R 020004Z AUG 06
FM CMC WASHINGTON DC(UC)
TO AL MARADMIN(UC)
UNCLASSIFIED//
MARADMIN 363/06
MSGID/GENADMIN/CG TECOM QUANTICO VA//
SUBJ/TACTICAL COMBAT CASUALTY CARE (TCCC) AND COMBAT LIFESAVER (CLS)
/FUNDAMENTALS, PHILOSOPHIES, AND GUIDANCE//
REF/A/MSG/CG TECOM/081955ZJUN05//
REF/B/DOC/TCCC TRANSITION INITIATIVE/12MAR2005//
REF/C/UNS/TCCC/2FEB2006//
REF/D/UNS/CLS KIT//2FEB2006//
NARR/MSGID/GENADMIN/CG TECOM QUANTICO VA//
SUBJ/TACTICAL COMBAT CASUALTY CARE (TCCC) AND COMBAT LIFESAVER (CLS)
/FUNDAMENTALS, PHILOSOPHIES, AND GUIDANCE//
REF/A/-/CG TECOM QUANTICO VA/081955ZJUN2005//
REF/B/DESC:DOC/TCCC TRANSITION INITIATIVE/12MAR2005//
REF/C/DESC:UNS/TCCC/02FEB2006//
REF/D/DESC:UNS/CLS KIT/02FEB2006//
POC/M. R. BRANTLEY/CDR, NC, USN/TECOM/LOC:QUANTICO, VA
/TEL:(703) 784-3024/TEL:278-3024/EMAIL:MICHAEL.BRANTLEY@USMC.MIL//
NARR/REF (A) IS THE COMBAT LIFESAVERS AND TACTICAL COMBAT CASUALTY
CARE (TCCC) COURSES SUBJECT MATTER EXPERT (SME) CONFERENCE AFTER
ACTION REPORT (AAR). REF (B) IS THE TCCC TRANSITION INITIATIVE
POINT PAPER FROM CAPT BUTLER, MC, USN, AND COL HOLCOMB, MC, USA, DTD
12 MAR 05. REF (C) IS UNS SUBMITTED BY MARFORCOM TO FORMALIZE TCCC
TRAINING. REF (D) IS THE UNS TO STANDARDIZE CLS KITS AND
TRAINING.//
GENTEXT/REMARKS/1. PURPOSE. TO PROMULGATE TCCC FUNDAMENTALS AND
PHILOSOPHIES AND PROVIDE GUIDANCE TO COMMANDERS IN THE
IMPLEMENTATION OF TCCC WITHIN THE FULL SPECTRUM OF THE USMC HEALTH
SERVICE TRAINING CONTINUUM.
2. BACKGROUND.
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 GUIDELINES ARE PUBLISHED IN THE PREHOSPITAL TRAUMA
LIFE SUPPORT (PHTLS) MANUAL. THE COMMITTEE ON TACTICAL COMBAT
CASUALTY CARE (COTCCC), UNDER THE EXECUTIVE AGENCY OF THE NAVAL
OPERATIONAL MEDICINE INSTITUTE (NOMI), IS CHARGED WITH THE PERIODIC
REVIEW AND UPDATE OF TCCC GUIDELINES. IN RESPONSE TO NEEDS
ARTICULATED BY THE MARFOR AND LESSONS LEARNED, TECOM CHARTERED AN
SME CONFERENCE TO DETERMINE APPLICABILITY OF TCCC AS SUSTAINMENT
TRAINING FOR MEDICAL PERSONNEL ASSIGNED TO MARFOR UNITS AND AS THE
BASELINE PHILOSOPHY FOR HEALTH CARE IN THE TACTICAL ENVIRONMENT AND
STANDARDIZATION OF A COMBAT LIFE SAVER PROGRAM.
B. REF (A) RECOMMENDED IMPLEMENTATION OF THE TCCC COURSE FOR
USE AS SUSTAINMENT CASUALTY CARE TRAINING ACROSS THE MARINE CORPS
FOR MEDICAL PERSONNEL AND THE DEVELOPMENT OF A CLS PROGRAM FOR
SELECTED MARINES.
