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TECC Reports The revised Pediatric TECC Guidelines have been finalized
and approved. Dr Andy Garrett, the Pediatric Working Group
Dr David Callaway, C-TECC founding member and current Lead, presented the final version of the guidelines and high-
Chief Medical Officer for Team Rubicon, delivered a presen- lighted differences from prior iterations. The updated Pediatric
tation on the continuing efforts to train, prepare, and respond Guidelines will be published separately and made available on
to the ongoing armed conflict in Ukraine. Humanitarian aid the C-TECC.org website.
organizations working in conflict zones are bound by the in-
ternational humanitarian principles of humanity, neutrality, The Evacuation Care Working Group, led by Dr Matt Sztajn-
independence, and impartiality. Similar to the high-threat ca- krycer, remains actively engaged in ensuring revisions and clar-
sualty care provided in the civilian prehospital response sector, ifications of appropriate sections in the guidelines. The Board
TECC presents an important trauma response framework in of Directors is consulting with the working group to refine
conflict zones that align civilian and military resources in a definitions and objectives. The proposed changes should be fi-
common rubric while respecting the institutional and ethical nalized for the Winter Full Committee Meeting.
boundaries of each.
Dr Claire Park, Guidelines Committee, and Sgt Mike Paice of
Mr. Andrew Rowley, C-TECC Board of Advisors, provided New Scotland Yard (SCO19) described the implementation of
an update on the implementation of various TECC initiatives the Ten Second Triage (TST) tool in London, UK. TST can be
within the Drug Enforcement Administration Operational performed by non-medical providers depending on the loca-
Medicine Program. Mr. Rowley characterized the use of TECC tion of anatomic injury and casualty condition. Dr Park pre-
at various levels within the agency such as the agent and agent/ sented the research data utilized to validate the tool, as well
medical provider levels. He also described the challenges en- as strategies related to integration with the Major Incident
countered utilizing a national standardized training program Triage Tool. Preliminary exercise data suggest that the exist-
that is not customized to the specific tactics, techniques, proto- ing and novel triage systems are complementary and can be
cols, and resources of the program. Mr. Rowley acknowledged utilized in conjunction while decreasing times and improving
the utility of appropriate TECC guidelines and the flexibility outcomes. Sgt Paice presented such medical programs, which
to develop customized programs. are currently utilized by numerous law enforcement units in
London, UK.
Dr Jason Picket, Guidelines Committee, reported that the Na-
tional Tactical Officers Association (NTOA) is releasing the The next C-TECC Full Committee Meeting will be convened
Tactical Response and Operations Standard (TROS) for Law in Ft. Worth, TX on December 5, 2023. Agenda items will in-
Enforcement, which includes TECC as a minimum standard clude review of evidence on tourniquet use and side-effects
for the provision of point of wounding medical care. Addi- since its ubiquitous implementation in the civilian prehospital
1
tionally, the NTOA Public Order Response and Operations environment.
Standards, released on June 5, 2023 includes TECC as sug-
gested for all medical providers supporting law enforcement Acknowledgments
operations. 2 The C-TECC Board of Directors would like to thank the Spe-
cial Operations Medical Association (SOMA) for its contin-
The Federal Emergency Management Agency (FEMA) Office ued support of TECC and for providing a meeting location
of Intelligence and Threat Analysis will be conducting a Tar- during the Scientific Assembly. The C-TECC relies on infor-
geted Violence Mass Casualty Hospital Response Workshop at mation sharing between our civilian and military partners and
ECU Health in Greenville, NC on June 13, 2023. The work- is grateful that the vast majority of C-TECC members are also
shop features C-TECC founders Dr Reed Smith and Mr. Geoff SOMA members who were thus able to attend the entire Sci-
Shapiro, Past-Chair Dr Rich Kamin, and Director Chief Jim entific Assembly. Additionally, the C-TECC Board of Directors
Schwartz. The workshop objectives include identifying gaps recognizes the outstanding efforts and ongoing contributions
and best practices related to individual, systems, and interdis- of our Executive Director, Ms. Daneen Matheson.
ciplinary coordinated efforts in response to large-scale high-
threat incidents with significant impact on healthcare delivery. References
1. National Tactical Officers Association. NTOA Tactical Response
Guideline Updates and Scientific Advances and Operations Standard for Law Enforcement Agencies. 2023.
https://ntoa.org/pdf/TROS.pdf. Accessed 22 August 2023.
A significant addition to the TECC Guidelines was presented 2. National Tactical Officers Association. Public Order Response

at the plenary session. Each TECC Guideline will now include and Operations Standards. June 2023. https://ntoa.org/pdf/Public
a preamble, which identifies, clarifies, and contextualizes ele- Order.pdf. Accessed 22 August 2023.
ments of the guidelines and their applications. Although the
founding principles of C-TECC remain intact from its incep-
tion, key elements of TECC specific to individual guidelines Keywords: tactical emergency casualty care; TECC; special
need to be highlighted. The preamble addresses tenets and operations; SOF; trauma
applicability of TECC in various contexts and is included as
Appendix A.

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