Page 156 - Journal of Special Operations Medicine - Fall 2015

Vendor-Taught TCCC: Problems with Non-
Butler Experience 2002 Standard TCCC Courses

In 2002, I was working for the Naval Special Warfare
Command and was preparing to deploy to • Incorrect messaging
Afghanistan with the Navy Special Missions Unit. I – Instructor drift
had already trained one of their squadrons in TCCC,
but the command wanted me to go to a formal – “Never take off a tourniquet in the field”
course that supposedly taught TCCC before I • Negative media coverage
deployed. I went to a combat trauma course taught
by a commercial vendor near Aquia, VA. The course – Example 1
lasted 11 days with two additional days of travel. The – Example 2
course fee was just over $2000 per person and with – Example 3
TAD costs, the total cost to the government for me to
take this course was about $5000. The course did • Vendor-supplied training is expensive
not teach TCCC adequately and was largely a waste
of time and money. • Inappropriate training

Instructor Drift
Navy Active Shooter GMT
TCCC Course 2015
Instructor Drift
• Wrong phase
• TBI not a CI for
ketamine
• Shock – can use
ketamine
• Allergies – not As of the week of 27 April 2015
to both 48 49

Inappropriate Training Special Ops Major Command
Surgeon email: 24 April 2015
• “Shock labs”
• “Cognition labs” • Whole blood field transfusion practical lab here for
medics as well as ketamine.
• Insertion of intraosseous devices on course • It is all voluntary, consented and supervised.
attendee volunteers • “Almost everyone has some experience with the usual
• Regional nerve blocks by non-medical opioids and the ability to walk, talk and obey directions.
Ketamine is another matter. We found it very instructive
personnel for the non-medical line types to see what effect giving
• Central venous catheter placement by an operator 50 mg of ketamine IM will have on mission.
LL: you have at least 2 people off the gun and probably
prehospital providers more like 3. In a squad size element that is no small
• Arterial blood draws deal. I understand the above is controversial but to not
do it can create a real world tactical problem as well.”

144 Journal of Special Operations Medicine Volume 15, Edition 3/Fall 2015