What is Tactical Emergency Casualty Care ?

In 2011, the Committee for Tactical Emergency Casualty

Care (C-TECC) published guidelines of care for

law enforcement and EMS, based on the successful

US Military’s Tactical Combat Casualty Care (TCCC)

program, adapted for high threat incidents in a

civilian setting.  C-TECC recognized that the civilian

environment could benefit from the same simple skills

applied in mass casualty incidents, where injuries are

similar to those sustained on the battlefield.


Adding “Tactical” to the title of these skills is not a marketing ploy or just to sound “tacti-cool.”  C-TECC defines “Tactical” as “of or pertaining to a maneuver or plan of action designed as an expedient toward gaining a desired  end or temporary advantage.”


These skills and techniques are a structured plan of action with one goal in mind, to save lives from traumatic injuries before advanced medical care can be provided.

What are the principles of TECC ?

The guidelines of Tactical Emergency Casualty Care define three distinct phases of care during emergency medical responses, whether terrorist, intentional, accidental, or disaster related mass casualty accidents. 


These three phases are:


   Direct Threat Care – A current active threat exists, goal is neutralization of

                         threat and rapid care of immediate life-threatening injuries.


   Indirect Threat Care – Threat may be near, or situation is unstable, goal is

                         swift assessment and management of life-threatening injuries

                         in preparation for transport to a trauma hospital.


   Evacuation Care – Threat is neutralized or contained, goal is rapid

                         transport to a trauma hospital.


According to TECC, injuries are assessed, treated, and managed using the MARCHe acronym:


   M   –   Massive Hemorrhage

   A   –   Airway

   R   –   Respirations

   C   –   Circulation

   H   –   Hypothermia / Head Injury

   e    –   Everything else

Are these skills complicated ?

The skills of TECC are simple. 

     - Stop rapid, severe bleeding using tourniquets and hemostatic gauze.

     - Open and keep the airway open using manual techniques and

       proper victim positioning.

     - Manage lung compromise from penetrating wounds using chest seals.

     - Treat lesser bleeding using pressure bandages.

     - Prevent hypothermia by keeping the victim insulated and warm.

     - Manage head injuries by assessing mental status and using proper victim 


The tools of TECC are simple.

     - A quality commercial tourniquet, such as TacMed Solutions' SOF-T or

       North American Rescue's CAT tourniquets

     - Approved hemostatic gauze, such as MedTrade Products' Celox Rapid

       Gauze or Z-Medica's Quikclot Combat Gauze

     - Chest seals such as MedTrade Products' FoxSeal Chest Seals,

       North American Rescue's Hyfin Chest Seals, or PMI's Halo Chest Seals

     - All-in-one pressure dressings, such as TacMed Solutions' Olaes Modular

       Bandage or North American Rescue's Emergency Trauma Dressing

     - Emergency "Space" Radiant Heat Blanket

These skills are required for Law Enforcement  !

CAPOST and CAEMSA approved the use of tactical tourniquets, the application of hemostatic gauze, the use combat chest seals, and the use of trauma pressure bandages in April 2015, including these skills into the scope of practice for Law Enforcement Officers.  These skills became required, mandated skills for CA Law Enforcement in April 2017.