Principles & Application of TCCC

#### TCCC Phases of Care

#### TCCC is divided into three phases:

Care Under Fire / Threat (CUF/T)

Tactical Field Care (TFC)

Tactical Evacuation Care (TACEVAC)

#### Care Under Fire / Threat phase

is provided by the first TCCC-trained individual in the presence of an immediate threat (combat or noncombat related); it is the most dangerous time to deliver care for both the first responder and the casualty. During this phase, the first responder should remain engaged with the threat; only life-threatening, external bleeding will be addressed, as airway management is best deferred to the next phase. In essence, only those lifesaving interventions that must be performed immediately are undertaken during this phase while minimizing impact on the mission.

#### Tactical Field Care (TFC) phase

is characterized by a reduced level of hostile action or threat; the casualty should be transferred to medical personnel if available, more extensive casualty care can be provided in this phase. Interventions directed at other life-threatening conditions, as well as resuscitation and other measures to increase the comfort of the patient, may be performed. Tactical field care also applies to situations in which an injury has occurred on a mission but there has been no hostile fire. Additional consideration should be applied in areas with elongated evacuation routes; medical personnel should be prepared to institute prolonged casualty care (PCC) guidelines, as appropriate.

#### Tactical Evacuation (TACEVAC) phase

casualties are being transported to an advanced role of care by any means available (air, land, or maritime); in this phase, there may be an opportunity to provide additional medical personnel and equipment to maintain the interventions already performed, to further increase the capability of care rendered to the casualty and to be prepared to deal with the potential for the patient’s condition to change during transport.