R 131609Z APR 12
UNCLASSIFIED//
MARADMIN 209/12
MSGID/GENADMIN/CMC WASHINGTON DC CDI//
SUBJ/USMC TACTICAL COMBAT CASUALTY CARE (TCCC) COMBAT LIVESAVERS (CLS) PROGRAM GUIDANCE//
REF/A/DOC/MEMO FOR ASD (HA) TO SERVICE SECRETARIES DTD 4 MAR 2009//
REF/B/DOC/NAVMC 3500.84//
REF/C/MEMO/9 AUGUST 2010/BUMED PRE-DEPLOYMENT TRAUMA TRAINING FOR NAVAL MEDICAL PERSONNEL//
REF/D/DTM/09-033/POLICY GUIDANCE FOR MANAGEMENT OF TRAUMATIC BRAIN INJURY (TBI) IN THE DEPLOYED SETTING//
NARR/REF A IS ASSISTANT SECRETARY OF DEFENSE, HEALTH AFFAIRS (ASD (HA)) MEMO REQUESTING USE OF TCCC FOR PRE-HOSPITAL TRAINING.  REF B IS THE HEALTH SERVICES (HS) TRAINING AND READINESS MANUAL RELEASED 09 NOV 2010.  REF C IS THE BUMED MEMO STATING PRE-DEPLOYMENT TRAUMA TRAINING REQUIREMENTS FOR NAVAL PERSONNEL.  REF D IS THE SECRETARY OF DEFENSE DIRECTIVE TYPE MEMORANDUM POLICY GUIDANCE FOR MANAGEMENT OF TBI IN THE DEPLOYED SETTING.//
POC/CDR/STEVEN J. PARKS/TECOM/GROUND TRAINING DIVISION/MEDICAL PROGRAMS OFFICER 703-784-3051/0184/DSN: 278-3051/0184/EMAIL: STEVEN.J.PARKS(AT)USMC.MIL//
GENTEXT/REMARKS/1.  PURPOSE.  THE TCCC/CLS PROGRAM GUIDANCE PROVIDES DIRECTION ON THE TCCC AND CLS SKILLS TRAINING AT THE FIELD MEDICAL TRAINING BATALLIONS (FMTB) EAST AND WEST AND THE OPERATING FORCES AS WELL AS THE APPROVAL AND RELEASE GUIDANCE OF TCCC/CLS UPDATES AND CHANGES VIA ASD (HA) AND TRAINING AND EDUCATION COMMAND.   
2.  BACKGROUND
2.A.  IN 1996, THE NAVAL SPECIAL WARFARE COMMAND DEVELOPED A NEW SET OF TACTICALLY APPROPRIATE BATTLEFIELD TRAUMA CARE GUIDELINES NAMED TCCC.  THE TCCC GUIDELINES WERE ADOPTED BY THE U.S. SPECIAL OPERATIONS COMMAND (USSOCOM) AND APPROVED BY THE AMERICAN COLLEGE OF SURGEONS (ACS) AND THE NATIONAL ASSOCIATION OF EMERGENCY MEDICAL TECHNICIANS.  THE COMMITTEE ON TCCC WAS ESTABLISHED IN 2001 AND WAS DIRECTED TO FURTHER DEVELOP THE TCCC STANDARDS AND GUIDELINES.  THE COMMITTEE ON TCCC FUNCTIONS AS A WORKING GROUP OF THE TRAUMA AND INJURY SUBCOMMITTEE OF THE DEFENSE HEALTH BOARD (DHB), WHICH HAS A CHARTER TO PROVIDE MEDICAL RECOMMENDATIONS TO ASD (HA) AND THE SERVICE SURGEONS GENERAL.
2.B.  TCCC CONCEPTS WERE INCORPORATED INTO THE 8404 CORPSMAN TRAINING CURRICULUM IN 2005.  THE TCCC/CLS TRAINER COURSE WAS DEVELOPED IN 2006 TO PROVIDE CORPSMEN AS TRAINERS TO TEACH AND SUSTAIN TCCC STANDARDS TO CORPSMEN AND CLS SKILLS TO SELECTED MARINES WITHIN THE OPERATING FORCES. 
2.C.  THE IMPLEMENTATION OF TCCC ACROSS ALL SERVICES HAS BEEN IDENTIFIED AS ONE OF THE CONTRIBUTING FACTORS TO THE HIGHEST COMBAT CASUALTY SURVIVAL RATES IN HISTORY AND IS RECOMMENDED BY ASD (HA) FOR USE WHEN TRAINING COMBAT MEDICAL PERSONNEL, REF B.  TCCC INFORMATION IS PUBLISHED IN THE PREHOSPITAL TRAUMA LIFE SUPPORT MANUAL (PHTLS), MILITARY EDITION, WHICH IS UPDATED EVERY FOUR YEARS.  DEPARTMENT OF DEFENSE (DOD) APPROVED TCCC TRAINING CURRICULA ARE UPDATED ON THE DOD WEBSITE MHS.OSD.MIL/EDUCATION AND TRAINING/TCCC.ASPX AS THE TCCC GUIDELINES CHANGE.
3.  GOAL.  ELIMINATE PREVENTABLE LOSS OF LIFE ON THE BATTLEFIELD.  IN ACCOMPLISHING THIS GOAL, THE MOST RECENT TCCC GUIDELINES APPROVED BY DOD ARE TO BE UTILIZED AS A MEANS OF PROVIDING STANDARDIZED TRAINING TO THE MARINE CORPS AND IMPROVING FIRST RESPONDER CARE AT THE POINT OF INJURY.
