Page 14 - ATP-P 11th Ed

Changes in 2019–2021
➤ Updated C-TCCC dated 1 October 2019 and USSOCOM Tactical Trauma protocols
SECTION 1 December 2021.
to reflect most current CoTCCC TCCC Guidelines for Medical Personnel dated 15

Summary of 2021 TCCC Changes:
3. Massive Hemorrhage
b. “CoTCCC-Recommended” is removed from junctional tourniquets. No specific
products are recommended by the CoTCCC. End users should select any FDA ap-
proved device that is indicated for junctional hemorrhage control.
4. Airway Management
d. Removes Cric-Key technique as preferred option for surgical cricothyroidotomy
and remove “least desirable option” from the standard open surgical technique.
Units and end users should use the technique they are best trained to execute. Air-
way Notes: Removes iGel as the preferred extraglottic airway. Units may still use
iGel if mission are at high elevation or evacuation is at high altitudes.
6. Analgesia – adjust Ketamine IV/IO dosing to 20–30mg (or 0.2–0.3mg/kg)
12. Inspect and dress known wounds
b. Adds the preference of cleaning abdominal evisceration with clean and warm wa-
ter if possible; clarifies guidance on conditions to attempt reduction of abdominal
contents; that patient should remain NPO and NOT be administered oral medicals
(Combat Wound Medication pack) and removes prolonged care considerations
(now covered in separate PCC guidelines).
➤ The 11th Ed of our Advanced Tactical Paramedic Protocols Handbook updates include:
Section 1 – Tactical Trauma Protocols (TTPs) – updated CoTCCC-TCCC Guidelines
to reflect the committee’s current version dated 15 December 2021; also in Section
1, the Prolonged Casualty Care (PCC) formally known as the Prolonged Field Care
(PFC) section has been vastly updated to reflect their version dated 21 December
2021.
Section 4 has been significantly updated with the Canine/K9 C-TCCC updates dated
1 October 2019.

4 SECTION 1 TACTICAL TRAUMA PROTOCOLS (TTPs) ATP-P Handbook 11th Edition 5