C. BETWEEN JUN AND NOV 2005, CLS AND TCCC COURSES FOR USE BY
CERTIFIED TRAINERS, CLS TRAINERS (CLS-T) AND TCCC TRAINER (TCCC-T)
COURSES WERE DEVELOPED AND BETA TESTED BY FIELD MEDICAL SERVICE
SCHOOLS (FMSS) WEST AND EAST. DATA COLLECTED FROM BETA TESTING WAS
USED TO REFINE COURSES RESULTING IN APPROVAL OF CLS-T COURSE AND
TCCC-T COURSE.
3. GOAL. ELIMINATE PREVENTABLE LOSS OF LIFE ON THE BATTLEFIELD.
IN ACCOMPLISHING THIS GOAL, TCCC AND CLS PROGRAMS ARE BEING DIRECTED
AS A MEANS OF IMPROVING FIRST RESPONDER CARE AT THE POINT OF WOUND.
4. IMPLEMENTATION.
A. TCCC.
(1) TRAINING IN TCCC IS INTENDED FOR MEDICAL PERSONNEL AS
SUSTAINMENT TRAINING IN COMBAT CASUALTY CARE. TCCC HAS THREE
PHASES: CARE UNDER FIRE, TACTICAL FIELD CARE AND CASEVAC CARE.
THE INTENT IS FOR ALL MEDICAL PERSONNEL TO BE TRAINED IN TCCC PRIOR
TO DEPLOYMENT INTO A POTENTIAL COMBAT AREA.
(2) THE TCCC-T PROGRAM FOR MEDICAL PERSONNEL ASSIGNED TO
MARINE CORPS OPERATING FORCES IS READY FOR EXECUTION.
(3) IN MAY 2006, FMSS EAST AND WEST BEGAN TCCC-T COURSES
TO PROVIDE TCCC TRAINERS TO THE OPERATING FORCES. FMSS EAST AND
WEST WILL EACH CONDUCT TWO COURSES PER YEAR WITH A TOTAL OF 30
CLASS SEATS PER COURSE. THIS WILL PRODUCE 120 TRAINERS PER YEAR
FOR THE OPERATING FORCES AND MILITARY TREATMENT FACILITY READINESS
AND TRAINING DEPARTMENTS. TCCC-T STUDENTS WILL COME FROM STUDENTS
ATTENDING FMSS [UNITS MAY SEND AND FUND ADDITIONAL CORPSMEN TO
ATTEND THE TCCC-T COURSE ON SPACE AVAILABLE BASIS].
(4) TCCC TRAINERS WILL RECEIVE THE STANDARDIZED TRAINING
MATERIAL(S) UPON COMPLETION OF THE FMSS TCCC-T.
(5) FMSS WILL DEVELOP AND MAINTAIN ALL LESSON PLANS, MEDIA
AND EXAMINATIONS AND DISSEMINATE UPDATES TO UNIT TCCC TRAINERS AS
REQUIRED.
(6) TCCC TRAINING WILL BE A UNIT TRAINING RESPONSIBILITY
WITHIN THE MEFS AND MARFORRES USING THE TRAINERS WHO HAVE COMPLETED
THE TCCC-T COURSE GIVEN AT THE FMSS.
(7) OPERATIONAL COMMANDERS WILL DEVELOP POLICY TO ENSURE ALL
INCOMING MEDICAL PERSONNEL HAVE BEEN, OR WILL BE, TRAINED IN TCCC
AFTER REPORTING TO THEIR RESPECTIVE COMMANDS.
(8) TRAINING WILL INCLUDE, AT A MINIMUM, THE TCCC CURRICULUM
DEVELOPED BY FMSS AND HANDS ON TRAINING IN THE ADEQUATE USE OF
COMBAT TRAUMA MEDICAL EQUIPMENT IDENTIFIED WITHIN THE CURRICULUM.
B. CLS
(1) TRAINING IN CLS IS INTENDED FOR SELECTED MARINES TO
PROVIDE ADVANCE LIFE SAVING SKILLS TO INCLUDE: HEMORRHAGE CONTROL;
AIRWAY MANAGEMENT; AND SHOCK MANAGEMENT. TRAINING IS ACCOMPLISHED
THROUGH A COMBINATION OF CLASSROOM AND PRACTICAL APPLICATION BY
CORPSMEN TRAINED AS CLS TRAINERS.
(2) THE CLS-T COURSE IS FOR MEDICAL PERSONNEL ASSIGNED TO
MARINE CORPS OPERATING FORCES, AND IS READY FOR EXECUTION.
