Section II: Care Under Fire
Download the full "TCCC"
TACTICAL COMBAT CASUALTY CARE HANDBOOK here
Care under fire is the care rendered by the rescuer at the point of injury while he and the casualty are still under effective hostile fire. The risk of additional injuries at any moment is extremely high for both the casualty and the rescuer. The major considerations during this phase of care are the following
: • Suppression of hostile fire.
• Moving the casualty to a safe position.
• Treatment of immediate life-threatening hemorrhage.
Casualty care during the care under fire phase is complicated by several tactical factors.
First, the medical equipment available for care is limited to that which is carried by the individual Soldiers and the rescuers.
Second, the unit’s personnel will be engaged with hostile forces and, especially in small unit engagements, will not be available to assist with casualty treatment and evacuation.
Third, the tactical situation prevents the medic or medical provider from performing a detailed examination or definitive treatment of casualties.
Furthermore, these situations often occur during night operations, resulting in severe visual limitations while treating the casualty.
Defensive Actions
The best medicine on the battlefield is fire superiority.
The rapid success of the combat mission is the immediate priority and the best way to prevent the risk of injury to other personnel or additional injuries to casualties.
Medical personnel carry small arms to defend themselves and casualties in the field.
The additional firepower from the medical personnel may be essential to obtaining fire superiority.
Initially, medical personnel may need to assist in returning fire before stopping to care for the casualty.
Additionally, casualties who have sustained non-life-threatening injuries and are still able to participate in the fight must continue to return fire as they are able.
As soon as the rescuer is directed or able, his first major objective is to keep the casualty from sustaining additional injuries.
Wounded Soldiers who are unable to participate further in the engagement should lay flat and still if no ground cover is available or move as quickly as possible if nearby cover is available
The medic may be able to direct the injured Soldier to provide self-aid.
Airway Management
Do not perform any immediate management of the airway during the care under fire phase.
Airway injuries typically play a minimal role in combat casualties, comprising only 1 to 2 percent of casualties primarily from maxillofacial injuries.
The primary concern is to move the casualty to cover as quickly as possible.
The time, equipment, and positioning required to manage an impaired airway expose the casualty and rescuer to increased risk.
Rescuers should defer airway management until the tactical field care phase, when the casualty and rescuer are safe from hostile fire.
Download the full "TCCC"
TACTICAL COMBAT CASUALTY CARE HANDBOOK here
Care under fire is the care rendered by the rescuer at the point of injury while he and the casualty are still under effective hostile fire. The risk of additional injuries at any moment is extremely high for both the casualty and the rescuer. The major considerations during this phase of care are the following
: • Suppression of hostile fire.
• Moving the casualty to a safe position.
• Treatment of immediate life-threatening hemorrhage.
Casualty care during the care under fire phase is complicated by several tactical factors.
First, the medical equipment available for care is limited to that which is carried by the individual Soldiers and the rescuers.
Second, the unit’s personnel will be engaged with hostile forces and, especially in small unit engagements, will not be available to assist with casualty treatment and evacuation.
Third, the tactical situation prevents the medic or medical provider from performing a detailed examination or definitive treatment of casualties.
Furthermore, these situations often occur during night operations, resulting in severe visual limitations while treating the casualty.
Defensive Actions
The best medicine on the battlefield is fire superiority.
The rapid success of the combat mission is the immediate priority and the best way to prevent the risk of injury to other personnel or additional injuries to casualties.
Medical personnel carry small arms to defend themselves and casualties in the field.
The additional firepower from the medical personnel may be essential to obtaining fire superiority.
Initially, medical personnel may need to assist in returning fire before stopping to care for the casualty.
Additionally, casualties who have sustained non-life-threatening injuries and are still able to participate in the fight must continue to return fire as they are able.
As soon as the rescuer is directed or able, his first major objective is to keep the casualty from sustaining additional injuries.
Wounded Soldiers who are unable to participate further in the engagement should lay flat and still if no ground cover is available or move as quickly as possible if nearby cover is available
The medic may be able to direct the injured Soldier to provide self-aid.
Airway Management
Do not perform any immediate management of the airway during the care under fire phase.
Airway injuries typically play a minimal role in combat casualties, comprising only 1 to 2 percent of casualties primarily from maxillofacial injuries.
The primary concern is to move the casualty to cover as quickly as possible.
The time, equipment, and positioning required to manage an impaired airway expose the casualty and rescuer to increased risk.
Rescuers should defer airway management until the tactical field care phase, when the casualty and rescuer are safe from hostile fire.
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