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stations offered by the ATCN. It is a program of the Soci- provide a foundation for the standardization of tactical
ety of Trauma Nurses. For more information, go to www emergency medical support protocols. ‡
.trauma-nurses.org/atcn.
Tactical Emergency Casualty Care (TECC)
Trauma Nursing Core Course (TNCC) The Committee for Tactical Emergency Casualty Care
Trauma Nursing Core Course (TNCC) was developed by (C-TECC) was formed in 2010 to adapt military TCCC
the Emergency Nurses Association to provide standard- principles to civilian high threat prehospital environ-
ized nursing knowledge to improve the care of trauma ments. The C-TECC does not offer courses but directs
patients, including the identification of life-threatening that its principles be used as written by educational
injuries, patient assessment, and interventions to pro- partners. The C-TECC is a not-for-profit organization.
mote better outcomes. The two-day course includes skill Representatives from several federal agencies, including
stations for nurses to practice a systematic approach to the Federal Emergency Management Agency, Depart-
the trauma patient. For details, go to https://ena.org/ ment of Homeland Security Office of Health Affairs,
education/ENPC-TNCC/ tncc/Pages/aboutcourse.aspx. and multiple federal law enforcement agencies, are in-
volved with C-TECC. TECC is included in the Joint
Prehospital Trauma Life Support (PHTLS) Counter Terrorism Workshop Series, which is a program
Prehospital Trauma Life Support (PHTLS) is the premier to assist urban areas to prepare for mass casualty inci-
prehospital trauma education course; its mission “is to dents. More information is available at: http://c-tecc.org
promote excellence in trauma patient management by /images/content/C-TECC-Overview.pdf.
all providers involved in the delivery of prehospital care
through global education.” It was developed by the Na- Law Enforcement and First Response Tactical
tional Association of Emergency Medical Technicians Casualty Care (LEFR-TCC)
(NAEMT) in collaboration with the ACS COT. It is a The Law Enforcement and First Response Tactical
16-hour course offered in two formats. One format is Casualty Care (LEFR-TCC) course is offered through
a traditional face-to-face course with lectures and skill the NAEMT PHTLS program. It is designed for pub-
stations; the other format is a hybrid course in which lic safety first responders (nonmedical) to provide them
a portion is taken online and is followed by a one-day with skills for hemorrhage control and the use of gauze
skill session. More information is available at www. packs, topical hemostatic agents, and tourniquets. The
naemt.org/education/PHTLS/whatisPHTLS.aspx. course also emphasizes opening an airway. It conforms
with the TECC guidelines and the recommendations of
the Hartford Consensus. More information about this
To support the principles of the one-day course is available at: www.naemt.org/educa-
Hartford Consensus, all responders tion/LEFR-TCC/What IsLE-FRTCC.aspx.
in all disciplines and in all care
environments should be properly Bleeding Control Course (B-Con)
The Bleeding Control Course (B-Con) is a course lasting
trained in hemorrhage control. two and a half hours to teach civilians with little or no
medical training how to respond before EMS person-
nel arrive. It is offered through the NAEMT/ PHTLS
Tactical Combat Casualty Care (TCCC) and is endorsed by the ACS COT. Examples of potential
The NAEMT Tactical Combat Casualty Care (TCCC) students include nontactical law enforcement officers,
course is designed to teach strategies for the best trauma firefighters, security personnel, and teachers. The course
care on the battlefield. TCCC guidelines are endorsed includes a lecture and skill stations for tourniquet appli-
by the ACS and the NAEMT through the PHTLS pro- cation, wound packing, and jaw thrust. B-Con may be
gram. The NAEMT TCCC course is offered under the used along with a module about the Hartford Consen-
auspices of the PHTLS program. It is designed for com- sus to introduce the LEFR-TCC course to law enforce-
bat EMS/military personnel. The course can be adapted ment personnel. More information is available at: www.
for law enforcement special weapons and tactics and naemt.org/education/B-Con/WhatIsB-Con.aspx.
special response teams. TCCC guidelines, available at
www.naemt.org/education/TCCC/TCCC_home.aspx,

‡ McSwain NE, Pons PT, eds. Prehospital Trauma Life Support. 8th ed. Burlington, MA: Jones and Bartlett Learning; 2014.

162 Journal of Special Operations Medicine Volume 15, Edition 4/Winter 2015