Page 107 - JSOM Spring 2020

An Ongoing Series

Canine Tactical Combat Casualty Care
(K9TCCC) Guidelines

Thomas H. Edwards, DVM, MS, DACVECC *; Lee Palmer, DVM, MS, DACVECC, EMT-T, NRP, TP-C ;
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Rebecca L. Baxter, DVM ; Thomas C. Sager ; James G. Coisman, DVM, MS, DACVS ;
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Jamie C. Brown, DVM, DACVS ; Clinton George, DVM, DACVPM ; and
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Andrew C. McGraw, DVM, MS, DACVIM ; on behalf of the Education and
Training Subcommittee of the Canine Combat Casualty Care Committee

ABSTRACT
First introduced in 1996, Tactical Combat Casualty Care Background
(TCCC) redefined prehospital, point-of-injury (POI), battle- Since the start of the War on Terror and ensuing conflicts in
field trauma care for the human combat casualty. Today, many Iraq and Afghanistan, Tactical Combat Casualty Care (TCCC) †
consider TCCC as one of the most influential interventions has undergone significant evolutions that have benefitted the
for reducing combat-related case fatality rates from prevent- human combatant. Originally published in 1996, the TCCC
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able deaths in human combat casualties. Throughout history, concept and guidelines standardized point-of-injury (POI) care
Military Working Dogs (MWDs) have proved and continue to for human combat casualties by incorporating evidence-based,
prove themselves as force multipliers in the success of many best-practice, prehospital trauma care guidelines applicable to
military operations. Since the start of the Global War on Ter- the battlefield environment. The Committee on Tactical Com-
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ror in 2001, these elite canine operators have experienced bat Casualty Care (CoTCCC), under the Joint Trauma System
an upsurge in combat-related deployments, placing them at (JTS), routinely updates the TCCC guidelines on the basis of
a higher risk for combat-related injuries. Until recently, con- the availability of new, prehospital trauma care evidence in
sensus-based Canine-TCCC (K9TCCC) guidelines for POI conjunction with feedback from the user (i.e., individual Ser-
battlefield trauma care did not exist for the MWD, leaving a vicemembers, Combat Medics, Corpsmen, Pararescue). By do-
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critical knowledge gap significantly jeopardizing MWD sur- ing so, the CoTCCC remains at the forefront of advocating and
vival. In 2019, the Canine Combat Casualty Care Commit- implementing advancements in battlefield trauma care for the
tee was formed as an affiliate of the Committee on Tactical US Military. Since its implementation on the battlefield, TCCC
Combat Casualty Care with the intent of developing evi- remains one of the most influential interventions for reducing
dence-based, best practice K9TCCC guidelines. Modeled after combat-related case fatality rates from preventable deaths. Its
the same principles of the human TCCC, K9TCCC focuses on proven success for saving lives contributed to TCCC’s adoption
simple, evidence-based, field-proven medical interventions to by all branches of the US Military and many other allied na-
eliminate preventable deaths and to improve MWD survival. tions as the standard for battlefield trauma care. 4,5
Customized for the battlefield, K9TCCC uniquely adapts the
techniques of TCCC to compensate for canine-specific ana- The Global War on Terror has led to a significant upsurge in
tomic and physiological differences.
the call to duty of MWDs. Similar to their human counterparts,
MWDs deployed in a tactical or combat environment remain
Keywords: canine; Military Working Dog; Tactical Combat at high risk for suffering preventable deaths. Despite their in-
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Casualty Care; prehospital care; trauma valuable contribution to mission success, facets of prehospital
*Correspondence to US Army Institute of Surgical Research, 3698 Chambers Pass, JBSA Fort Sam Houston, TX; or thomas.h.edwards.mil@
mail.mil.
1 LTC Edwards is the chief of the Research Support Division at the US Army Institute of Surgical Research, JBSA Fort Sam Houston, TX.
2 LTC Palmer is a veterinary corps officer assigned to the 20th Special Forces Group, Alabama Army National Guard and is lead of the K9 Tactical
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Emergency Casualty Care Working Group. MAJ Baxter and MSG Sager are with the US Army Special Operations Command. LTC Coisman
is Chief of Animal Medicine for the Defense Health Agency. LTC Brown is the veterinary clinical specialist in the 64th Medical Detach-
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ment, Baumholder, Germany. COL George is the Chief of Radiology at the Department of Defense Military Working Dog Veterinary Service,
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JBSA Lackland AFB, Texas. COL McGraw is the Director of the Department of Defense Military Working Dog Veterinary Service, JBSA Lack-
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land AFB.
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