R 201837Z JUL 10
UNCLASSIFIED//
MARADMIN 406/10
MSGID/GENADMIN/CMC MCCDC WASHINGTON CDI//
SUBJ/TACTICAL CASUALTY COMBAT CARE (TCCC) GUIDELINES AND UPDATES JUN 2010//
REF/A/MSGID:MARADMIN 0645-09/DTG/3017139//
REF/B/MSGID:DOC MEMO FROM ASD, /HA TO SERVICE SECRETARIES DTD/-/4 MAR 2009/NOTAL//
REF/C/MSGID:MSG/CG TECOM/0219399//
REF/D/MSGID:DOC/TCCC GUIDELINE UPDATES DTD/YMD:20091104//
REF/E/MSGID:MSG/MARADMIN 363-06 DTG /081955Z/JUN05//
NARR/REF A IS MARADMIN 0645/09 TACTICAL CASUALTY COMBAT CARE (TCCC) GUIDELINES AND UPDATES RELEASED OCTOBER 09.  REF B IS ASD, HA MEMO REQUESTING SERVICES REVIEW TCCC GUIDELINES FOR TRAINING OF MEDICAL PERSONNEL.  REF C IS CG TECOM MESSAGE REQUESTING OPERATING FORCE INPUT ON NEW TCCC GUIDELINES.  REF D IS TCCC GUIDELINE UPDATES AS OF 04 NOV 09.  REF E IS MARADMIN 363/06 TACTICAL CASUALTY COMBAT CARE (TCCC) AND COMBAT LIFESAVER FUNDAMENTALS, PHILOSOPHIES, AND GUIDANCE.//
POC/S. J. PARKS/LCDR NC USN/UNIT:MEDICAL PROGRAMS OFFICER/NAME:TECOM/TEL:GTB/TEL:(703) 784-3051/ EMAIL:STEVEN.J.PARKS@USMC.MIL//
POC/J. R. MILES/YC-02/UNIT:S-5 FMTB-E/NAME:(910) 450-0815 /EMAIL:JOHN.R.MILES@USMC.MIL//
GENTEXT/REMARKS/1.  TACTICAL COMBAT CASUALTY CARE (TCCC) CONCEPTS WERE DEVELOPED IN 1996 AS A SPECIAL OPERATIONS INITIATIVE.  THE COMMITTEE ON TACTICAL COMBAT CASUALTY CARE (COTCCC) WAS ESTABLISHED IN 2001 TO ENSURE THE LESSONS LEARNED FROM THE MODERN DAY BATTLEFIELD WERE ANALYZED AND INCORPORATED INTO THE TCCC GUIDELINES.  TCCC HAS BEEN IDENTIFIED AS ONE OF THE REASONS THAT US MILITARY OPERATIONS HAVE EXPERIENCED THE HIGHEST CASUALTY SURVIVAL RATES IN HISTORY.  MEMBERS OF THE COTCCC REPRESENT ALL SERVICES AND THE CIVILIAN SECTOR TO INCLUDE HIGHLY EXPERIENCED NAVY CORPSMEN, US ARMY MEDICS, AIR FORCE PARARESCUEMEN, SPECIAL FORCES MEDICS, TRAUMA SURGEONS, EMERGENCY MEDICINE AND CRITICAL CARE PHYSICIANS, RESEARCH SCIENTISTS, AND MEDICAL EDUCATORS WHO MEET 3-4 TIMES A YEAR TO DISCUSS TOPICS IN CASUALTY CARE, INCLUDING TECHNIQUES, PROCEDURES, EQUIPMENT, AND DRUGS/AGENTS.
A.  THIS MARADMIN SUPERCEEDS MARADMIN 645/09 (REF A).
B.  THE COTCCC DEVELOPED NEW GUIDELINES, BASED ON OPERATIONAL EXPERIENCE AND SERVICE LESSONS LEARNED, AND BRIEFED THE DEFENSE HEALTH BOARD AND ASST SECRETARY OF DEFENSE HEALTH AFFAIRS (ASD HA) IN MARCH 2009. 
C.  ASD, HA REQUESTED ALL SERVICES REVIEW THE NEWLY PUBLISHED GUIDELINES AND IMPLEMENT AS APPROPRIATE (REF B).
D.  REF C REQUESTED COMMENT FROM THE OPERATING FORCES OF THE MARINE CORPS ON THE GUIDELINES.  BASED ON FEEDBACK PROVIDED BY THE OPERATING FORCES, THE MEDICAL OFFICER OF THE MARINE CORPS REVIEWED THE TCCC GUIDELINE CHANGES IN REF D AND CONCURS WITH THEIR IMPLEMENTATION.
2.  NEW COTCCC GUIIDELINES INCLUDING BURNS WERE PUBLISHED IN NOVEMBER 2009 (REF D).
3.  SUMMARY OF TCCC GUIDELINE CHANGES:
A.  ADD DETAIL ON BASIC MANAGEMENT PLAN FOR CARE UNDER FIRE.
B.  DELETE HEMOSTATIC AGENT USE DURING CARE UNDER FIRE PHASE.
C.  ADD DETAIL ON USE OF TOURNIQUET IN CARE UNDER FIRE PHASE.
D.  ADD DETAIL ON NEEDLE THORACENTESIS PROCEDURE.
E.  ADD DETAIL ON SUCKING CHEST WOUNDS.
F.  COMBAT GAUZE AS HEMOSTATIC AGENT OF CHOICE.
G.  ADD DETAIL ON HEMORRHAGE CONTROL IN TACTICAL FIELD CARE.
H.  ADD OF PENETRATING EYE TRAUMA IN TACTICAL FIELD CARE.
I.  ADD OF TREATMENT FOR BURNS IN TACTICAL FIELD CARE AND TACTICAL EVACUATION CARE.
J.  TERMINOLOGY CHANGE FROM CASEVAC TO TACEVAC.
4.  NEW TCCC GUIDELINES ARE POSTED ON FIELD MEDICAL TRAINING BATTALION-EAST (FMTB-E) WEBSITE AT FOLLOWING LINK HTTP:SLASHSLASHWWW.LEJEUNE.USMC.MIL/FMTB/TCCCDOCS.HTML.
5.  EFFECTIVE IMMEDIATELY, THE RECENTLY APPROVED TCCC GUIDELINES WILL BECOME THE STANDARD TO WHICH TRAINING EFFORTS SHOULD BE FOCUSED AND EVALUATION WILL BE BASED (REF E).  THESE CHANGES WILL AFFECT NUMEROUS TRAINING PROGRAMS AND COURSES.  EFFORTS ARE ALREADY UNDERWAY TO UPDATE STANDARDS AND WILL BE ACCOMPLISHED THROUGH THE NORMAL STAFFING PROCESS.  A KEY ELEMENT OF THE TCCC GUIDELINES IS THEIR APPLICABILITY TO MEDICAL PERSONNEL, COMBAT LIFESAVERS, AND INDIVDUAL DEPLOYING COMBATANTS.
6.  THIS MARADMIN IS APPLICABLE TO THE MARINE CORPS TOTAL FORCE.
7.  RELEASE AUTHORIZATION BY LTGEN GEORGE J. FLYNN, DEPUTY COMMANDANT FOR COMBAT DEVELOPMENT AND INTEGRATION.//