Tactical Combat Casualty Care: A new standard of trauma care training

Students and instructors from various joint units, come together during a feedback session after a combat scenario during a Tactical Combat Casualty Care (TCCC) course at MacDill Air Force Base, Fla., April 18, 2018. TCCC at MacDill is unique as the course is partnered with combatant commands and tenant units such as, U.S. Central Command (CENTCOM), U.S. Special Operations Command (SOCOM), Special Operations Command Central (SOCCENT), Marine Corps Forces Central Command (MARCENT), and U.S. Africa Command (AFRICOM). (U.S. Air Force photo by Airman 1st Class Ashley Perdue)

U.S. Air Force Airmen drag a manikin during a Tactical Combat Casualty Care (TCCC) course at MacDill Air Force Base, Fla., April 18, 2018. At MacDill, TCCC has been expanded to a three-day course where Department of Defense personnel learn to implement medical care under fire, tactical field care, and tactical evacuation. (U.S. Air Force photo by Airman 1st Class Ashley Perdue)

U.S. Air Force Airmen provide security while a classmate performs care under fire during a Tactical Combat Casualty Care (TCCC) course simulation at MacDill Air Force Base, Fla., April 18, 2018. TCCC is a three-day course where students learn to implement medical care under fire, tactical field care, and tactical evacuation during combat situations. (U.S. Air Force photo by Airman 1st Class Ashley Perdue)

U.S. Army Sgt. Hannah Gustafson, a medical operations NCO with the Joint Communications Support Element, provides feedback after a combat scenario during a Tactical Combat Casualty Care (TCCC) course at MacDill Air Force Base, Fla., April 18, 2018. TCCC is designed as a two-day course, but MacDill has extended it to a third day, culmination day, where students participate in a simulated combat zone supported by joint units throughout the base. (U.S. Air Force photo by Airman 1st Class Ashley Perdue)

Students practice exiting a UH-60 Black Hawk aircraft during a simulated medical evacuation scenario as part of the Tactical Combat Casualty Care (TCCC) course at MacDill Air Force Base, Fla., April 19, 2018. TCCC is designed as a two-day course, but MacDill has extended it to a third day, culmination day, where students participate in a simulated combat zone supported by joint units throughout the base. (U.S. Air Force photo by Airman 1st Class Ashley Perdue)

Students, from various joint units, walk out of a UH-60 Black Hawk aircraft during a simulated medical evacuation scenario as part of the Tactical Combat Casualty Care (TCCC) course at MacDill Air Force Base, Fla., April 19, 2018. TCCC is designed as a two-day course, but MacDill has extended it to a third day, culmination day, where students participate in a simulated combat zone supported by joint units throughout the base. (U.S. Air Force photo by Airman 1st Class Ashley Perdue)

MACDILL AIR FORCE BASE, Fla. --

MacDill Air Force Base, Florida, geared up for its first Tactical Combat Casualty Care for Medical Personnel (TCCC-MP) course of the year, April 17, 2018.

This course is one of two certified TCCC courses that have been offered to all Department of Defense personnel over the past five years at MacDill. TCCC-MP is intended for medical providers while the other course is meant for those not in medical careers.

“Everything taught during TCCC is evidence-based, meaning it has been proven in combat,” said James Norbech, the medical program director with the 6th Medical Group. “There is a committee on TCCC that meets two to four times a year, and interviews medics fresh out of theater who have experienced incidents, to see what is and isn’t working.”

These courses are designed to teach lifesaving techniques and how to provide the most effective trauma care during combat.

“We are uniquely positioned in the state of Florida to be able to offer this course to a multitude of units in the regional area,” Norbech added. “We also partner up with the combatant commands and tenant units on base such as U.S. Central Command, U.S. Special Operations Command, Special Operations Command Central, Marine Corps Forces Central Command, and U.S. Africa Command.”

The Medical Provider course is designed to last two days, but MacDill has added a third, culmination day. The first two days are dedicated to learning and applying skills on stations set up within the medical simulation lab. Once all personnel demonstrate proficiency at each station, they are introduced to a new dynamic.

“We add in various simulated scenarios that encompass the three phases of TCCC, which are care under fire, tactical field care, and tactical evacuation,” Norbech added.

Once in the field, personnel are armed with paintball guns and run through a simulated combat scenario testing their ability to rescue casualties. During the scenario, they must provide medical care while also returning fire. Personnel administer care to manikins as instructors stand by and provide feedback and guidance.

On day three, supporting units were brought in to provide smoke and ground burst simulators, along with personnel armed with paintball guns to act as enemy combatants. Once participants have ceased fire, they must complete an evacuation simulation requiring them to transport casualties to a UH-60 Black Hawk helicopter, provided by the Army unit 'G' Company 5-159th Medevac, from Clearwater, Florida.

“TCCC, in itself, is one of the more innovative concepts being brought into the military,” said Army Sgt. Hannah Gustafson, a medical operations NCO with the Joint Communications Support Element. “Being able to run a real-world scenario is priceless for medics, as we need to keep our skills sharp and on point at all times.

“Having an actual UH-60 here to pick up our simulated casualties reminds us how loud a real world scenario is and how extremely limited our vocal communication will be. This includes being shot at by paintballs; even though not lethal, it was a constant reminder that this is a combat situation. It was pretty amazing getting to experience the edge you need to keep in this job.”

According to Norbech, TCCC’s importance falls on ensuring military personnel enter into combat possessing the confidence, appropriate skillset, and knowledge to save lives.

“The instructors for this course at MacDill have picked it up, surpassed the crawl-walk phase and are running with this program,” Gustafson concluded. “It’s amazing how they’re able to bring together personnel from all branches, possessing different training backgrounds, and help them operate cohesively in the same stressful environment.”