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Intro To Tactical Combat Casualty Care (TC3)

Introduction to Tactical Combat Casualty Care (TC3)

Some of this is straight from US Army 68W Combat Medical protocols, some of it is at the CLS (Combat Lifesaver) level, and there is a bit of opinion thrown in there too…..it is partly excerpted from the chapter in ‘Contact!: A Tactical manual for Post Collapse Survival‘ on casualties.

Contact! A Tactical Manual for Post Collapse Survival

This post would be usefully read along with ‘SHTF Combat Casualty – Considerations & Realities‘. Remember that these TC3 protocols assume evacuation to definitive care (Combat Hospital), so in the absence of that you have other factors to consider. The linked post delves into that  a little.

Read the rest on the MVT Forum:  Forums › Self-Reliance & Preparedness › Medical Care

21 responses to “Intro To Tactical Combat Casualty Care (TC3)”

  1. Have you used the king airways. We were trained in them but never issued. They seem to be a little easier to install as it seals off the whole throat. I just don’t know of any one in my area who uses them. Any feedback?

    • Yes. King Airway is great. A way to avoid having to do a crike, if the breathing tube can be inserted via mouth. It is not part of basic 68W protocol, but is taught as a follow on. If you had one in your kit, that would be a good thing, i-f you know how to use it.

  2. If one were to carry a King Airway kit in his IFAC, what size would be best? i.e. 3, 4 or 5. I am not familiar with this device, but have learned how to do a crike which I would prefer not to have to do if this is a good alternative.

    Tater, out.

    • King airway is not a suitable item for an IFAK (too large anyway). It is not CLS level kit. If you had a designated medic, he would carry it, if trained, in his enhanced medical kit.
      Don’t over complicate the IFAK. It is for a fellow CLS to use, on you, when he is treating you as per TC3.

      • P.S. Crike is also not CLS level, it is combat medic level. If you are trained, in a crisis it is an option. Crike will work, through front of airway in the neck, if the mouth is smashed up, where a king airway would not work. If you get hit in the mouth, it will be all fucked up. That is what crike is for, to gain an airway when the teeth, tissue, blood and bones are blocking it at mouth level.

        • Thanks. Although I am not “Combat Medic” trained/certified, right now I am the only person in my little “tribe” that has any sort of TC3, etc. “medical” training above the level of the RC basic CPR/1st Aid class. This would be something that I would probably start carrying in my scout pack.

          • Tater, are you working on getting the rest of your tribe trained up to the TC3 level? I don’t mean to be aggravating, but I felt the question is pertinent to the original topic.

      • King Airways come in sizes based on the patient’s height. Four, five, and six feet and up air the main adult sizes. Anyone under 4 feet is a nogo. I think the manufacturer is working on ped sizes, but need to confirm.

        I agree with Max on this one. Keep your IFAK simple and light. Someone needing a King Airway at the pointyest point at the tip of the spear would not be breathing or would be so obtunded that he would be considered expectant (or condition black). Anyone needing a King Airway requires ventilations with bag-valve mask, and when you check your triage algorithm, anyone unable to breathe on his own has to be passed over so people can focus on more immediate tasks at hand – ie you’re in Care Under Fire phase.

        If you have a CCP for Tactical Field Care and a logistics and transport chain in place for CASEVAC, the patient is most likely to get the airway either in Field Care or on board transport.

    • King airway size would usually be determined by the height of the individual on which it is used. If someone is badly injured enough to require an advanced airway, if there is no ER or ICU to which to transfer care, then IMHO, carrying such equipment is just extra weight because a casualty requiring such intervention will likely need to have the king airway removed and replaced with an endotracheal tube and placed on a ventilator unless they miraculously regain consciousness and the ability to maintain their own airway. In the event that there is a higher level of care to which to transfer care, then king airways are a very useful tool. Same goes for performing a cric.

  3. I have the SOF wide tourniquets sold by Tactical Medical Solutions ~$30.

    I recently saw a video on the NATO tourniquet ~$20 : http://www.youtube.com/watch?v=IHq-7DYIsVM

    It appears to be easier to apply, given that it doesn’t have to be unthreaded/rethreaded from any buckle or needing to have free access to the limb.

    Max, you used these? Any caveats?

    Joe

    • CAT was favored over the SOF-T for wider procurement because the SOF-T has that extra fiddly mechanism that you won’t be able to use when you have lost your fine motor skills in the trauma of a combat wounding.
      The ‘NATO’ (made in USA) TQ looks like a nightmare. Not only will it increase nerve/tissue damage by pinching where it is twisted, but I want to shoot that guy in the arm with a 5.56 and watch him wrap that fucker and tighten it up. (Of course, I won’t shoot him with a .308′, cos then he would have no arms left…) ;-)
      My opinion: stick with the CAT.

  4. Max states:

    “Yes. King Airway is great. A way to avoid having to do a crike, if the breathing tube can be inserted via mouth.”

    The correct term is “cric” not “crike.” If you cannot get the terminology correct it makes me suspect of all your other information.

    • Seriously? The correct term is cricothyrotomy. ‘Crike’ (‘Cric’) is just slang, and how I spell it, because it spells lie it sounds.
      Fuck off.