Now offering TECC and TCCC Workshops!
The Committee for Tactical Emergency Casualty Care used the military battlefield guidelines of Tactical Combat Casualty Care (TCCC) as an evidence-based starting point in developing civilian-specific medical guidelines for high-threat operations.
In environments with real or perceived threat(s), the traditional response
models that prioritize safety before patient care may result in
treatment delays that negatively affect patient and rescuer outcomes.
To address this gap, the Tactical Emergency Casualty Care (TECC)
guidelines describe patient care standards for persons of all ages
groups in an all-hazards, high-threat environment.
The TECC construct consists of three dynamic phases of care:
- Direct Threat
- Indirect Threat
- Evacuation
- Immediate access to the injured
- Rapid life-saving interventions at or near the point of injury
- Early extraction of those needing transport to definitive
medical care
TECC Phases
- Direct Threat Care: Emphasis on mitigating the threat, moving the wounded to cover or an area of relative safety, and managing massive hemorrhage utilizing tourniquets. Additionally, emphasis was placed on the importance of various rescue and patient movement techniques, as well as rapid positional airway management if operationally feasible. Treatment and operational requirements are the same for all provider levels during this phase of care.
- Indirect Threat Care: Initiated once the casualty is in relative safety, such as one with proper cover or one that has been cleared but not secured, where there is less of a chance of rescuers being injured or patients sustaining additional injuries. Assessment and treatment priorities in this phase focus on the preventable causes of death as defined by military medical evidence: Major Hemorrhage, Airway, Breathing/Respirations, Circulation, Head & Hypothermia, and Everything Else (MARCHE). Four provider levels were assigned to the scope of practice and skill sets based on training and certification levels.
- Evacuation Care: An effort is underway to transport the casualty to a definitive treatment facility. Most additional interventions during this phase of care are similar to those performed during normal EMS operations. However, major emphasis is placed on reassessment of interventions and hypothermia management.
