Page 35 - ATP-P 11th Ed

Where appropriate, a minimum-better-best format is included for situations in which the
operational reality precludes optimal care for a given scenario:
Minimum: This is the minimum level of care which should be delivered for a specified
level of capability SECTION 1
Better: When available or practical, this includes treatment strategies or adjuncts that im-
prove outcomes while still not considered the standard of care.
Best: This is the optimal medical for a given scenario based on the level of medical exper-
tise of the provider
Expectations of prehospital care, based on TCCC’s role-based standard of care, are in-
cluded within each section:
Tier 1: This is the basic medical knowledge for all service-members.
Tier 2: Those who have been through approved CLS training are expected to be able to
meet the standards at this level of care.
Tier 3 (Combat Medics/Corpsmen [CMC]): Those who are trained medics/corpsmen are
expected to meet the medical standards for this tier.
Tier 4 (Combat Paramedic/Provider [CPP]): This is the highest level of prehospital capa-
bility and will have a significantly expanded scope of practice.

Mascal/Triage
Background
The foundation of effective PCC is accurate triage for both treatment in the PCC setting
and for transportation to a higher level of care, as well as effective resource management
across the entire trauma system. Resource management includes the appropriate utiliza-
tion of medical and non-medical personnel, equipment and supplies, communications, and
evacuation platforms. Like most Mass Casualty incidents (MASCAL), the purpose of tri-
age in a PCC setting is to swiftly identify casualty needs for optimal resource allocation
in order to improve patient outcomes. However, PCC presents unique and dynamic triage
challenges while managing casualties over a prolonged period with a low likelihood of re-
ceiving additional medical supplies or personnel with enhanced medical capabilities apart
from pre-established networks. MASCAL in a PCC environment will necessitate more
conservative resource allocation than traditional MASCAL in mature theaters or fixed
medical facilities where damage control surgery, intensive care, and medical logistical
support are more readily available, and resupply is more likely. PCC dictates the need for
implementing various triage and resource management techniques to ensure the greatest
good for all. The objectives and basic strategies are the same for all MASCAL; however,
tactics will vary depending on the available resources and situations.

24 SECTION 1 TACTICAL TRAUMA PROTOCOLS (TTPs) ATP-P Handbook 11th Edition 25