Manikins and trainers for Tactical Combat Casualty Care (TCCC) and hemorrhage control training.
Tactical Combat Casualty Care
Tactical Combat Casualty Care (TCCC) are guidelines for supplying immediate medical care for life-threatening injuries on the battlefield. Training in the management of combat trauma and blast related injury should be provided to all medical and non-medical combatants. TCCC differentiates three phases of casualty care: care under fire, tactical field care and tactical evacuation care. Medical care training focuses on caring for the common combat wound scenarios with hemostatic dressings and airway management while tactical training adds skills like drags and carries to move the casualty to relative safety.
Care under fire
Life-threatening external hemorrhage or extremity hemorrhage should be controlled immediately during the first phase using limb tourniquets.
Tactical field care
During the second phase, massive hemorrhage will be controlled and the airway be managed (jaw thrust maneuver, nasopharyngeal airway). In the case of an airway obstruction or massive facial trauma, a cricothyrotomy might be necessary. At this stage, breathing and circulation will be closely monitored and checked for signs of tension pneumothorax and sucking chest wounds should be treated and sealed. Tourniquets should be reassessed to make sure bleeding is stopped and the casualty checked for signs of hemorrhagic shock. Further, measures of hypothermia prevention should be applied, fractures should be splinted and medication (pain relief, antibiotics) given. Another important factor is the monitoring and treatment of burns.
Tactical evacuation care
During the third phase, care given should be the same as in the preceding phase. If chest or abdominal trauma are present, the casualty should be monitored closely for signs of tension pneumothorax. Additionally, any persisting or renewed bleeding must be controlled and the casualty be kept warm.
Enhance Tactical Combat Casualty Care training with medical simulation
Wound management, fast evacuation, and infection control have always been a critical point in warfare. In 1919, Col. H.M. Gray stated in “The Early Treatment of War Wounds”:
“The hemorrhage that take[s] place when a main artery is divided is usually so rapid and so copious that the wounded man dies before help can reach him.”
Since then, the training for first responder skills in military settings has vastly improved. As in all fields of medical training, the use of simulation can enhance the training by offering realistic scenarios and hands-on learning. Simulating high-stress battlefield scenarios with combat trauma manikins and trainers can give all combatants the skills necessary to decrease the amount of preventable deaths.
Preventable deaths: using simulation to train combatants in TCCC
With the right training, medical and non-medical combatants can learn how to effectively care for the wounded and control hemorrhage until they can evacuate the casualty from the battlefield to reach medical personnel for further treatment.
The suite of Tactical Casualty Care Simulators (TCCS) and Tactical Hemorrhage Control Trainers (THCT) offers military, government forces, medical rescue, and private security a realistic way for TCCC training in life-saving techniques and strategies for trauma care on the battlefield. TCCC simulation is based on common wound patterns in combat and can enhance preparedness and reaction times of all combatants to significantly reduce the number of preventable death.
“The fate of the wounded lies in the hands of the ones who apply the first dressing.”
Dr. Nicholas Senn, founder of the Association of Military Surgeons of the United States.