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Tactical Medicine TACMED España Marca Registrada Nº. 377.032. “Medicina Bona Locis Malis” tm. Good Medicine In Bad Places España by EMS Solutions International

Jul 19, 22
Tactical Medicine TACMED España Marca Registrada Nº. 377.032. “Medicina Bona Locis Malis” tm. Good Medicine In Bad Places España by EMS Solutions International

ar: los agentes del SAMU 83 ahora equipados con chalecos antibalas.
23 de septiembre de 2018 ● 1:25 p. M.

La decisión fue tomada: el personal del SAMU 83 del área de Toulon ahora estará equipado con chalecos antibalas.

Han llegado dos lotes, uno para el SMUR La Seyne, el segundo para uno de los equipos de Toulon explica Var-Matin.


"También intervenimos muy regularmente en situaciones muy delicadas"

"El SMUR no está destinado, durante un ataque, a estar presente en los corredores de extracción, pero interviene cerca de estas áreas. También trabajamos con regularidad en situaciones altamente sensibles, aún no estabilizados, tales como disparos o ataques con cuchillos ", dijo el Dr. Lawrence BeCe, gerente de servicio de ambulancia 83, el periódico regional.

¿Harán otros SAMU franceses la misma inversión? Al igual que los bomberos, regularmente se enfrentan a actos de violencia y con frecuencia intervienen al mismo tiempo que la policía.
Ciencia 🧬 🧪 🩺 🦠 ℹ️ 🤢 🤧 ‍⚕️ ‍⚕️ 🇪🇸 🇪🇺 🥼🧑‍ ‍ 🤒 🤕 🥵 ️
FUCK #Covid_19 #YOMEVACUNO #CORONAVIRUS #SARS_Cov_2 #FuckCovid19
¿Por qué es más fácil aceptar las teorías de conspiración que las científicas?
Porque para entender las teorías científicas hay que estudiar #YOMEVACUNO #Covid19 @DrRamonReyesMD



TCCC Guidelines 01 AUGUST 2018 Tactical Combat Casualty Care by JTS / CoTCCC. FREE pdf 



"Estoy a favor 100% de la creacion y puesta en operacion de las RTF Rescue Task Force o FUERZAS DE TAREA DE RESCATE en toda IBEROAMERICA, por una razon simple SALVAN VIDAS, hablo castellano-español perfecto, estoy solo encontra del uso uniformidad LEO (Fuerzas del Orden), la tendencia entiendo es erronea de utilizar a Sanitarios (Personal Medico) Desarmado con uniformidad de agentes que su principal TARGET (Objetivo) es suprimir la amenaza, salvo el sanitario sea TESM (Tactial EMS) que no es mas que un agente de autoridad armado y entrenado como sanitario. Todavia insisten en tratar de descalificar, pero insisto no soy propietario de la verdad, la verdad siempre estara ahi y sera obvia, asi que os dejo una vez mas mis argumentos en la compilacion de articulos y documentos, aunados a mi opinion profesional y personal al respecto. No creo que descalificar sea el mejor metodo para defender una posicion. Mientras os invito a visitar el link (enlace)". by Dr. Ramon Reyes, MD​




MEDICINA TACTICA: PDF Manuales y GUIAS

MAS LIBROS MEDICINA Y SALUD 


GUIA DE SOPORTE VITAL PARA SEGURIDAD PRIVADA COMO PRIMER INTERVINIENTE EN INCIDENTES ARMADOS. by Juan Jose Pajuelo Castro y David Grevillen Carretero. SEMES 2018 

http://emssolutionsint.blogspot.com.es/2018/02/guia-de-soporte-vital-para-seguridad.html


PROTOCOLO PARA INTERVENCIONES DE SOPORTE VITAL EN INCIDENTES DE MÚLTIPLES VÍCTIMAS POR ATENTADOS TERRORISTAS ABRIL 2016 (Actualizado Marzo 2018) by Juan Jose Pajuelo


8 trampas a evitar en el controlhemorragias 

Guia de Soporte en Incidentes con Amenaza para Primer Interviniente Policial by Juan Jose Pajuelo Castro  emssolutionsint.blogspot.com/2018/07/guia-de-soporte-en-incidentes-con.html

TACTICAL COMBAT CASUALTY CARE Handbook version 5 May 2017 emssolutionsint.blogspot.com/2017/07/tactical-combat-casualty-care-handbook.html

Updated TCCC Guidelines (31 JAN 2017) "Actualizacion 2017 de las Guias" Tactical Combat Casualty Care emssolutionsint.blogspot.com/2012/07/presentacion-del-programa-phtls-tccc.html

TCCC TACTICAL COMBAT CASUALTY CARE Quick Reference Guide First Edition 2017 FREE PDF  emssolutionsint.blogspot.com/2018/07/tccc-tactical-combat-casualty-care.html

Updated TCCC Guidelines (31 JAN 2017) "Actualizacion 2017 de las Guias" Tactical Combat Casualty Care emssolutionsint.blogspot.com.es/2012/07/presentacion-del-programa-phtls-tccc.html

MANUAL DE SOPORTE VITAL AVANZADO EN COMBATE Ministerio de Defensa España 2014   http://emssolutionsint.blogspot.com.es/2016/02/manual-de-soporte-vital-avanzado-en.html


COMTOMS TACTICAL MEDIC HANDBOOK 2013 Edition

Guías para el Manejo de Heridos en Incidentes Intencionados con Múltiples Víctimas y Tiradores Activo "MACTAC" emssolutionsint.blogspot.com/2016/12/guias-para-el-manejo-de-heridos-en.html


Manejo de Heridos en Incidentes Intencionados Múltiples Víctimas y Tiradores Activos 09/07/2017 emssolutionsint.blogspot.com/2018/07/manejo-de-heridos-en-incidentes.html 

TERRORISMO Y SALUD PÚBLICA - "GESTIÓN SANITARIA DE ATENTADOS TERRORISTAS POR BOMBA"  emssolutionsint.blogspot.com/2013/08/terrorismo-y-salud-publica-gestion.html


TRAUMA DE TORAX: DOCENA DE LA MUERTE en trauma toracico

https://emssolutionsint.blogspot.com.es/2013/01/penetrating-chest-trauma-photo-trauma.html

75th Ranger Regiment Trauma Management Team (Tactical) Ranger Medic Handbook FREE pdf  emssolutionsint.blogspot.com.es/2018/02/75th-ranger-regiment-trauma-management.html



SPECIAL OPERATIONS FORCES Medical Handbook Free PDF  emssolutionsint.blogspot.com/2018/02/special-operations-forces-medical.html

Balística de las heridas: introducción para los profesionales de la salud, del derecho, de las ciencias forenses, de las fuerzas armadas y de las fuerzas encargadas de hacer cumplir la ley http://emssolutionsint.blogspot.com/2017/04/balistica-de-las-heridas-introduccion.html

Guía para el manejo médico-quirúrgico de heridos en situación de conflicto armado by CICR http://emssolutionsint.blogspot.com/2017/09/guia-para-el-manejo-medico-quirurgico.html