(3) IN MAY 2006, FMSS EAST AND WEST BEGAN CLS-T COURSES TO
PROVIDE CLS TRAINERS TO THE OPERATING FORCES. FMSS EAST AND WEST
WILL EACH CONDUCT THREE COURSES PER YEAR WITH A TOTAL OF 30 CLASS
SEATS PER COURSE. THIS WILL PRODUCE 180 TRAINERS PER YEAR FOR THE
OPERATING FORCES AND MILITARY TREATMENT FACILITY READINESS AND
TRAINING DEPARTMENTS. CLS-T STUDENTS WILL COME FROM STUDENTS
ATTENDING FMSS [UNITS MAY SEND AND FUND ADDITIONAL CORPSMEN TO
ATTEND THE CLS-T COURSE ON SPACE AVAILABLE BASIS].
(4) FMSS DESIGNATED CLS-T HOSPITAL CORPSMEN ARE THE ONLY
TRAINERS AUTHORIZED TO CONDUCT CLS TRAINING.
(5) CLS-T WILL RECEIVE THE STANDARDIZED TRAINING MATERIAL(S)
UPON COMPLETION OF THE FMSS CLS-T COURSE.
(6) FMSS WILL DEVELOP AND MAINTAIN ALL LESSON PLANS, MEDIA
AND EXAMINATIONS, AND DISSEMINATE UPDATES TO UNIT CLS TRAINERS AS
REQUIRED.
(7) CLS TRAINING FOR SELECTED MARINES WILL BE A UNIT
TRAINING RESPONSIBILITY WITHIN THE MEFS AND MARFORRES USING THE
TRAINERS WHO HAVE COMPLETED THE CLS-T COURSE GIVEN AT THE FMSS.
(8) PER REF (A), OPERATIONAL COMMANDERS WILL DEVELOP POLICY
TO TRAIN AT LEAST TWO CLS TRAINED MARINES PER T/O UNIT CORPSMEN
PRIOR TO DEPLOYING.
C. REFRESHER/SUSTAINMENT TRAINING FOR CLS AND TCCC MUST BE
COMPLETED EVERY TWO YEARS OR WITHIN THREE MONTHS OF DEPLOYMENTS.
D. UNIT COMMANDERS MUST ENSURE THAT CASUALTY CARE TRAINING
BECOMES AN INTEGRAL PART OF SUSTAINING SPECIFIED COMBAT MEDICAL
SKILLS AND CAPABILITIES [INCLUDING ENHANCED FIRST AID AND COMBAT
LIVESAVER] IOT ENSURE THAT MORTALITY AMONG CASUALTIES WILL BE
MINIMIZED.
E. HEALTH SERVICES TRAINING AND EDUCATION CENTER OF EXCELLENCE
(HSTECOE) AT FMSS EAST WILL WORK WITH USMC ENTRY LEVEL SCHOOLS TO
ENSURE THAT FIRST AID AND BUDDY AID PROGRAMS ARE IN COMPLIANCE WITH
TCCC GUIDELINES.
F. THE DIRECTOR, HEALTH SERVICES TRAINING AND EDUCATION CENTER
OF EXCELLENCE (HSTECOE)FMSS EAST, IN COORDINATION WITH TECOM, GROUND
TRAINING BRANCH AND MARINE CORPS CENTER FOR LESSONS LEARNED WILL
DEVELOP A MECHANISM TO OBTAIN PERIODIC FEEDBACK FROM RETURNING
COMBAT MEDICAL PERSONNEL REGARDING THE STRENGTHS AND WEAKNESSES OF
CURRENTLY RECOMMENDED TECHNIQUES AND EQUIPMENT. THIS FEEDBACK WILL
BE PROVIDED TO THE COTCCC VIA FMSS EAST TO BE INCORPORATED INTO
FUTURE REVISIONS
OF THE TCCC GUIDELINES.
G. NAVY PERSONNEL TRAINING WILL BE TRACKED IN CETARS. MARINES
RECEIVING CLS TRAINING WILL BE TRACKED IN THE SHORT TERM VIA UNIT
INDIVIDUAL TRAINING RECORDS AND LONG TERM VIA AN ELECTRONIC TRAINING
RECORD WHEN DEVELOPED.
H. COURSE QUOTAS FOR EACH COURSE WILL BE MANAGED LOCALLY BY THE
FIELD MEDICAL SERVICE SCHOOLS.
5. THIS MARADMIN IS APPLICABLE TO THE MARINE CORPS TOTAL FORCE.//