TACTICAL COMBAT CASUALTY CARE
As a combat medic on today's battlefield, you will experience a wide variety of
conditions not previously experienced. Your training has prepared you on standards
that apply to the civilian emergency medical service (EMS) world that may not apply to
the combat environment. These tools are a good basis for sound medical judgment;
on today's battlefield, this judgment could save the lives of your fellow soldiers. The
US Army found the need to migrate away from the civilian standards and allow the
combat medics to analyze situations in ways not previously thought of. These
techniques are called "tactical combat casualty care" (TC3). These techniques and
factors will be discussed in the following paragraphs. Factors influencing combat
casualty care include the following.
a. Enemy Fire. It may prevent the treatment of casualties and may put you at
risk in providing care under enemy fire.
b. Medical Equipment Limitations. You only have what you carried in with
you in your medical aid bag.
c. A Widely Variable Evacuation Time. In the civilian community, evacuation
can be under 25 minutes; but in combat, evacuation may be delayed for several hours.
d. Tactical Considerations. Sometimes the mission will take precedence
over medical care.
e. Casualty Transportation. Transportation for evacuation may or may not
be available. Air superiority must be achieved before any air evacuation assets will be
deployed. Additionally, the tactical situation will dictate when or if casualty evacuation
can occur. In addition, environmental factors may prevent evacuation assets from
reaching your casualty.
STAGES OF CARE
In making the transition from civilian emergency care to the tactical setting, it is
useful in considering the management of casualties that occurs in a combat mission as
being divided into three distinct phases.
a. Care Under Fire. Care under fire is the care rendered by the soldier medic
at the scene of the injury while he and the casualty are still under effective hostile fire.
Available medical equipment is limited to that carried by the individual soldier or the
soldier medic in his medical aid bag.