Published evidence and battlefield experience accumulated over the 25 years since the original TCCC paper was published have resulted in all services in the U.S. Military and many allied nations using TCCC concepts to care for their combat wounded. All U.S. combat medics, corpsmen, and pararescuemen are now taught battlefield trauma care techniques based on the TCCC Guidelines. Military units that have trained all their members, including both medical and non-medical personnel, in TCCC have documented the lowest incidence of preventable deaths among their casualties in the history of modern warfare. TCCC-based prehospital trauma training is now widespread in the US civilian sector as well.

TCCC guidelines are reviewed on an ongoing basis and updated as needed by the CoTCCC. Proposed changes to the Guidelines must be approved by a 75% majority of the CoTCCC to be accepted. Changes recommended by the CoTCCC are then forwarded to the Director of the Joint Trauma System for final approval. Once approved, updated versions of the TCCC Guidelines are posted on the Joint Trauma System website as well as the websites of the Defense Health Agency (“Deployed Medicine”), the National Association of Emergency Medical Technicians (NAEMT), the Journal of Special Operations Medicine, and the Special Operations Medical Association. TCCC-based training now provided to all U.S. combat medical personnel includes:

 

References

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Butler FK Jr, Holcomb JB, Shackelford S, et al: Management of Suspected Tension Pneumothorax in Tactical Combat Casualty Care: TCCC Guidelines Change 17-02. J Spec Oper Med 2018;18:19-35.

Butler FK: Introduction to TCCC Changes Summary 6 May 2021. J Spec Oper Med 2021;21:107

Butler FK. Two decades of saving lives on the battlefield: Tactical Combat Casualty Care turns 20. Mil Med. 2017;182(3):e1563-e1568.

Butler FK, Blackbourne LH, Gross KR. The Combat Medic Aid Bag: 2025.

CoTCCC top ten recommended battlefield trauma care research, development, and evaluation priorities for 2015; J Spec Oper Med. 2015;15(4):7-19.

Butler FK. Tactical combat casualty care: update 2009. J Trauma. 2010;69(suppl):S10–S13.

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Onifer D, McKee J, Faudree L, et al: Management of hemorrhage form craniomaxillofacial injuries and penetrating neck injury in Tactical Combat Casualty Care: iTClamp mechanical wound closure device TCCC Guidelines proposed change 19-04 06 June 2019. J Spec Oper Med 2019;19:31-44

Onifer D, Butler F, Gross K, et al: Replacement of promethazine with ondansetron for treatment of opioid and trauma-related nausea and vomiting in tactical combat casualty care. J Spec Oper Med 2015;15:17-24

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