Page 12 - ATP-P 11th Ed

SECTION 1 USSOCOM Tactical Combat Casualty Care

Tactical Trauma Protocols (TTPs)

Preface
The USSOCOM Tactical Trauma Protocols (TTPs) in many ways mirror the DoD De-
fense Health Board (DHB) Committee on Tactical Combat Casualty Care (CoTCCC)
Guidelines. However, the TTPs are also very unique in several ways. They recognize the
advanced skills and knowledge of the SOF Medic and consequently include recommenda-
tions for advanced interventions such as fresh whole blood collection and administration
in the field, head injury management, fasciotomy, escharotomy, and sedation. They further
take into consideration the unique and austere nature of the SOF environment by including
recommendations for extended tactical field care. The additional items are in green font.

Changes in 2012:
➤ Added the Junctional Emergency Tool as an option to apply mechanical pressure
for inguinal and proximal lower extremity bleeds not amenable to other means of
hemorrhage control
➤ Added intranasal, intramuscular, and intravenous ketamine as options for pain
management of combat casualties
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➤ Changed the alternate chest decompression site at the 4 /5 intercostal space from
the mid-axillary to the anterior axillary line
➤ Modified the USSOCOM severe TBI management guidelines to establish consis-
tency with the new TBI guidelines
➤ Authorized use of an incompletely blood collection bag as long as the total infusion
time remains the same as that of a completely filled blood collection bag
Changes in 2014:
➤ Added e-mail address for suggested changes
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➤ Added Abdominal Aortic & Junctional Tourniquet – AAJT and SAM Junctional
Tourniquet
➤ Added additional characteristic recommendation for supraglottic airways
➤ Revised the Administration of Blood and Blood Components Protocol to allow
for routine transfusion of low titer type O whole blood as a functional “universal
donor” and untitered type O fresh whole blood in extremis
➤ Removed recommendation for premedication with epinephrine and/or diphenhydr-
amine from the Administration of Blood and Blood Components Protocol
➤ Minor changes to Crush Syndrome Protocol and added an example Crush Injury Kit

2 SECTION 1 TACTICAL TRAUMA PROTOCOLS (TTPs) ATP-P Handbook 11th Edition 3