9
- IV fluids?
- Urgency for evacuation?
The Committee on Tactical Combat Casualty Care
Standing tactical Medicine Committee
Sponsored by USSOCOM and BUMED
Naval Operational Medicine Institute
Tri-Service and Civilian
Trauma Surgeons, ER, SOF unit physicians, USMC, combat medics
Monitor literature and technology
Periodic update to guidelines
TCCC Revision 2003 Photo PHTLS Manual
Per TCCC Committee Recommendations
Published in Revised Fifth Edition of PHTLS Manual
TCCC Changes in 2003
Casualty continues as combatant if able
Disarm casualties with altered sensorium
Fluid resuscitation if no radial pulse or unconscious
PO fluids OK in combat casualties
Hextend instead of Hespan
Cefotetan instead of cefoxitin
HemCon
dressings
TCCC Changes in 2003 (cont)
PO meds (Combat Pill Pack) if able to use
Gatifloxacin 400 mg qd
Acetaminophen
1000
mg
Vioxx 50 mg (now using Mobic 15 mg)
Intraosseous access if IV difficult
Blood Products on Helicopters
Changed oxygen guidelines for CASEVAC
Mogadishu Workshop: UCH + Decreased Menta Status
"There was, however, a clear consensus in the panel that should a casualty with
uncontrolled hemorrhage have mental status changes or become unconscious (blood pressure of
50 systolic or below), he should be fluid resuscitated. "
Butler and Hagmann, 1998