CIRUGÍA DE GUERRA TRABAJAR CON RECURSOS LIMITADOS EN CONFLICTOS ARMADOS Y OTRAS SITUACIONES DE VIOLENCIA VOLUMEN 1 C. Giannou M. Baldan CICR http://emssolutionsint.blogspot.com.es/2013/01/cirugia-de-guerra-trabajar-con-recursos.html

Manual Suturas, Ligaduras, Nudos y Drenajes. Hospital Donostia, Pais Vasco. España http://emssolutionsint.blogspot.com/2017/09/manual-suturas-ligaduras-nudos-y.html

Técnicas de Suturas para Enfermería ASEPEYO y 7 tipos de suturas que tienen que conocer estudiantes de medicina http://emssolutionsint.blogspot.com/2015/01/tecnicas-de-suturas-para-enfermeria.html

Manual Práctico de Cirugía Menor. Grupo de Cirugia Menor y Dermatologia. Societat Valenciana de Medicina Familiar i Comunitaria http://emssolutionsint.blogspot.com/2013/09/manual-practico-de-cirugia-menor.html



Protocolo de Atencion para Cirugia. Ministerio de Salud Publica Rep. Dominicana. Marzo 2016 http://emssolutionsint.blogspot.com/2016/09/protocolo-de-atencion-para-cirugia.html

Manual de esterilización para centros de salud. Organización Panamericana de la Salud http://emssolutionsint.blogspot.com/2016/07/manual-de-esterilizacion-para-centros.html

Asistencia de salud en peligro: la importancia de proteger al personal de salud en zonas de guerra PDF Gratis http://emssolutionsint.blogspot.com/2018/06/asistencia-de-salud-en-peligro-la.html

SERVICIOS PREHOSPITALARIOS Y DE AMBULANCIAS EN SITUACIONES DE RIESGO. PDF GRATIS http://emssolutionsint.blogspot.com/2018/06/servicios-prehospitalarios-y-de.html


PDF Update on Prehospital Trauma Courses, NAEMT, Alex Eastman, Lieutenant and Deputy Medical Director, City of Dallas http://emssolutionsint.blogspot.com.es/2016/12/phtls-prehospital-trauma-life-support.html



Tactical Emergency Casualty Care (TECC) Guidelines for First Responders with a Duty to Act Guías para Primeros Respondedores con Deber de Actuar “En Acto de Servicio” (Fuerzas de Seguridad, Bomberos no SEM)    emssolutionsint.blogspot.com/2018/07/tactical-emergency-casualty-care-tecc.html


PAGINA FCEBOOK 
https://www.facebook.com/TACMEDEspana/ 

TACMED Spain Medicina Tactica España  GRUPO  https://www.facebook.com/groups/311284402300505/


Medicina: Conjunto de conocimientos y técnicas aplicados a la predicción, prevención, diagnóstico y tratamiento de las enfermedades humanas y, en su caso, a la rehabilitación de las secuelas que puedan producir.

Táctico, ca
Del lat. mod. tacticus, y este del gr. τακτικός taktikós, der. de τάσσειν tássein 'poner en orden'; la forma f., del lat. mod. tactica, y este del gr. τακτική taktikḗ.

1. adj. Perteneciente o relativo a la táctica.
2. adj. Experto en táctica. U. t. c. s.
3. f. Arte que enseña a poner en orden las cosas.
4. f. Método o sistema para ejecutar o conseguir algo.
5. f. Habilidad o tacto para aplicar una táctica.
6. f. Mil. Arte de disponer, mover y emplear la fuerza bélica para el combate.
Fuente: RAE

#TACMED Tactical Medicine Tacmed España @TACMEDEspaña #PHTLS #CTECC #CoTCCC #TCClefr




Tactical Combat Casualty Care TCCC

PDF Update on Prehospital Trauma Courses, NAEMT, Alex Eastman, Lieutenant and Deputy Medical Director, City of Dallas
No one should die from a survivable injury "Nadie debería morir por una muerte prevenible"...
Control de Sangrados España. STOPTHEBLEED BCon Basic by TACMED España 



#McTAC #MEDICO #MD #MedicalDoctor #TACMEDSpain #EMS #TacticalMedicalSpecialist #TCCC #TECC #TACMED #TCCCac #TCCCmp #TCCLEFR #EMS 




 "SI TE OFERTAN EL CURSO TCC-LEFR por la NAEMT, pues le informo que desde hace un tiempo, NAEMT, NO Imparte este curso (Imparten el TCCC-AC). Asi que No tires tu dinero la NAEMT, NO te dara certificado oficial, valido por 4 años, si tomas un curso supuestamente oficial NAEMT" Dejo enlace a cursos certificados NAEMT (en web oficial), y ademas contactos en caso de tener dudas puedes contactar a sus autoridades, hablan en Español. (No aceptes ningun certificado, NO OFICIAL NAEMT.

Dejo enlace a ejemplo de certificados originales con codigo (Son los unicos validos desde Enero 2017).

Listado Cursos Oficiales NAEMT con Certificado valido por 4 años. NO TE DEJES TIMAR.
Advanced Medical Life Support (AMLS)


All Hazards Disaster Response (AHDR)


Emergency Pediatric Care (EPC)


Emergency Vehicle Operator Safety (EVOS)
EMS Safety
Geriatric Education for Emergency Medical Services (GEMS)
Prehospital Trauma Life Support (PHTLS)
Principles of Ethics and Personal Leadership (PEPL)
Psychological Trauma in the EMS Patient (PTEP)
Tactical Combat Casualty Care (TCCC) for medical military personnel
Tactical Combat Casualty Care for All Combatants (TCCC-AC) for NON-medical military personnel
Tactical Emergency Casualty Care (TECC)


NATIONAL ASSOCIATION OF EMERGENCY MEDICAL TECHNICIANS

PO Box 1400

Clinton, MS 39060-1400
Physical Address:
132-A East Northside Dr.
Clinton, MS 39056
1-800-34-NAEMT
P: 601-924-7744
F: 601-924-7325
Info@naemt.org
Publicacion by Dr. Ramon Reyes, MD

















TACTICAL MEDICINE TACMED España by EMS Solutions International
“Medicina Bona Locis Malis” tm 

Disminuir Mortalidad en España y a nivel global como consecuencia de violencia, incluyendo todos los escenarios posibles Combate (Medicina de Guerra), Terrorism
o, Tiradores Activos y para ello nos enfocamos en compartir las actividades docentes, protocolos establecidos a nivel global por el CoTECC, CoTCC, OTAN, Consenso de Hartford, no somos excluyentes con la informacion, tratamos de llevar el mas alto nivel de impacialidad posible en la informacion y documentos compartidos.
Att.