4.  EXECUTION
4.A.  TCCC AND CLS TRAINING FOR MEDICAL PERSONNEL AND SELECTED MARINES IS A UNIT TRAINING RESPONSIBILITY WITHIN THE MEFS AND MARFORS.  TRAINERS WHO HAVE COMPLETED THE TCCC/CLS TRAINER COURSE AT FMTB EAST OR WEST SHALL BE USED TO CONDUCT THIS TRAINING.
4.B.  ALL 8404 HOSPITAL CORPSMEN ASSIGNED TO THE MARINE CORPS WILL BE TCCC CERTIFIED AND HAVE SUSTAINMENT TRAINING FOR TCCC EVERY 12 MONTHS PER REF C OR WITHIN 180 DAYS OF DEPLOYMENT PER REF D.
4.C.  OPERATIONAL COMMANDERS SHALL MAINTAIN AT LEAST TWO CLS MARINES PER T/O UNIT CORPSMEN.  COMMANDERS ARE ENCOURAGED TO TRAIN ADDITIONAL CLS MARINES FOR THEIR UNITS.
4.D.  FMTB EAST AND WEST IN COORDINATION WITH TECOM WILL WORK WITH USMC ENTRY LEVEL SCHOOLS TO ENSURE TCCC TRAINING REMAINS IN COMPLIANCE WITH TCCC GUIDELINES APPROVED BY DOD.  MANAGEMENT OF TRAUMATIC BRAIN INJURY (TBI) AND THE MILITARY ACUTE CONCUSSION EVALUATION (MACE) TRAINING SHALL ALSO BE INCORPORATED INTO ALL TCCC AND CLS CURRICULA PER REF D.
4.E.  FEEDBACK FROM RETURNING COMBAT MEDICAL PERSONNEL IS HIGHLY ENCOURAGED.  DOCUMENTATION OF STRENGTHS AND AREAS FOR IMPROVEMENT OF CURRENTLY RECOMMENDED TCCC TECHNIQUES AND EQUIPMENT CAN BE SUBMITTED VIA UNIT AFTER ACTION REPORTS, THE MARINE CORPS CENTER FOR LESSONS LEARNED (MCCLL) AND/OR THE NAVAL OPERATIONAL MEDICAL CENTER FOR LESSONS LEARNED (NOMCLL).  THIS FEEDBACK CAN ALSO BE FORWARDED TO FMTB EAST S-5 PLANS OR FMTB WEST ACADEMICS DEPARTMENT WHICH WILL IN TURN BE FORWARDED TO THE COMMITTEE ON TCCC IN COORDINATION WITH TECOM, GROUND TRAINING DIVISION, FOR CONSIDERATION FOR FUTURE REVISIONS OF THE TCCC GUIDELINES.
4.F.  POC FOR FEEDBACK SUBMISSION: FMTB EAST COMM: (910) 450-0815/1867 DSN: 750-0815/1867.  FMTB WEST COMM: (760) 725-6459 DSN: 365-6459.
5.  USMC HS TCCC GUIDELINE CHANGE APPROVAL PROCESS
5.A.  CHANGES RECOMMENDED BY THE COMMITTEE ON TCCC ARE SENT TO ASD (HA) FOR DOD APPROVAL AND POSTING ON MHS.OSD.MIL WEBSITE.
5.B.  HQMC HEALTH SERVICES (HQMC, HS) SHALL ROUTE COMMITTEE ON TCCC PROPOSED CHANGES TO MARFOR SURGEONS VIA FORMAL TASKER FOR COMMENT TO BE INCLUDED IN THE COMMITTEE ON TCCC AND DHB DRAFT PROCESS.
5.C.  THE UNIVERSAL NEEDS STATEMENT PROCESS WILL BE UTILIZED IF A GAP IS IDENTIFIED BETWEEN DOD APPROVED TCCC GUIDELINES AND MARINE CORPS TCCC EXECUTION.
5.D.  HQMC, HS WILL NOTIFY ASD (HA) IF THE MARINE CORPS WILL MODIFY THE DOD APPROVED TCCC GUIDELINES FOR EXECUTION IN THE MARINE CORPS.  MODIFICATIONS WILL BE RELEASED VIA MARADMIN BY TECOM.
5.E.  FMTB EAST AND WEST WILL POST ANNOUNCEMENTS OF THESE UPDATES AND MODIFICATIONS ON THEIR WEBSITES: HTTPS:/WWW.MARINES.MIL/UNIT/ TECOM/FMTBN-E/PAGES/DEFAULT.ASPX, HTTPS:SLASHSLASHWWW.TECOM.USMC.MIL/FMTBWEST/
5.F.  FMTB EAST AND WEST ARE THE ONLY APPROVED SOURCES FOR TCCC AND CLS CURRICULA AND TCCC/CLS-TRAINER TRAINING FOR THE MARINE CORPS.  THEY WILL INCORPORATE ANY MARINE CORPS MODIFICATIONS TO THE DOD APPROVED TCCC GUIDELINES, DEVELOP AND MAINTAIN ALL MARINE CORPS SPECIFIC LESSON PLANS, AND DISSEMINATE UPDATES AND MODIFICATIONS TO UNIT TCCC/CLS TRAINERS UPON REQUEST.
6.  CERTIFIED TCCC/CLS TRAINERS ARE THE ONLY PERSONNEL APPROVED TO CONDUCT INITIAL AND SUSTAINMENT CLS TRAINING TO MARINES.
7.  THIS MARADMIN IS APPLICABLE TO THE MARINE CORPS TOTAL FORCE.
8.  RELEASE AUTHORIZATION BY LTGEN RICHARD P. MILLS, DEPUTY COMMANDANT FOR COMBAT DEVELOPMENT AND INTEGRATION.//