Although the principles of TCCC apply to trauma in both combat and noncombat settings, the environmental differences can play a significant role in how those principles are applied.

For example:

- Hostile fire
- Darkness
- Environmental extremes
- Different wounding epidemiology
- Limited equipment
- Need for tactical maneuver
- Long delays to hospital care
- Different medic training and experience

If a ballistic injury occurs in an urban setting with highly capable trauma surgery assets and rapid evacuation to a nearby civilian or military hospital, the issues surrounding assessment, treatment options, and casualty evacuation preparation will be very different than in an austere hostile setting, where a higher level of care is not readily available and responders are working in an austere location. TCCC Guidelines and training were developed assuming that most scenarios would lack nearby advanced trauma and evacuation assets.