Dr. Ramon Reyes, MD
Ex-Teniente de Navio
Faculty TCCC, TECC, PHTLS
@drramonreyesmd


Estamos en Facebook 

Tactical Medicine Tacmed España @TACMEDEspana

Fan Page https://www.facebook.com/TACMEDEspana/ 





Christian Goring, EMT-P USA-Chile, Dr. Luis Alfredo Perez-Bolde, MD Mexico, Dr Ramon Reyes, MD Rep. Dominicana-España. 
Exponieniendo situacion actual a nivel IBEROAMERICANO, como parte del Grupo Internacional del Comite TECC





Peter T. Pons, MD 
Associate Director for Emergency Medicine at Denver Health Medical Center
Professor in the Division of Emergency Medicine in the Department of Surgery at the University of Colorado Health Sciences Center. 

Responsable de que hoy hablemos de 8va edicion PHTLS, numeros libros y articulos, PPT de TECC-NAEMT, Desarrollo del TCC-LEFR, Bleeding Control Course PPT, PHTLS 8va PPT, entre otros trabajos importantes para reducir muertes por trauma. 


Ultimo articulo del Dr. Pons en el enlace




8 pitfalls to avoid in hemorrhage control by Dr. Peter Pons, FACEP

http://emssolutionsint.blogspot.com.es/2018/02/8-pitfalls-to-avoid-in-hemorrhage.html



  https://www.facebook.com/notes/tactical-medicine-tacmed-espa%C3%B1a/stop-the-bleed-8-pitfalls-to-avoid-in-hemorrhage-control/1454537254641361/


Has been PHTLS Associate Medical Director Email: ptpons@aol.com Peter T. Pons, MD, is an emergency physician in Denver and has been actively involved with prehospital care and disaster preparedness for more than 30 years. He has worked as the Associate Director for Emergency Medicine at Denver Health Medical Center (formerly Denver General Hospital) and as Professor in the Division of Emergency Medicine in the Department of Surgery at the University of Colorado Health Sciences Center. Pons has served as the EMS Medical Director for the 9-1-1 paramedic ambulance service in Denver, based at Denver Health, as well as for several fire- based EMS systems. He has published numerous peer-reviewed journal articles on EMS and edited several textbooks for emergency medical technicians and paramedics. He has served as the physician director for numerous mass gatherings and special events in Denver, including the Denver Grand Prix, World Youth Day and the visit of Pope John Paul II. He has lectured nationally and internationally on EMS and served as a member and chair of the EMS Committee for the American College of Emergency Physicians. In addition, Pons has participated as an investigator on several federal grants including two AHRQ grants dealing with regional surge capacity and national bed availability and a HRSA WMD training grant (BNICE) for which he is curriculum coordinator and a trainer. http://www.naemt.org/education/peter%20pons%20bio.pdf


Tactical Emergency Casualty Care

NAEMT's  Tactical Emergency Casualty Care (TECC) teaches EMS practitioners and other prehospital providers how to respond to and care for patients in a civilian tactical environment. It is designed to decrease preventable deaths in a tactical situation.  The course presents the three phases of tactical care:

  • Direct Threat Care that is rendered while under attack or in adverse conditions.
  • Indirect Threat Care that is rendered while the threat has been suppressed, but may resurface at any point.
  • Evacuation Care that is rendered while the casualty is being evacuated from the incident site. 
The 16-hour classroom course covers the following topics:
  • Hemorrhage control;
  • Surgical airway control and needle decompression;
  • Strategies for treating wounded responders in threatening environments;
  • Caring for pediatric patients; and
  • Techniques for dragging and carrying victims to safety.
NAEMT's TECC course meets the guidelines established by the Committee on TECC and the updated National Tactical Emergency Medical Support Competency Domains. This course is accredited by CAPCE and recognized by NREMT.


Guia de Soporte en Incidentes con Amenaza para Primer Interviniente Policial
by Juan Jose Pajuelo Castro

TERRORISMO:
El vehículo como arma de guerra

Curso TCC-LEFR Tactical Casualty Care for Law Enforcement First Responders 
(Marca Registrada en EUA) by Dr. Peter Pons
Pronto tendremos de vuelta Curso TCC-LEFR Tactical Casualty Care for Law Enforcement First Responders
Este Curso ha sido adaptado de los Cursos de los Militares de los Estados Unidos,
Tactical Combat Casualty Care Course por parte del Denver Health Paramedic Division
en cooperacion con laUnidad SWAT del Departamento de Policia de Denver y es consistente con las Directrices del TECC Tactical Emergency Casualty Care.
El enfoque de este entrenamiento se basa en la identificacion de lesiones potencialmente mortales con tratamiento medico apropiado en situaciones TACTICAS o Escenario Peligroso.

Dirigido en Exclusivo a Fuerzas de Seguridad del Estado
Policias, Policias Militares, Policias Locales, Unidades de Internvencion Militares que trabajan en Entornos Civiles.
Guardia Civil
UME
Policia Local
CNP





Updated TCCC Guidelines (31 JAN 2017) "Actualizacion 2017 de las Guias" Tactical Combat Casualty Care


There is no official or national certification in TECC. There is no official designation as a TECC instructor. The Committee maintains the belief that the guidelines are the evidenced based 'what to do' and 'why to do it.' The 'how' is up to you, and that planning and training should occur on an local/agency level.
So, take the guidelines and create your own training. However, if you can't, be sure to chose a training entity that displays the CTECC recognized educational content logo. This means the training adheres to the Committee's educational principles.

No existe una certificación oficial o nacional en tecc. No hay designación oficial como instructor de tecc. El Comité mantiene la creencia de que las directrices son las que se basan en " qué hacer " y " por qué hacerlo " el " Cómo " depende de ti, y que la planificación y la formación deben tener lugar a nivel local o de la agencia.
Así que, toma las directrices y crea tu propio entrenamiento. Sin embargo, si no puedes, asegúrate de elegir una entidad de entrenamiento que muestre el logotipo de contenido educativo reconocido por ctecc. Esto significa que la formación se atiene a los principios educativos del comité.
TECC NAEMT Tactical Emergency Casualty Care



What you get:  
Abbreviated TCCC Guidelines
TCCC in Algorithm Format
Pharmacology Reference specific to TCCC
Planning Considerations, and more…
Authorized for re-printing at DoD Installation Printing Offices.

CONTOMS Counter Narcotic and Terrorism Operational MEDICAL SUPPPORT

El programa CONTOMS se inició en 1990 para satisfacer la necesidad de capacitación médica especializada y apoyar a las fuerzas del orden publico en operaciones especiales.

La aplicación de la ley sigue siendo una ocupación peligrosa. Un total de 1,466 agentes del orden público murieron en el cumplimiento de su deber durante los últimos 10 años, un promedio de una muerte cada 60 horas o 146 por año. Hubo 117 policías en cumplimiento del deber en 2014. En promedio, en la última década, se han registrado 58,930 agresiones contra las fuerzas del orden público cada año, lo que ha provocado 15,404 heridos. Nuestros propios datos sugieren que los miembros del Equipo SWAT corren un alto riesgo de sufrir lesiones, y que mantienen un índice de bajas tan alto como 9 por cada 1000 misiones de oficiales.

