TCCC Guidelines

Since 2001, the CoTCCC has continued to monitor developments in prehospital trauma care. The TCCC Guidelines are updated based upon: (1) an ongoing review of the published civilian and military pre-hospital trauma literature; (2) ongoing interaction with military combat casualty care research laboratories; (3) direct input from experienced combat corpsmen, medics, and PJs; (4) input from the service medical Lessons Learned Centers; (5) case reports discussed at the weekly Joint Trauma System (JTS) process improvement video-teleconferences; (6) observations on the causes of death in combat fatalities gleaned from JTS-Armed Forces Medical Examiner System (AFMES) conferences; and (7) expert opinion from both military and civilian trauma experts.

#### Changes to the TCCC Guidelines

Each change to the TCCC Guidelines is now supported by a change paper published in the Journal of Special Operations Medicine. Guideline changes are also included in each revision of the PHTLS textbook. The current version of the TCCC Guidelines is also maintained on both the Defense Health Agency’s “Deployed Medicine” website as well as the NAEMT website.

#### Applicability of TCCC Guidelines

Although the TCCC Guidelines are evidence-based, best-practice trauma care guidelines customized for use on the battlefield, they are guidelines only. There are no rigid protocols in combat, including Tactical Combat Casualty Care. If the recommended TCCC combat trauma management plan doesn’t work for the specific tactical situation that a combat medic, corpsman, or PJ encounters, then care must be modified to best fit the tactical situation. Scenario-based planning is critical for success in TCCC.