Tactical medical training historically was modeled on civilian courses like the Emergency Medical Technician (EMT) and Advanced Trauma Life Support (ATLS) courses and mirrored civilian trauma resuscitation guidelines, which provided excellent in-hospital care and results. But the principles they reflect often needed to be modified for the tactical setting, and that was not routinely done.

In previous conflicts, the use of tourniquets was discouraged, crystalloid fluid resuscitation was used for shock, hemostatic agents were not available, and airways were established through endotracheal intubation. At the start of the war in Afghanistan, TCCC was used only by a few innovative units in the US military. The impact of this limited use of TCCC was not well-appreciated until the first preventable death analysis was conducted. That study by Holcomb and others found that 8 of the 12 individuals who died from injuries that were potentially survivable might have been saved simply by the proper application of TCCC principles.