La aplicación de la ley y los servicios militares han reconocido desde hace tiempo que el apoyo médico a las operaciones especiales puede aumentar la probabilidad de éxito de la misión. Este tipo de apoyo requiere una experiencia única y adicional, que es complementaria a las calificaciones básicas de los proveedores de atención médica prehospitalaria. Los sistemas comunitarios de servicios médicos de emergencia (SEM) en los Estados Unidos y en el extranjero se desarrollaron para responder a las necesidades de pacientes individuales en situaciones controladas. Sin embargo, en algunos lugares, los técnicos en emergencias medicas capacitados para el rol dentro del Servicio de Soporte Contra-Terrorismo, han prestado servicio para apoyar la lucha contra el terrorismo, la interdicción de drogas y otras actividades de aplicación de la ley sin ningún tipo de capacitación adicional. Estas actividades se han vuelto de naturaleza cada vez más especializadas, caracterizadas por operaciones prolongadas, fuerzas opositoras organizadas, uso de armas de tipo militar, muertes y lesiones cada vez mayores entre los agentes del orden público, los perpetradores y ciudadanos inocentes.

The CONTOMS Program was started in 1990 to meet the need for specialized medical training to support law enforcement special operations.

Law enforcement remains a dangerous occupation. A total of 1,466 law enforcement officers died in the line of duty during the past 10 years, an average of one death every 60 hours or 146 per year. There were 117 law enforcement officers killed in the line of duty in 2014. On average, over the last decade, there have been 58,930 assaults against law enforcement each year, resulting in 15,404 injuries. Our own data suggests that SWAT Team members are at high risk for injury, sustaining a casualty rate as high as 9 per 1000 officer-missions.

Law enforcement and the military services have long recognized that medical support of special operations can enhance the probability of mission success. This type of support requires a unique, additional expertise, which is complementary to the basic qualifications of prehospital health care providers. Community emergency medical services (EMS) systems in the United States and abroad were developed to respond to the needs of individual patients in controlled situations. However, in some locales, emergency medical technicians trained for the EMS role have been pressed into service to support counter terrorism, drug interdiction and other law enforcement activities without any additional training. These activities have become increasingly specialized in nature, characterized by prolonged operations, organized opposing forces, use of military-type weapons, and increasing death and injury among law enforcement officers, perpetrators and innocent citizens.
GUIA PARA LE MANEJO DE HERIDOS EN INCIDENTES 
INTENCIONADOS CON MULTIPLES VICTIMAS Y TIRADORES ACTIVOS
GUIA M.A.C.T.A.C.  Actualizacion 2017 

Tamaño del archivo en PDF Gratis 
2.34 MB
21 Paginas 
Este obra cuyo autor es JUAN JOSE PAJUELO CASTRO Y JOSE CARLOS MENESES PARDO está bajo una licencia de Reconocimiento-NoComercial-SinObraDerivada 4.0 Internacional de Creative Commons.






Manejo de Heridos en Incidentes Intencionados Múltiples Víctimas y Tiradores Activos 09/07/2017

Compendio de HARTFORD-TECC
by Juan Jose Pajuelo Castro
Tamaño del archivo en PDF Gratis
742 KB

http://emssolutionsint.blogspot.com/2017/09/tactical-medicine-tacmed-espana-by-ems.html

JUAN JOSE PAJUELO CASTRO está bajo una licencia de Reconocimiento-NoComercial-SinObraDerivada 4.0 Internacional de Creative Commons.



TERRORISMO Y SALUD PÚBLICA - "GESTIÓN SANITARIA DE ATENTADOS TERRORISTAS POR BOMBA" 



EPI  Equipo de Proteccion Individual en Medicina Tactica  (Personal Protective Equipment PPE) in Tactical Medicine

Medicina Tactica y Multiples Victimas en Ataque Terrorista
What is IFAK? Is the Individual First Aid Kits (IFAK) for Traumatic Wounds
¿Que es IFAK? Su traduccion del ingles Kit de Primeros Auxilios Individuales para heridas traumaticas. by Dr. Ramon Reyes, MD

Mini IFAK Contents (Contenido Mini IFAK)

Mini IFAK Contents (Contenido Mini IFAK):

  • TK-4L Rugged Combat Tourniquet
  • QuikClot Advanced Clotting Sponge
  • WoundStop Home Care First Aid Wound Dressing
  • 3” x 18” Petrolatum Gauze
  • 4” x 6 yds. Compressed Gauze
  • Waterproof Combat Tape
  • Pair Medical Gloves (XL) 
While I was at SOFIC I spent some time with the Raven Concealment Systems and CLEER Medical guys going over their new MBOK (Mini BlowOut Kit). Later, after I started reading the comments left on Facebook under MBOK-related posts, I went and spent some more time with them. You see, the MBOK may be the most maligned piece of gear to come out in a long time. I’ve posted a screenshot below to give you an sample; you’ll see many more examples once I put this article up on Facebook. Many of them will be from people who are responding to just the image and the MSRP, which is unfortunate – not because I’m an MBOK apologist, but because I think all declamations should be based on all available information.

But I digress.

The MBOK is a miniaturized IFAK (Individual First Aid Kit) that can be worn on your belt as an “EDC” item or in/on gear as a lightweight replacement for one of the many other medical kits out there (many of which are very good kits, all of which are substantially larger). It retails for anywhere from $249.99 to $329.99, with the possibility of $20.00 off if you preorder.

I will leave it to you to determine if it’s worth the MSRP.

The MBOK is comprised almost completely of proprietary individual components, each developed specifically to streamline and lighten the kit (this is plays no small part in the price). The contents are kept inside a medical “wallet” that fits inside a tubular “sleeve” designed so you can deploy the contents up or down. The kit contains all of what most would consider your “first line” trauma gear for immediate response to something like a gunshot wound, shy of applying a TQ (tourniquet), which you can carry alongside the MBOK in a Eleven 10 Rigid TQ Case. There is a reason why the TQ is not included in the MBOK. We’ll get to that eventually.

This is an evolved version of what we first looked at after SHOT back in January. Although the contents have remained consistent, the pouch itself is much different. There are 2 types of MBOK – basic and advanced. The difference lies in the contents of the wallet, not the sleeve. Inside the basic kit are a NAR (North American Rescue) dressing built specifically for the MBOK, a proprietary CELOX Rapid ribbon, dual chest seals (so you can address both entry and exit wounds), 3M medical tape and tan bear claw gloves. The advanced wallet includes a Rusch nasal pharyngeal airway with lube and chest dart (14 gauge x 3.25″). The initial MBOKs will be in a MOLLE pouch built of Blue Force Gear’s Helium Whisper and Ultracomp, with the option to pick up the rigid TQ case (built by Eleven 10, carried by CLEER) and an RCS paddle. In the very near future there will be additional mounting options available.

Each piece of the kit, from the gloves (which were chosen in brown to better show the results of a blood sweep) to the medical tape (which is in pre-cut strips), was selected, sized and packaged after much deliberation. The end goal was a comprehensive medical kit that takes up the absolute minimum amount of real estate.

