Page 136 - Journal of Special Operations Medicine - Summer 2014

Appendix 1 Enabling and Terminal Learning Objectives for Tactical Medical Providers and Operators
DOMAIN 1: Tactical Combat Casualty Care (TCCC)/ ELOs:
Tactical Emergency Casualty Care (TECC) Methodology • Describe the TFC/ITC environment
• Identify when it is appropriate to search and disarm a ca-
Competency 1.1: Tactical medical skills in the Care Under sualty and how to remove weapons and render them safe
Fire (CUF)/Direct Threat Care (DTC) phase of TCCC/TECC
Operator TLO 1.1.1: Demonstrate interventions performed • Demonstrate the ability to conduct a tactical primary
during the CUF/DTC phase of TCCC/TECC survey using the MARCH mnemonic, prioritize and treat
casualties
ELOs: • Describe key care that should be provided during the TFC/
• Demonstrate the ability to identify the CUF/DTC scenario ITC phase including: inspect and dress wounds, splint frac-
• Demonstrate the ability to return fire tures and recheck pulses, reassess tourniquets, establish
• Demonstrate the ability to conceal and cover intravenous (IV) access, administer medications and fluids
• Demonstrate the ability to stop life threatening external as indicated, and apply rigid eye shield for a casualty with
hemorrhage penetrating eye injury after performing field expedient vi-
• Demonstrate the ability to position a casualty in the re- sual acuity exam
covery position and direct a casualty to self-treat
• Demonstrate the ability to remove a casualty from a Competency 1.3: Tactical medical skills in the Tactical Evacu-
burning vehicle and stop burn injury to the casualty if ation Care (TACEVAC)/Evacuation (EVAC) phase of TCCC/
needed TECC
Operator TLO 1.3.1: Describe appropriate assistance and
• Discuss the possible need to defer airway management protection of the medical provider and the CCP
until TFC/ITC
ELOs:
Operator TLO 1.1.2: Explain the key elements of hand-off
to the next level of care • Demonstrate the ability to provide security for both the
medical provider and casualties
ELOs: • Demonstrate the ability to assist with physical transfer
• Demonstrate the ability to identify injuries of patients to TACEVAC/EVAC platform
• Demonstrate the ability to provide appropriate interventions Medical Provider TLO 1.3.1: Perform appropriate casualty
• Demonstrate the ability to report mechanism of injury care at your level of training in the TACEVAC/EVAC phase of
and interventions to medical providers
TCCC/TECC
Medical Provider TLO 1.1.1: Perform appropriate casualty ELOs:
care at your level of training in CUF/DTC phase of TCCC/ • Demonstrate the ability to reassess the casualty (e.g., the
TECC
MARCH mnemonic and secondary assessment)
ELOs: • Demonstrate the ability to re-evaluate all interventions
• Demonstrate the ability to identify the CUF/DTC scenario
Medical Provider TLO 1.3.2: Describe the actions to ar-
• Describe the environment during the CUF/DTC phase range casualty evacuation by both ground and air
including the return of fire and elimination of the threat
• Demonstrate the ability to conceal and cover ELOs:
• Demonstrate the ability to stop life threatening external • Demonstrate the ability to transfer casualties to the landing
hemorrhage zone or medical exchange point for transport to the next
• Demonstrate the ability to position a casualty in the re- level of care according to the prearranged medical plan
covery position
Medical Provider TLO 1.3.3: Describe the key elements of
• Demonstrate the ability to direct casualty to self-treat handoff to the next level of care
• Describe the need to remove casualty from immediate
hazards (e.g., burning vehicle) ELOs:
• Discuss the possible need to defer airway management • Demonstrate the ability to provide documentation of
until TFC/ITC care rendered
• Demonstrate the ability to deliver an organized verbal
Competency 1.2: Tactical medical skills in the Tactical Field report during transfer of care
Care (TFC)/Indirect Threat Care (ITC) phase of TCCC/TECC
Operator TLO 1.2.1: Describe appropriate casualty care, Competency 1.4: Use of TCCC/TECC as a system in the tacti-
assistance, and protection of the medical provider and the ca- cal environment
sualty collection point (CCP) Operator TLO 1.4.1: Describe the components of the indi-
vidual first aid kit (IFAK)
ELOs:
• Demonstrate the ability to appropriately disarm a casualty ELOs:
• Demonstrate the ability to conduct a tactical primary • Describe the components of your agency-provided IFAK
survey using the MARCH mnemonic (Massive Hemor- and the purposes of each (e.g. nasal airway device, pressure
rhage, Airway, Respiration, Circulation, Hypothermia/ dressing, gauze, chest seal, tourniquet, hemostatic dress-
Head Injury), prioritize and treat casualties ing, casualty documentation card with permanent marker,
• Demonstrate the ability to provide security for the CCP 2" utility tape, gloves, catheter for chest decompression)
• Demonstrate use of the items included in your IFAK
Medical Provider TLO 1.2.2: Perform appropriate casualty
care at your level of training in the TFC/ITC phase of TCCC/
TECC (continues)

126 Journal of Special Operations Medicine Volume 14, Edition 2/Summer 2014