Page 103 - JSOM Summer 2025

have to keep that flame burning in peacetime so that it will be How do you see TCCC developing in the future?
ready if and when we find ourselves in another war. • Improved capability to provide fluid resuscitation with ei-
ther whole blood or dried plasma for all casualties who
You said in the TCCC book that advances in medicine and need it.
other areas are not inevitable. What did you mean by that? • Better technology or medications to stop or slow non-
Just reflect on that fact that the United States put a man on compressible torso hemorrhage for casualties with torso
the moon before we figured out that it would be a good idea wounds.
to put wheels on suitcases, so that you could roll them rather • Better delivery of updated TCCC training materials for all
than having to carry the whole weight of the suitcase. It was who may need to care for combat casualties.
a great idea—it just took a while for someone to think of it. • Improved simulation techniques to better train medics on
how to perform a surgical airway.
And even when an individual has a good idea that deserves to • Tactical innovations that assist medics in caring for casu-
be implemented, there is definite risk to an innovator in pursu- alties on battlefields where hostile First-Person View (FPV)
ing his or her idea. Think of General Billy Mitchell and his pre- drones are present.
scient vision after WWI that airplanes would be the dominant • Optimized use of drone technology to assist in providing
strategic weapons system of the future. He was right on target battlefield trauma care.
about that, but his reward for conceiving and advocating for
this vision was that he got court-martialed—and convicted— Any final words of advice to those who follow in your
by a military bureaucracy that opposed it. footsteps?
The men and women who serve in combat units do so with the
What do you think is necessary in training to maintain the expectation that their unit medical personnel and the military
quality that TCCC has reached? medical trauma care system will take the best possible care of
The Committee on TCCC must continue to do a good job of them if they are wounded in combat. That is a sacred trust that
ensuring that the TCCC Guidelines combine the best possible we must live up to every day.
medicine with the best possible tactical awareness.
About the Authors
The Joint Trauma System must improve their ability to rapidly Captain (Ret) Frank Butler was a Navy SEAL platoon com-
implement new changes in the TCCC Guidelines into TCCC mander before he went to medical school. He was one of the
training material. founders of Tactical Combat Casualty Care (TCCC) for which
he received an award from Admiral Bill McRaven. He was
TCCC must be taught within an educational infrastructure also awarded the “Lifetime Military Service Award” from the
that has excellent quality control with respect to both curric- American College of Surgeons and recently received the “Pres-
ulum content and instructor performance. It must also be able idential Citizens Medal” from President Joe Biden.
to accurately document the TCCC training that each individ-
ual in the military has received. The organization that has done COL (Ret) Kevin O’Connor was Command Surgeon for
that most successfully to date is the National Association of DELTA force in Afghanistan (2002) and Iraq (2003) and
Emergency Medical Technicians. returned to Afghanistan with the 75th Ranger Regiment in
2005. O’Connor served on the White House Medical Staff for
Unit commanders must hold their medical and training staff 14 years and was the 16th Physician to the President of the
directly responsible for ensuring that TCCC training is accom- United States.
plished as required by current DoD instructions. In the words
of the JTS Senior Enlisted Medical Advisor Sergeant Major Jeff Butler is a former Navy SEAL platoon commander turned
Mike Remley: “Doers do what checkers check.” CIA officer. He is currently the Battalion Chief of the Spring-
field, Missouri Fire Department.

Interview with Frank Butler | 101