Mini IFAK Contents (Contenido Mini IFAK)


Trauma Response Kit "Bag"

Individual First Aid Kit IFAK by Dr. Ramon Reyes, MD 

Pues en España tenemos unos """"EXPERTOS"""" como los llamo yo, expertos de escritorio,,, que dicen que han leido mucho de esto y por eso ellos no trabajan en entorno tactico, lo primero es que no quieren llamarlo ATAQUE TERRORISTA... Cada cosa se llama por su nombre y no existe otra forma de llamar a este tipo de situaciones desafortunadas que vivimos hoy en dia.
Me hago una preguna ¿Que pasara con esa madre amputada?
¿Que pasara con ese maestro con un pneumotorax?, ¿Que pasara con el que muera por obstruccion de via aerea ahogado en su propia sangre?
Mi pregunta es ¿Se negaron a acturar los SEMs en Barcelona? Cuando decidi ser medico me comprometi a salvar vidas, cuando decidi ser callejero lo hice por conviccion personal, me encanta ver como personas que se la pasan tonteando en las redes sociales, o vendediendose como expertos en la materia, a la hora de la verdad bailan como Michael Jackson hacia detras,,, no veo seriedad, ni mucho menos compromiso, en aquel que me diga que le teme a un tiro en un situacion de peligro, pero sin embargo pincha el acelerador de la ambulancia sin medir consecuencias y sin pensar en sus familiares. Pues Yo digo y repito, primero enterese que es Medicina Tactica, luego enterese cuales son las fases de actuacion con multiples victimas en situaciones tacticas (pero repito LEA) y luego se pasea por las redes sociales vendiendo fotos de que eres un experto en algo que inclusive los mas basico ignoras. les remito una de las que me han dicho en defensa de quedarse comiendo palomitas de maiz mientras las victimas en esas circunstancias mueren o empeoran ( es que no quiero que me peguen un tiro) y cuando le recrimino las falta de informacion esta es su respuesta...
Pues me han dicho, "mis asesores leen mucho", y yo le contesto a esas personas, Mis asesores, escriben lo que leen tus asesores...
Me da la impresion que lo que existe en todo esto es una mala interpretacion de las intervenciones del personal Sanitario (Medico) Civil en entorno Tactico... Y esta muy bien definido a nivel internacional, por ejemplo en los EUA esto sucede a diario y los paramedicos (EMS), no hemos tenido ni fatalidad, ni incidentes al respecto.... El Personal Sanitario en Entorno Tactico, Lleva su EPI (ver fotos adjuntas) especial como los periodistas, que se colocan chaleco y casco antibalas, asi como botas y guantes resistentes y nunca sin proteccion ocular... Ahora bien no intervenimos en donde existe fuego cruzado, solo en entornos barridos por el 1º Equipo de Contacto (funcion neutralizar la amenaza, NO ATIENDEN VICTIMAS, no es su mision) ¿Saben todos que es neutralizar Amenaza? les contesto pues ellos no van a conversar con el atacante para nada... Pues lo dicho entramos en el 2º Equipo de Rescate, a sacar y tratar victimas (Pero siempre protegidos por el 2º equipo, que tiene las mismas condiciones y entrenamientos que el equipo 1º "Contacto"), ellos salvaguardan nuestra seguridad, y si no entramos por la razon que sea,,,, aumentara la mortalidad por las famosas muertes prevenibles, Hemorragias Extremidades, Neumotorax, Obstrucions Vias Aereas, etc... les dejo este simple analisis,, que no me invento, es lo que dicen los que saben,,, por favor no matar al mensajero. Ahora bien si USTED, no tiene el entrenamiento, ni tiene ni idea de esto, no se invente un curso por favor y desinforme a tantos ilusos que tenemos en este medio...

Att.

Dr. Ramon Reyes, MD​
drramonreyesmd
Tactical Medical Specialist-USA
Ex-Tte de Navio Medico de la Armada
PHTLS-TECC-TCCC Facultado Internacional
Medico Especialista en Misiones de Alto Riesgo y Zonas Hostiles
Colegiado en España
Fuente: 

PAGINA FCEBOOK 
https://www.facebook.com/TACMEDEspana/ 

TACMED Spain Medicina Tactica España  

GRUPO  https://www.facebook.com/groups/311284402300505/

EPI Equipo Proteccion Indivual 

https://www.youtube.com/watch?v=ccIpnDjQjA0&feature=push-u-sub&attr_tag=Te_gBrXdW88JRKga%3A6
 Este es un afortunado operador  el  #EPI Equipo de Proteccion Individual, hace su trabajo. Heridas de metralla por  #RPG explosión en el aire de lanzacohetes antitanque portátil 

 Este es un afortunado operador  el  #EPI Equipo de Proteccion Individual, hace su trabajo. Heridas de metralla por  #RPG explosión en el aire de lanzacohetes antitanque portátil 

 Este es un afortunado operador  el  #EPI Equipo de Proteccion Individual, hace su trabajo. Heridas de metralla por  #RPG explosión en el aire de lanzacohetes antitanque portátil 


 Este es un afortunado operador  el  #EPI Equipo de Proteccion Individual, hace su trabajo. Heridas de metralla por  #RPG explosión en el aire de lanzacohetes antitanque portátil 

 Este es un afortunado operador  el  #EPI Equipo de Proteccion Individual, hace su trabajo. Heridas de metralla por  #RPG explosión en el aire de lanzacohetes antitanque portátil 

 Este es un afortunado operador  el  #EPI Equipo de Proteccion Individual, hace su trabajo. Heridas de metralla por  #RPG explosión en el aire de lanzacohetes antitanque portátil 


Este es un afortunado operador  el  #EPI Equipo de Proteccion Individual, hace su trabajo. Heridas de metralla por  #RPG explosión en el aire de lanzacohetes antitanque portátil 

EPI  Equipo de Proteccion Individual en Medicina Tactica  (Personal Protective Equipment PPE) in Tactical Medicine


EPI  Equipo de Proteccion Individual en Medicina Tactica  (Personal Protective Equipment PPE) in Tactical Medicine


EPI  Equipo de Proteccion Individual en Medicina Tactica  (Personal Protective Equipment PPE) in Tactical Medicine


EPI  Equipo de Proteccion Individual en Medicina Tactica  (Personal Protective Equipment PPE) in Tactical Medicine


EPI  Equipo de Proteccion Individual en Medicina Tactica  (Personal Protective Equipment PPE) in Tactical Medicine


EPI  Equipo de Proteccion Individual en Medicina Tactica  (Personal Protective Equipment PPE) in Tactical Medicine


EPI  Equipo de Protección Individual en Medicina Tactica  (Personal Protective Equipment PPE) in Tactical Medicine

EPI  Equipo de Proteccion Individual en Medicina Tactica  (Personal Protective Equipment PPE) in Tactical Medicine


