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Grounded in Tactical Combat Casualty Care, TECC focuses on point-of-wounding care and the operational constraints that shape intervention during atypical, dangerous emergency response. The introduction contrasts TECC with civilian first-responder limitations and with Tactical Combat Casualty Care’s battlefield origins, arguing that direct transfer of TCCC principles to civilian settings is fundamentally flawed without accounting for differences in liability, patient populations, and evacuation barriers.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/tactical-emergency-casualty-care-tecc-guidelines-for-the-provision-of-prehospital-trauma-care-in-high-threat-environments/367074/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/tactical-emergency-casualty-care-tecc-guidelines-for-the-provision-of-prehospital-trauma-care-in-high-threat-environments/367074.png","ImageObject",300,407,{"name":92,"@type":93},"Putri","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-27","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",17,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What gap does TECC aim to address in civilian tactical emergency medical support?","Question",{"text":113,"@type":114},"TECC targets the lack of a standard of care for high-threat prehospital trauma within TEMS, including point-of-wounding care needs that civilian first-responder practices do not adequately address.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How is TECC based on Tactical Combat Casualty Care (TCCC)?",{"text":118,"@type":114},"TECC is derived from TCCC principles and is designed to fill an operational gap, adapting trauma care concepts for high-threat civilian prehospital settings.",{"name":120,"@type":111,"acceptedAnswer":121},"Why can rigid application of TCCC guidelines be inadequate for civilian environments?",{"text":122,"@type":114},"The document argues that differences in liability, patient demographics (including geriatrics and pediatrics), and barriers to evacuation and care mean TCCC’s combat-theater design does not directly fit civilian contexts.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},367074,1790216234,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":56,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},962085571259,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","TACTICAL EMERGENCY CASUALTY CARE (TECC): GUIDELINES FOR THE PROVISION OF PREHOSPITAL TRAUMA CARE IN HIGH THREAT ENVIRONMENTS  \nCallaway DW; Smith ER; Cain J; Shapiro G; Burnett WT; McKay SD; and Mabry R  \nCorresponding Author:  \nDavid W. Callaway, MD  \nDirector, The Operational Medicine Institute (OMI) Assistant Professor of Emergency Medicine Carolinas Medical Center  \n1000 Blythe Blvd  \nCharlotte, NC 28203 Authors  \nE. Reed Smith, MD Operational Medical Director Arlington County Fire Department  \nAssistant Professor of Emergency Medicine The George Washington University  \nAddress is 1020 North Hudson Street, 3rd Floor Arlington, VA 22201  \nJeffery S. Cain, MD  \nMedical Director, McKinney SWAT 2804 Atwood Drive  \nMcKinney, TX 75070  \nGeoff Shapiro, EMT-P  \nCoordinator, Operational Medicine Programs The George Washington University  \n2131 K Street, NW Suite 510  \nWashington, DC 20037  \nW. Thomas Burnett, MD, FACEPOperational Medicine Director Department of Emergency Medicine Virginia Tech Carilion School of Medicine  \nSean D. McKay, EMT-P  \nAssociate, Asymmetric Combat Institute (ACI) 115-136 Wade Hampton Blvd.  \nTaylors, SC 29687  \nRobert L. Mabry, MD United States Army  \nInstitute of Surgical Research 3400 Rawley E, Chambers Ave Fort Sam Houston, TX 78234  \n 104  Journal of Special Operations Medicine Volume 11, Edition 3 / Summer/Fall 11  \nINTRODUCTION  \nCivilian Tactical Emergency Medical Support (TEMS) has a long history in the United States. Enormous progress has been made during the past ten years in developing professional and operational standards within the field. However, to date, there still exists no standard of care within TEMS specifically, and more broadly for high threat prehospital trauma care. Current civilian first responder practices and principles do not adequately address the need for point of wounding care in atypical, high threat emergency response. The enclosed Tactical Emergency Casualty Care (TECC) guidelines are based upon the principles of Tactical Combat Casualty Care and specifically designed to address this operational gap.1  \nThe “holy grail” of trauma care outcomes remains eliminating preventable deaths. In 1996, Butler and Hagmann’s seminal paper on modern battlefield prehospital care examined the manner in which people die in combat, discussed the limitations ofAdvanced Trauma Life Support (ATLS) for combat medics and proposed a new set ofprinciples for high threat trauma care: Tactical Combat Casualty Care (TCCC) .2 The initial TCCC guidelines focused on the three major preventable causes of death on the modern battlefield: isolated extremity hemorrhage, tension pneumothoraces and airway obstruction. Perhaps more importantly, TCCC initiated a paradigm shift in prehospital trauma care, emphasizing tactical constraints (e.g., incoming fire, light/noise discipline, and mission success) as a major determinant of trauma intervention.  \nDuring the past decade, the implementation ofTactical Combat Casualty Care (TCCC) has been one ofthe major factors in reducing preventable death on the modern battlefield. 3 TCCC guidelines are credited with reducing the case fatality rate (CFR) in current combat operations from approximately 14% in Vietnam to 7.4-9.4% during Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) .4,5 In a memorandum dated 6 August 2009, the Defense Health Board (DHB) noted that in several Special Operations units in which all members were trained in TCCC, no reported incidents of preventable battlefieldfatalities occurred during the entirety oftheir combat deployments. Given this high rate of efficacy, the DHB now recommends TCCC training for all deploying combatants and medical department personnel.  \nThe proven success ofTCCC on the battlefield, led the civilian medical community, both tactical and conventional, to examine closely the tenants ofthe TCCC doctrine and integrate portions into civilian trauma care. Many agencies have simply implemented TCCC as their st","cbCaibHnFoRhGfeP","https://ap.wps.com/l/cbCaibHnFoRhGfeP","pdf",1135116,"English","# Introduction\n## Civilian TEMS and the care gap\n## Preventable deaths and the TCCC foundation\n## From battlefield success to civilian adaptation challenges\n## Why civilian high-threat care differs (scope, patients, evacuation)","[{\"question\":\"What gap does TECC aim to address in civilian tactical emergency medical support?\",\"answer\":\"TECC targets the lack of a standard of care for high-threat prehospital trauma within TEMS, including point-of-wounding care needs that civilian first-responder practices do not adequately address.\"},{\"question\":\"How is TECC based on Tactical Combat Casualty Care (TCCC)?\",\"answer\":\"TECC is derived from TCCC principles and is designed to fill an operational gap, adapting trauma care concepts for high-threat civilian prehospital settings.\"},{\"question\":\"Why can rigid application of TCCC guidelines be inadequate for civilian environments?\",\"answer\":\"The document argues that differences in liability, patient demographics (including geriatrics and pediatrics), and barriers to evacuation and care mean TCCC’s combat-theater design does not directly fit civilian contexts.\"}]","TACTICAL EMERGENCY CASUALTY CARE (TECC) - GUIDELINES FOR THE PROVISION OF PREHOSPITAL TRAUMA CARE IN HIGH THREAT ENVIRONMENTS | PDF",1790169143,48]