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Brian Willis is a retired officer, trainer and author who now serves as deputy executive director for the International Law Enforcement Educators and Trainers Association (ILEETA).

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Doug Wyllie

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William Harvey

William "Bill" Harvey is currently serving as chief of police in south central Pennsylvania. He retired from the Savannah (Ga.) Police Department where he worked assignments in training, patrol, and CID. Harvey has more than 25 years of experience working with recruits, rookies, and FTOs.

Trauma Care on the Front Lines of Patrol

North American Rescue's Tactical Combat Casualty Care training course trains you to deliver medical treatment in tactical scenarios.

November 11, 2011  |  by Scott Smith - Also by this author

North American Rescue of Carthage, N.C., is known for providing trauma medical personnel worldwide with the best and most advanced equipment possible, including casualty evacuation and diagnostic gear. The company also offers configurations to meet individual, team or agency needs.

This year, North American Rescue organized staff, equipment and training to teach first responders, military operators, and civilians to treat and cope with major trauma. The staff's skill set include being the lead medic for the Army Rangers, special forces senior medics, a Ranger battalion medic, and paramedics who have experiance in combat and with mass-casualty scenarios.

The training and equipment company is bringing the military's Tactical Combat Casualty Care (T.C.C.C.) to the military, private security and EMS market. As officers, we need to know combat medicine to save your own or your teammate's life. You may be involved in a shootout. What if you suffer a traumatic injury from a vehicle accident, a fall, or natural disaster? You should be prepared for it.

T.C.C.C. is being taught to GIs, and is saving lives. One of the most notable users of T.C.C.C. is Sgt. First Class Leroy Petry, who was awarded the Congressional Medal of Honor. Petry lost his hand when he recovered and threw a grenade away, saving the lives of his squad members. Following an explosion that amputated his right hand, Petry applied his personal tourniquet to stop the bleeding. This ultimately saved his life.

T.C.C.C. has shown that troops can be given basic focused training on applying pressure dressings, tourniquets, haemostatic agents, control hypothermia, as well as how to reduce tension pneumothorax. Performing these steps has saved countless lives in Iraq and Afghanistan. Odds are good they will save lives of numerous police and other first responders.

I attended the course in which North American Rescue stresses that one of the most overlooked elements of being a "tactical first responder" is the tactical part of being an EMT or medic. In a tactical situation, being the first man to your injured comrade could make you another casualty. You'll need to first solve the "tactical" portion of the equation, which requires you to ask whether we need to shoot first, find cover to move to or from with myself and the casualty, and determining whether the area we're moving to is secure enough to perform basic lifesaving techniques. You also must consider how you're going to extract yourself and the casualty after the initial onsite treatment without more victims. As the team medic, you'll need to consider these items as part of your overall evaluation of the treatment of the patient.

Once your agency has decided to use T.C.C.C., you'll need to set standard operating procedures, including where to carry your individual treatment kit. Yes, each member should carry a personal kit if they require treatment. How complex will your kits be? Will you carry more than just a tourniquet and haemostatic gauze, or will your team be trained to handle a nasopharyngeal airway (NPA) to ensure an unconscious casualty has an airway.

Inserting a nasal trumpet (NPA). Photo: Scott Smith
Inserting a nasal trumpet (NPA). Photo: Scott Smith

Do your local or state regulations allow for non-medical personal to reduce a tension pneumothorax (NPT)? You'll need to address these questions when setting up your unit or agency's tactical medical care. In their course, N.A.R. covers these areas to provide guidance for your training and decision-making.

N.A.R. gives the non-medical first responder a solid base to treat traumas. That doesn't mean you'll be a paramedic in a few days. However, since the tasks are simple and presented as a step by step process, you'll gain the knowledge and skills that could save your life. This was the best basic medical course I've had in my 20 years of government service, most of which was in a uniform carrying a gun. Instructors dispel the myths of tourniquets; tell you a major trauma will be bloody; and give you the mental conditioning to do this task.

You'll learn about non-open wound trauma, such as a fall from heights greater than 12 feet. These injuries can induce an NPT, and you'll learn how to recognize the symptoms of one without seeing an entry wound.

The N.A.R. course also stresses making treatment notes to pass on to medical personal. You'll need to tell them you did an NPT reduction; explain how the casualty is breathing; and given an approximate pulse rate. This information helps medical personal give quicker, skilled treatment, so they can avoid doing the same task twice or ensuring it was done properly. These details save lives.

The N.A.R. course also teaches you how to ensure your patient doesn't become hypothermic, which can be caused by injuries involving blood loss. Do you have emergency blankets on hand? If so, do members of the team know where to find them? If you're the lone first responder, as many police are these days, do you have these items?

The last consideration is transporting the victim. Are you in BFE and have to use your duty vehicle for transport? Or do you have medical transport? Are you transporting under hostile conditions? Is weather a factor? Do you have a litter to help move the victim so you can reduce the odds of further injury? Do you need to move them without one?

As you can see, the basic Tactical Combat Casualty Care course from North American Rescue is far from basic. It's designed for those with little or no formal first-responder training to save a life in the event of a traumatic injury. If you carry a sidearm and wear a shield for a living, it's a course you should take.

Related: Tactical Medical Kits (photos)

Comments (7)

Displaying 1 - 7 of 7

Deputy Mike Burkey @ 11/14/2011 3:46 PM

Great article! Please email me with information. I live in Northeast Ohio and am interested in learning more about T.C.C.C

Mark Boswell @ 11/14/2011 7:02 PM

I too, attended this course. I am already a nationally registered paramedic and have started pursuing more training along the lines of tactical medicine. While this was just the First Responded level TCCC, I took it as an introduction to other tactical training I have planned. I felt this was a great adaptation of tactical medicine tailored to the entry level responder and NAR did a good job of making it easy to complete the course for those with little to no EMS or casualty experience. The instructor cadre was top notch with 2 of them being Army Ranger Medics and one a SOF Medic. If anyone is interested in learning more than just "first aid" especially if you could ever find your self looking at a tactical casualty even just from recreational shooting/hunting...this course would be a good starting point. The things one can do in the first 2-4 minutes following a tactical injury can save a life!

Officer Jeffrey Shanley @ 11/15/2011 7:47 PM

I would like to take this training. Please send me more info. This training should be taken by any and all serious professionals.

Mike Massaro @ 11/16/2011 3:55 AM

Guardian Academy,, is a provider of the Trauma First Response and Tactical Combat Casualty Care courses. As a NAEMT training site, Guardian is authorized to provide training for each discipline. Take a look at the one day Trauma First Response course. It is geared more to the non-medical first responsder.

Rick @ 11/16/2011 8:44 AM

Induced hypothermia is being studied as a treatment for trauma patients in order to reduce bleeding and extend the amount of time surgeons have to repair the injuries. Depending upon what these studies reveal (they are in the human trial phase), warming trauma patients may go away.

Sean @ 11/16/2011 9:26 AM

Sounds great,however look at the International School of Tactical Medicine in Palm Springs, CA. This school really started the ball rolling so to speak several years ago. Dr.Heiskell and faculty do a outstanding job

Mark @ 11/17/2011 11:15 AM

There are a lot of good tactial medical courses out there. CONTOMS and TCCC are to my knowledge the only nationally accepted Tactical Medical Programs. I like the idea of that type of foundation if I have to go to court.

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