EPI  Equipo de Proteccion Individual en Medicina Tactica  (Personal Protective Equipment PPE) in Tactical Medicine
NATIONAL INSTITUTE OF JUSTICE GUIDE BODY ARMOR Selection & Application Guide 0101.06 to Ballistic-Resistant Body Armor by U.S. Department of Justice

EPI  Equipo de Proteccion Individual en Medicina Tactica  (Personal Protective Equipment PPE) in Tactical Medicine


EPI  Equipo de Protección Individual en Medicina Tactica  (Personal Protective Equipment PPE) in Tactical Medicine




#TCCC #TECC #CoTECC #CoTCCC #TC2 #TCClefr #DrPeterPons #EMS #TACMED #MEDICINATACTICA 


¿Como actuar ante un ataque terrorista o individuos armados? Algoritmo




IFAK Individual First Aid Kit 
Bolin Chest Seal
TRAUMA DE TORAX: DOCENA DE LA MUERTE en trauma toracico

Updated Training on How To Apply and Use the Bolin Chest Seal, our valved pneumothorax chest dressing
#Trauma #Openwound #Shoot #wound #TCCC #TECC #CTECC #CoTCCC #NAEMT #TACMEDSpain #MedicinaTacticaEspaña #EETI #PeterPons #Tourniquet #Pneumothorax #NEUMOTORAX #BCON #PHTLS #ATLS #TCClefr #TC2 #TC3 #ESPAÑA #SOMA #EMSWORLD



Comite LatinoAmericano de Medicina Tactica


GUIA DE SOPORTE VITAL EN INCIDENTES CON AMENAZA ELEVADA PARA PRIMER INTERVINIENTE POLICIAL by Juan Jose Pajuelo. España 2017


El objetivo de estas Guías no es otro que resumir de manera breve y concisa los pasos ideales (en ocasiones lo ideal no es lo real) para una valoración y manejo iniciales de las principales causa de muerte evitable, hasta la llegada de los Servicios de Emergencia, en los compañeros o ciudadanos heridos.
Se pretende que estas Guías aborden la asistencia inicial, en el contexto de una intervención o incidente donde exista un alto nivel de amenaza, en el que se vean involucrados los “policías de a pie”, puesto que ha quedado demostrado que son los primeros (y en ocasiones los únicos) en abordar inicialmente tanto al incidente en sí mismo, como a las víctimas si se han producido.
Un incidente con alto nivel de amenaza no se limita a sucesos como atentados terroristas con múltiples víctimas, si no que contempla también otro tipo de circunstancias como incidentes con individuos armados y/o, aglomeraciones populares con individuos violentos.
Toman como referencia las Directrices para Primeros Intervinientes con la Obligación de Asistir (First Responders with a Duty to Act) del Comité del Tactical Emergency Casualty Care que, al igual que estas Guías, son meras recomendaciones y no protocolos rígidos que deben adaptarse a la legislación vigente y, a las especificidades de cada Institución/Servicio/Organismo.
Con independencia de lo mencionado anteriormente, tienen como objetivo final estandarizar un lenguaje y unas actuaciones a nivel nacional dado que, están basadas en la evidencia científica “in vivo” y, en las lecciones aprendidas de muchos profesionales nacionales e internacionales. Estas recomendaciones/guías, no sustituirán el buen juicio clínico.
Por lo tanto, se espera que las recomendaciones que se presentan a continuación sirvan de ayuda para todo aquél personal policial que se pueda ver involucrado en un incidente con un nivel de amenaza elevado, a la hora de enfrentarse al manejo de las principales causas de muerte evitable que se producen en actuaciones con un alto nivel de amenaza.

75th Ranger Regiment Trauma Management Team (Tactical) Ranger Medic Handbook FREE pdf

SPECIAL OPERATIONS FORCES Medical Handbook Free PDF 

TACTICAL MEDICINE TACMED “Medicina Bona Locis Malis” tm. Good Medicine In Bad Places España by EMS Solutions International http://emssolutionsint.blogspot.com.es/2017/09/tactical-medicine-tacmed-espana-by-ems.html

Les esperamos en Nuestro Grupo en TELEGRAM
Sociedad Iberoamericana de Emergenciashttps://t.me/joinchat/FpTSAEHYjNLkNbq9204IzA
 


Related: 

TACTICAL MEDICINE TACMED “Medicina Bona Locis Malis” tm. Good Medicine In Bad Places España by EMS Solutions International



Bolin Chest Seal
TRAUMA DE TORAX: DOCENA DE LA MUERTE en trauma toracico

Updated Training on How To Apply and Use the Bolin Chest Seal, our valved pneumothorax chest dressing
#Trauma #Openwound #Shoot #wound #TCCC #TECC #CTECC #CoTCCC #NAEMT #TACMEDSpain #MedicinaTacticaEspaña #EETI #PeterPons #Tourniquet #Pneumothorax #NEUMOTORAX #BCON #PHTLS #ATLS #TCClefr #TC2 #TC3 #ESPAÑA #SOMA #EMSWORLD


Curso TECC TACTICAL EMERGENCY CASUALTY CARE http://emssolutionsint.blogspot.no/2012/01/tactical-combat-casualty-care-tccc.html


PHTLS



Todos Nuestros VIDEOS en YouTube https://www.youtube.com/c/RamonReyes2015 

Grupo en TELEGRAM Sociedad Iberoamericana de Emergencias
https://t.me/joinchat/FpTSAEHYjNLkNbq9204IzA


Balística de las heridas: introducción para los profesionales de la salud, del derecho, de las ciencias forenses, de las fuerzas armadas y de las fuerzas encargadas de hacer cumplir la ley http://emssolutionsint.blogspot.com/2017/04/balistica-de-las-heridas-introduccion.html
Guía para el manejo médico-quirúrgico de heridos en situación de conflicto armado by CICR http://emssolutionsint.blogspot.com/2017/09/guia-para-el-manejo-medico-quirurgico.html
CIRUGÍA DE GUERRA TRABAJAR CON RECURSOS LIMITADOS EN CONFLICTOS ARMADOS Y OTRAS SITUACIONES DE VIOLENCIA VOLUMEN 1 C. Giannou M. Baldan CICR http://emssolutionsint.blogspot.com.es/2013/01/cirugia-de-guerra-trabajar-con-recursos.html
Manual Suturas, Ligaduras, Nudos y Drenajes. Hospital Donostia, Pais Vasco. España http://emssolutionsint.blogspot.com/2017/09/manual-suturas-ligaduras-nudos-y.html
Técnicas de Suturas para Enfermería ASEPEYO y 7 tipos de suturas que tienen que conocer estudiantes de medicina http://emssolutionsint.blogspot.com/2015/01/tecnicas-de-suturas-para-enfermeria.html
Manual Práctico de Cirugía Menor. Grupo de Cirugia Menor y Dermatologia. Societat Valenciana de Medicina Familiar i Comunitaria http://emssolutionsint.blogspot.com/2013/09/manual-practico-de-cirugia-menor.html

