Page 154 - JSOM Summer 2020

Tactical Combat Casualty Care (TCCC) Update

Harold R. Montgomery, ATP; Brendon G. Drew, DO

he Committee on Tactical Combat Casualty Care In 2018, the Assistant Secretary of Defense for Health Affairs
(CoTCCC) drives on with its mission despite COVID-19 established working groups focused on oversight and devel-
Tquarantines, meeting cancellations, and changes in orga- opment of a tiered set of curricula to integrate TCCC training
nizational structure. at all levels of the DoD. These working groups with represen-
tation of CoTCCC members and service representatives have
been critical in establishing common learning objectives and
Committee Charter
metrics that drives the curriculum development.
The CoTCCC has been chartered as a DoD committee since
2002 and had several parent organizations from US Special The curricula development is a comprehensive collaboration
Operations Command (USSOCOM) to the Naval Operational of subject-matter experts and education professionals from the
Medicine Institute (NOMI) to the Army Institute of Surgical CoTCCC, the JTS Joint Trauma Education & Training Branch
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Research (USAISR) to the Defense Health Board (DHB). With (JTETB), the University of Miami, the University of Central
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the move of the Joint Trauma System (JTS) to the Defense Florida, Army Futures Command, the Defense Medical Mod-
Health Agency (DHA) in 2018, the most recent re-charter was eling & Simulation Office (DMMSO), and the Defense Medi-
the most robust and redefining in the history of CoTCCC. cal Readiness Training Institute (DMRTI)
The CoTCCC is now a component committee within the newly TCCC for All Service Members (TCCC-ASM) was released in
chartered Defense Committee on Trauma (DCoT) which is a August of 2019 and is being integrated into the initial entry
branch of the JTS under DHA. The CoTCCC is also aligned training of the services as well as at unit level. TCCC for Com-
with the now formally established peers of the Committee on bat Lifesavers (TCCC-CLS) will be released no later than June
En Route Combat Casualty Care (CoERCCC) and the Com- of 2020 and will standardize content of existing combat life-
mittee on Surgical Combat Casualty Care (CoSCCC). The saver and first responder programs across the services. Upon
CoTCCC mission remains consistent but is now aligned with the release of TCCC-CLS, we will officially shelve the preced-
the CoERCCC and CoSCCC to implement a streamlined set ing TCCC for All Combatants (TCCC-AC) to the archives of
of guidelines that span the continuum of care. As such, the JTS TCCC success stories.
clinical practice guidelines will be synchronized from point of
injury through evacuation to a fixed medical facility. TCCC for Combat Medics and Corpsman (TCCC-CMC) is
targeted for release later in the year which will provide cur-
Fundamentally, the purpose of the DCoT and component ricula content replacing the existing TCCC for Medical Per-
committees are to produce and document the guidelines that sonnel ( TCCC-MP). The TCCC-CMC curricula modules will
will define tactical and operational standards of care for com- expansively cover the TCCC training requirements of junior
bat casualties. Additionally, the charter stipulates options in medics and corpsman in a modularized package. The intent
which the DCoT can establish working groups to address spe- of the modularized content is to optimize delivery in multiple
cific issues and problem sets such as prolonged casualty care. methods that the services, organizations, and individuals can
employ. The modules can be integrated into larger curricula
As the JTS has been designated as the DoD reference body for courses such as initial entry medical training such as MOS,
trauma, the DCoT and its component committee membership NEC, and AFSC producing courses. The modules may be con-
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will be the core of that reference body. Made up of specially solidated into a stand-alone TCCC-CMC course akin to how
selected subject matter experts, the DCoT is poised to provide TCCC-MP was previously conducted. The modules may also
the service medical departments with sound guidance fused be time-spaced to serve as sustainment training at unit level
from evidence-based medicine, trauma registry data, best prac- like the traditional “sergeant’s time.” Finally, the modules are
tices, lessons learned, and expert opinion. intended to be anytime access for individuals to conduct self-
paced knowledge and skills maintenance.
Curriculum Development
TCCC for Paramedics and Providers (TCCC-CPP) is targeted
In accordance with the mandates of DODI 1322.24, Medical for both enlisted medical personnel trained to the paramedic
Readiness Training (MRT) dated 16 MAR 2018, the updat- level and for physicians, physician assistants, and other health
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ing and standardization TCCC curriculum are well under way. care professionals operating at the Role 1 level of care. While

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