This document provides information about Tactical Combat Casualty Care (TCCC) training conducted by Lethics LLC. It outlines the goals of TCCC, which are to treat casualties, prevent additional casualties, and complete the mission. The training includes classroom instruction followed by field exercises evaluating care under fire, tactical field care, and tactical evacuation care. Trainees are graded on critical life-saving skills like hemorrhage control, airway management, and communication during a simulated casualty scenario. The goal is to standardize first aid procedures for operators deploying to hazardous environments.

1. Lethics LLC
Tactical Combat Casualty Care
All operators should know and understand first aid, but they must be able to think quickly
on when to engage the enemy on the battlefield and also be able to provide care while under
fire. The TCCC qualification is something that must be implemented for
ensuring operators who deploy in the future have this as part of their skill set.

2. Lethics Combat Care Will Cover
• Tactical Combat
Casualty Care
• Tactical Combat
Casualty Care
Procedures
• Triage
• Evacuation
• 9-Line
• First Aid and Litter
Combat Casualty Kit

3. Lethics Combat Care Goals
An important guiding
principle of CC is
performing the correct
intervention at the
correct time in the
continuum of field care.
To this end, CC is
structured to meet
three important goals:
• Treat the casualty.
• Prevent additional
casualties.
• Complete the operation.

4. Stages Of Combat Casualty Care
Care Under Fire
Tactical Field
Care
Tactical
Evacuation Care
• Still Under Fire
• Risk Of Additional Casualties Is High
• Medical Equipment Is Limited
• Care Rendered When No Longer Under Effective Fire
• Medical Equipment Is Still Limited
• Time To Evacuation Is Evaluated / Min. – Hours?
• Care Given Once Casualty Has Been Picked Up
• Medical Equipment And Personnel That Have Been
Staged On Mode Of Pick Up Should Be Available

5. Care Under Fire
This is a very complicated phase because of a
few tactical factors.
1. Medical equipment is limited to personal
supplies
2. Limited assistance will be available. The rest of
the units operators will be engaging the enemy.
3. The tactical situation will limit the scope of the
examination.
4. Low light or smoke may create limited visual
acuity while treating the casualty.

6. Lethics Combat Casualty Care
Class Room
Teach Material
Set Goals For The Field
Preparation
Field Exercises
Care Under Fire
Tactical Field Care
Tactical evacuation Care
After Action And Assessment
Instructors Grade
Students
Student Critique Course
Standardize Team Med.
SOPs

7. Class Room Material
1.
2.
3.
4.
5.
6.
7.
Tactical Combat Casualty Care
Tactical Combat Casualty Care Procedures
Triage Categories
Evacuation Categories
9-Line Medical Evacuation
Improved First Aid
Aid Bag Considerations

8. Set Goals for the field
1.
2.
3.
4.
Students Learn what will be expected of them
Students will be familiar with grading proses
Students will Know field schedule
Students will understand safety material and Go,
No go criteria

9. Preparation
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•
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•
Gear list review
Weapons and comms checks complete
All environmental and safety briefs prepared
Stage to begin field exercises

10. Field Exercises
• Care Under Fire
Will lead into :
• Tactical Field Care
Will lead into:
• Tactical Evacuation Care
Tactical evacuation Care will only be graded until
casualty has been delivered to the evacuation
platform

11. Graded Parts of Care Under Fire
Training
•
•
•
•
•
•
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.
Suppression of hostile fire.
Moving the casualty to a safe position.
Activate 9 Line
Treatment of immediate life-threatening injuries.
Defensive actions
Transportation

12. Graded parts of Tactical Field Care
•
•
•
•
•
•
Tactical field care is the care rendered to the
casualty once the casualty and rescuer are no
longer under effective hostile fire.
Cardiopulmonary resuscitation (CPR)
Altered mental status
Airway management
Breathing
Hemorrhage control
Vascular access

13. Graded parts of Tactical Field Care
•
•
•
•
•
•
•
•
•
•
•
Fluid resuscitation
Hypothermia prevention
Monitoring/further evaluation
Pain control
Fractures
Infection control
Penetrating eye trauma
Burns
Spinal precautions
Communication
Documentation

14. Tactical evacuation care
Is the care rendered once the casualty has
been picked up by an aircraft, vehicle, or boat.
• Care in transportation to the evacuation
platform will be graded

15. Basic Management Plan for Care
Under Fire
1. Return fire and take cover.
2. Direct or expect casualty to remain engaged as a combatant if
appropriate.
3. Direct casualty to move to cover and apply self-aid if able.
4. Try to keep the casualty from sustaining additional wounds.
5. Airway management is generally best deferred until the tactical field
care phase.
6. Stop life-threatening external hemorrhage if tactically feasible:
• Direct casualty to control hemorrhage by self-aid if able.
• Use a tourniquet for hemorrhage that is
anatomically amenable to tourniquet application.
• Apply the tourniquet proximal to the bleeding site, over the uniform,
tighten, and move the casualty to cover

16. After Action and Review
• Final grades,
counseling, and
evaluation easements
are given to the
students.
• Students Evaluate
course.
• Team Medical SOPs are
constructed
• Med Kits and blow out
kits are standardized.