Protocolo de Atencion para Cirugia. Ministerio de Salud Publica Rep. Dominicana. Marzo 2016 http://emssolutionsint.blogspot.com/2016/09/protocolo-de-atencion-para-cirugia.html
Manual de esterilización para centros de salud. Organización Panamericana de la Salud http://emssolutionsint.blogspot.com/2016/07/manual-de-esterilizacion-para-centros.html





Saber mas sobre @TACMEDEspaña  

TACTICAL MEDICINE TACMED España by EMS Solutions International


http://emssolutionsint.blogspot.co.uk/2017/09/tactical-medicine-tacmed-espana-by-ems.html



Rapid Access Modular Medical Panel  

Designed by ARSOF medical operators, the RAMMP system is a fully customizable panel for trauma care and sick care providers working in fixed or temporary facilities as well as ground/air platforms.Key Features:
• Fully customizable medical panel
• Zippered center allows panel to be split in two
• Removable interchangeable pouches
• Modular pouches can accommodate mission specific customization of medical supplies
• Bridges the gap between aid bags and larger storage containers
• Comes with interchangeable high visibility labels allow for easy supply category recognition
• Folds in half for easy storage
• Material: 1000D Cordura® Nylon
• Lifetime Warranty
• Made in the USA
• Weight: 9.6lbs











ACTIVE SHOOTER MASS CASUALTY PACK W/ FREE TRAINING MODULE https://www.officersurvivalsolutions.com/products/active-shooter-kit-detail.html

The OSS Active Shooter Mass Casualty ( soft ) is a mass casualty kit containing ten (10 Individual throw kits used to treat multiple victims when involved in any penetrating trauma injury such as gunshot/s wound/s.

The OSS Active Shooter Mass Casualty Kit ( soft ) is a mass casualty kit containing ten (10 Individual throw kits used to treat multiple victims when involved in any penetrating trauma injury such as gunshot/s wound/s. This kit is contained in a compact, soft readily identifyable red pack to be deployed into the field as a sling pack or backpack by any officer, agent or rescue personnel .The pockets are set up to allow instant and immediate access to all the critical medical items.The throw kits contain a tourniquet, an OSS Combat Compression bandage, Sterile Packing Gauze, a set of nitrile gloves and a field instruction/casualty card. These individual kits can be dropped, kicked or thrown to individual victims in or around a mass casualty scene. The critical lifesaving medical items are typically used by medical staff to treat life threatening injuries such a those incurred by a single or multiple gunshots or penetrating trauma injuries resulting in massive and uncontrolled bloss loss. This Active Shooter / Mass Casualty ( soft ) is currently in use by several federal, state and local Law Enforcement, EMS, Fire Rescue and scholastic agencies and departments worlds-wide.

This Pack is also a complete training center contained in the front cover pouch. It has an individual Training Module that is removable and deployable into any environment. It has everything you need to teach any and all staff that may have to deploy these lifesaving items into a critical incident. It also comes with a Training Powerpoint to aid those learning about the use of these kits. A typical training class can take as little as under 30 minutes for most buisnesses training 25 or more individuals. 

** More Complete Training Programs available from OSS, please see Training Section in our menu on this website or contact us directly at (760) 696-0120 **

ASMC Contents;
 10 Individual Pocket Packs;
        10 Tourniquets 
        10 OSS Combat Compression Bandages
        10 Sterile Packing Gauze Packs
        10 Pair of Nitrile Glove
        10 Field Instruction / Casualty Cards
4 - Sets of Emergency Rescue Shears
4- Cohesive Bandage Wraps
4- Cloth Tapes 1'
4- Emergency Blankets
1 Complete OSS Training Module;
        4 Tourniquets
        4 OSS Combat Compression Bandages
        4 Sterile Packing Gauze Packs
        4  Pair of Nitrile Glove
        4 Field Instruction / Casualty Cards





Description

In todays society Active Shooter and Mass Casualty events are being experienced at much greater frequency than before. The fact is that Emergency Services at its quickest reponse, is generally 6-11 minutes in most urban areas, you can bleed to death in under three (3). The first initial response to any such incidents is going to be other civilians and the general public. OSS has invented numerous Advanced Bleeding Control kits designed for use by the general public. These kits are currently being used in Airports, Malls, Public Transportation Centers and Schools throughout the nation. They are designed to aid in stopping the blood loss from the most severe injuries experienced at these mass casualty events.

At OSS we have used our decades of professional experience to put together a "civilian model" of our Combat Casualty Care course that we have been teaching for several years to our nations first responders and emergency services operations. We offer this to the general public to help teach the most innovative tactics on first aid and help educate the general public on what to do on scene, how to be prepared and how to recognize the threats before they occurr.

This is one of our most popular Advanced Bleeding Control Packs to date, it includes six (6) individual Advanced Bleeding Control kits that are velcroed to an insert pack thus easily removable and readily available. These compact packs contain tourniquets, compression gauze, sterile rolled gauze, cloth medic tape and compression bandages. All of which are included in the Field Application card also contained in each kit. these kits can be thrown, kicked or slid to injured people on any surface and has bi-lateral zippers to make it easy to open with little effort. The insert is contained in our subdued colored medic backpack with identifiable PVC Patches affixed to the front and rear for rapid identification and deployment. The main backpack/bag contains its own critical medical supplies to treat several victims at the site and still contain the Insert to handout to individuals to aid others.

This and all our kits are built to the guidelines and in support of the national Stop The Bleed campaign being advertised by our federal government.

The Main Pack Contains:
SWAT T Tourniquet x 2
3" Sterile Rolled Gauuze x 6
3" OSS Combat Compression Bandage x 2
1" Cloth Medic Tape x 2
4" Kerlix Bandage Roll x 2
3" Cohesive Wrap Bandage  x 2
7.5" Rescue Shears
Nitrile Gloves / Blue / Size Large - 6 pairs
Sterile Trauma Sheet
60"x80" Emergency Survival Blanket x 6

Each Individual Advanced Bleeding Control Kits ( total of 6 ) Contain:
SOF T Tourniquet
3" Sterile Compressed Gauze Bandage
3" OSS Combat Compression Bandage
1" Cloth Medic Tape
5.5" Rescue Shears
3" Sterile Rolled Gauze x 2
Nitrile Gloves / Blue / Size Large x 2




 El curso Tactical Emergency Casualty Care (TECC) de NAEMT está basado en los principios del Tactical Combat Casualty Care (TCCC) y cumple con las guías establecidas por el Comité de Cuidado Táctico en Emergencias (C-TECC). Este curso enseña a los técnicos de emergencias médicas a cómo responder a un evento de tiroteo activo (“active shooter”) o de múltiples víctimas de trauma.

El curso de TECC está diseñado para primeros respondedores a un incidente de múltiples víctimas. Medicina Bona Locis Malis = medicina buena en lugares peligrosos.

Se describen las fases de manejo en situaciones tacticas por parte de los Rescue Task Force TFR.

