Part I Speaker: Dr. Charles Beadling, Col, US Air Force (Ret)
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Transcript Part I Speaker: Dr. Charles Beadling, Col, US Air Force (Ret)
Tactical Combat Casualty Care
Charles W. Beadling, MD, FAAFP, IDHA, DMCC
Center for Disaster and Humanitarian Assistance Medicine
Department of Military and Emergency Medicine
Uniformed Services University
PART I
Objectives
Tactical vs. Civilian
Trauma Care
Mortality in Combat
Stages of Tactical
Care
Tactics, Techniques
and Procedures (TTPs)
Students will compare and contrast the
differences between civilian and tactical
trauma.
The student will evaluate the importance of
this unique body of knowledge (TCCC) that
can decrease the KIA rate in modern
warfare.
Know the three phases of care
Identify the top three causes of preventable
combat mortality
List three methods of controlling
hemorrhage in the field
Outline additional equipment and skills
available with evacuation assets
Perform the CORRECT Intervention at
the CORRECT Time
Advantages
Widely accepted in US and internationally
The standard of care in civilian hospitals
Limitations in Combat
Intended for Advanced HCPs
Assumes availability of hospital diagnostic and
therapeutic equipment
Assumes immediate surgical capability
ATLS was never designed or
intended to be used in the tactical
environment.
90% die before reaching MTF
Epidemiology of Trauma
Tactical Environment
Equipment and Tactics
Techniques & Procedures
Significance to YOU
*Graphic Photo Content*
Burns
Burns
Blast = 3%
3%
6%
6% Blast
Other
Other ==6%
6%
Bullets
Bullets
= =
23%23%
Fragments
Fragments
Bullets
Bullets
Burns
Burns
Blast
Blast
Other
Other
Fragments
Fragments
62%
62%
(WWI, WWII, Korea, Vietnam, Middle East)
Those that will survive regardless
Those that will die regardless
Those who will die from preventable deaths
unless the proper life saving steps are taken
immediately
Killed in Action
(86% KIA)
versus
Died of Wounds
(12% DOW)
Understand Epidemiology = Develop
Appropriate Critical Skill Sets
Understand Environment = Modify Skill
Sets/Equipment to Maximize Benefit
Equipment
Training
Research
Multiple 2%
Aviation 13%
GSW 26%
MVC 3%
Unk 2%
Explosion
54%
Exanguinating extremity wounds – 61%
Tension pneumothorax – 33%
Airway obstruction – 6%
Control Hemorrhage
Open/Maintain Airway
Decompress a Tension Pneumothorax
Seal Open Chest Wound
Initiate Treatment for Shock
Employ Hypothermia Prevention
XABC
Care Under Fire
Tactical Field Care
Combat Casualty Evacuation Care
Care rendered at the scene of the
injury while rescuer and casualty are
still under effective hostile fire.
First action: Return Fire!
Your no good, if you are DEAD
Return Fire/Gain Fire Superiority
Devise Rescue Plan
Direct Conscious Casualty in Self Aid (SABA)
Aggressive Hemorrhage Control
Tourniquet
Airway?
C-spine?
60% Extremity Hemorrhage
Effective Tourniquets Save Lives
Improper training
Use when severe bleeding is not present
Loosening the device to allow intermittent
return of blood flow
Not applying it tight enough
Removing it prematurely