commonwealth Criminal Justice Academy, just visit their website, check out their training calendar and get signed up.


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