Tactical Combat Casualty Care in Operation Iraqi Freedom

## CPT Michael J. Tarpey, MC, USA

Army Medical Department Journal, 2005, PB 8-05-4/5/6 Apr/May/Jun

#### Description with Key Points:

At the time this article was written, the Tactical Combat Casualty Care (TCCC) guidelines had been widely practiced with excellent results throughout the SpecialOperations community. However, there had been very little spread of the use of the TCCC guidelines into conventional units. This article reviews the use of the principles of TCCC by a mechanized infantry unit in Operation Iraqi Freedom1 One (OIF I).

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Antibiotics were administered to all casualties with open wounds, even relatively minor fragmentation wounds. None of the casualties developed wound infections. The exact antibiotics recommended in the TCCC guidelines could not be obtained, but suitable alternatives were found. Soldiers who could take oral medicines received Levofloxacin, which was convenient due to its once daily dosing. Those wounded who could not take medicines orally received IV Cefazolin for extremity wounds and lV Ceftriaxone for abdominal injuries.

TCCC in Operation Iraqi Freedom
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# Take Home Message:

The adoption and implementation of the principles of TCCC by a medical platoon in OIF l resulted in overwhelming success.
Over 25 days of continuous combat with 32 friendly casualties, many of them serious, we had 0 KlAs and 0 died from wounds, while simultaneously caring for a significant number of Iraqi civilian and military casualties.
This success should serve as a model for other conventional combat units throughout the Army involved in Level I treatment.
The principles of TCCC are well-researched and proven effective and should be the foundation for the treatment of battlefield casualties.
32 casualties with open wounds, all received battlefield antibiotics, none developed wound infections.
Used TCCC recommendations modified by availability: Levofloxacin for an oral antibiotic, IV cefazolin for extremity injuries, IV ceftriaxone for abdominal injuries.