Page 137 - Journal of Special Operations Medicine - Summer 2016

Tourniquets in TCCC
Mil Med 1996

“It is very important, however, to stop major bleeding as
quickly as possible since injury to a major vessel may result
in the very rapid onset of hypovolemic shock….. Ischemic
damage to the limb is rare if the tourniquet is left in place
less than an hour and tourniquets are often left in place for
several hours during surgical procedures. In the face of
massive extremity hemorrhage, in any event, it is better to
accept the small risk of ischemic damage to the limb than to
lose a casualty to exsanguination….The need for immediate
access to a tourniquet in such situations makes it clear that
all SOF operators on combat missions should have a
suitable tourniquet readily available at a standard location
on their battle gear and be trained in its use.”
16

Committee on Tactical Combat Battlefield Trauma Care:
Casualty Care (CoTCCC) Now

• First funded by USSOCOM in 2001-2002 at the • Phased care in TCCC
Naval Operational Medicine Institute (NOMI) • Aggressive use of tourniquets initially
• Later sponsored by Navy and Army Surgeons • Combat Gauze as hemostatic agent
General and the U.S. Army Institute of Surgical • Aggressive needle thoracostomy
Research • Sit up and lean forward airway positioning
• 42 members - all services • Surgical airways for maxillofacial trauma
• Hypotensive resuscitation with blood products
• Trauma Surgeons, EM and Critical Care physicians, • IVs only when needed; IO access if required
operational physicians and PAs; medical educators; • PO meds, fentanyl lozenges, ketamine as
combat medics, corpsmen, and PJs “Triple Option” for battlefield analgesia
• 100% deployed experience in 2015 • Hypothermia prevention; avoid NSAIDs
• Relocated to the Defense Health Board in 2007 • Battlefield antibiotics
at the direction of ASD/HA • Tranexamic acid (TXA)
• Moved to the Joint Trauma System in 2013 18 • Junctional Tourniquets; XStat 19
18

TCCC: How Do We Know Tactical Combat Casualty
That it’s Working? Care (TCCC)

• Paper published 1996 in Mil Med
• First used by Navy SEALs,
75 Ranger Regiment, Army Special
th
Missions Unit, and Air Force
Pararescue in 1997
• PHTLS, ACS COT and NAEMT
endorsement 1999
• All of Special Ops adopted in 2005
• Now used throughout U.S. military
• Allied nations and civilian sector
20
as well 21

TCCC Updates 123