TACTICAL EMERGENCY CASUALTY CARE TECC
Course # TE-18-04082-03 - Site ID# 5388
Santo Domingo, Distrito Nacional
Republica Dominicana
http://emssolutionsint.blogspot.com.es/2017/09/curso-tecc-espana-28-septiembre-2017.html

Contactos:
Dr. Ramon Reyes, MD
eeiispain@gmail.com

Alex Pacheco
809 849 9295
eeiird@gmail.com

19-20 de Mayo 2018

****CUPOS LIMITADOS****

Nos reservamos el derecho de admision

Inicio inscripcion:
01 Mayo 2018

Fin Inscripcion:
10 Mayo 2018

Cupos Limitados

Precio US$190 (156 Euros) Equivalentes Pesos Dominicanos
Deposito Cuenta Banco Popular Dominicano
RD$ Nº 759765241 (Enviar Recibo para asegurar el cupo)

Rescue Task Force RTF? / FUERZAS de TAREA de RESCATE

Guatemala military/medic special ops team. Art byDansun Photos @DansunPhotos

Todos Nuestros VIDEOS en YouTubehttps://www.youtube.com/c/RamonReyes2015

Grupo en TELEGRAM Sociedad Iberoamericana de Emergencias https://t.me/joinchat/FpTSAEHYjNLkNbq9204IzA

http://emssolutionsint.blogspot.com.es/2018/03/tactical-medics-vs-rescue-task-force.html






What is Tactical Emergency Casualty Care? by CTECC 

Tactical Emergency Casualty Care (TECC) is a set of evidenced-based and best practice trauma care guidelines for civilian high-threat pre-hospital environments.  The TECC guidelines are built upon the critical medical lessons learned by US and allied military forces over the past 15 years of conflict and codified in the doctrine of Tactical Combat Casualty Care (TCCC). Using the military TCCC guidelines as a starting point, the Committee creates the civilian high threat medical guidelines through a process of literature research, evidence evaluation, expert discussion, and civilian best practices review. The TECC guidelines are built upon the foundations of TCCC but are different to meet the unique needs of the civilian medical and operational environments.  The differences address civilian specific language, provider scope of practice, population, civilian liability, civilian mission and operational constraints, logistics, and resource acquisition.


How are TECC and TCCC similar?

Tactical Emergency Casualty Care is a set of civilian medical guidelines for high threat operations. Tactical Combat Casualty Care is a set of military medical guidelines for care of the wounded during military combat operations. The two sets of guidelines are naturally related, but each with a necessary difference in language, scope, applicability and flexibility.

There are two key unifying principles of TCCC and TECC.  First is the process of guideline development.  Both Committees are comprised of medics, physicians, academics and operational leaders.  Both Committees began with prior operational and medical lessons learned- for CoTCCC this was Vietnam and Somalia, for C-TECC this was TCCC and OIF/OEF- and rapidly evolved their recommendations based on immediate lessons learned.  Second is an understanding that success requires developing and deploying a SYSTEM of care.  In the military, TCCC’s success fundamentally lies in the fact that all personnel deploying to a combat theater were trained in the principles of TCCC.  The operational and trauma care systems were built around this training. 

This second fact is also the main limiting factor for the deployment of TCCC in the civilian setting.  As a system, TCCC cannot be deployed in the civilian setting because many recommendations run counter to civilian scope of practice and medical standards (e.g. use of hextend for resuscitation, pre-hospital antibiotics, needle decompression practiced by non medical personnel, etc.).
 

How are TECC and TCCC different?

Tactical Emergency Casualty Care is the civilian evolution and application of the military Tactical Combat Casualty Care guidelines. When discussing the differences between the two, it is important to emphasize that TECC and TCCC are not in competition with each other; although, as the pictures from the recent Boston Marathon bombing demonstrate, the bullets and explosives may be similar in civilian settings as in military combat, this does not make the military guidelines directly applicable for civilian applications.

The two sets of guidelines are naturally related, but each with a necessary difference in language, scope, applicability and flexibility.  There are three primary differences between TECC and TCCC: guideline terminology, trauma care recommendations and operational focus.

Terminology/ Language:  TCCC was written by the military special operations community to specifically address the specificities and conditions surrounding combat operations. These guidelines are researched, developed, and written with the assumption that the patient is an otherwise healthy 18-45yo soldier and that the provider is working under the military defined scope of practice.  The TCCC guidelines assume a military medical support system, military rules of engagement, and military legal precedent.  While individual recommendations such as tourniquet use are valid, TCCC as a system has limited application in the civilian setting. The TCCC courses currently being taught were not intended for civilian application. The Pre-Hospital Trauma Life Support TCCC course comes from the military PHTLS textbook, a version that was specifically written for the military medical community because the civilian PHTLS textbook had a different focus and application.

All leaders with operational experience understand that the language changes in TECC are critical.  As with the Incident Command System (ICS), common operating language is important for interagency response to complex threats.  For example, “Care Under Fire”, has variable meanings across the Fire (e.g. actual fire), EMS (e.g. fire or gunshots- but a non operational zone) and Law Enforcement (e.g. active gunfire in the area) communities. Tactical Emergency Casualty Care was created to address these system limitations and specific scope of practice challenges related to TCCC.  The C-TECC members, many of whom are active and past CoTCCC members, worked with civilian leaders to codify threat based guidelines (the core of TCCC) in a way that was easily applicable to civilian operations, legal and liability limitations and scope of practice, and in a way that is broadly applicable to the entirety of the civilian patient population.

Trauma care guidelines:  TECC and TCCC trauma recommendations are closely related. TECC places less emphasis on pre-hospital antibiotics, hextend as a resuscitation fluid, and specific product solutions.  The TECC guidelines place more emphasis on interagency communication, integrated operations between EMS, Fire and Law Enforcement, casualty extraction and evacuation, and care of non-combatant civilians. Additionally, as the civilian high threat focus continues with the results of on-going study and medical data, the recommendations of TECC will necessarily diverge in small ways from TCCC. One recent example is the 2013 pediatric TECC guidelines. Children are not accounted for in the TCCC guidelines as they are not in the military deployable population. As such, the C-TECC specifically examined the research and data specific to the pediatric population and created a specific set of recommendations for children.

Operational:  The fundamental mission difference between the military and civilian high threat operations is important.  In general, military operations focus on clearing, holding, and/or gaining territory with an emphasis on domination of enemy forces.  By definition, civilian operations are rescue operations with the key missions of limiting civilian morbidity and mortality.  Civilian first responders are sworn to “serve and protect”.  Any guidelines must acknowledge this important difference and account for rescue operations, limitations in use of force, and other regional operational requirements.
 

How can I get certified in TECC?

The TECC guidelines are open source and non-proprietary with the exception of the TECC logo.  There are currently no “official TECC courses” or a certified TECC provider/instructor.

The C-TECC believes that, though there are universal “principles” of high threat response, the application must be tailored for individual agencies based upon local resources, political climate, budget and operational experience. “Cookie cutter” or standardized courses and applications for high threat operations fail to account for the differences among first responders that vary widely jurisdiction to jurisdiction, region to region, state to state, etc. As such, the concepts and skills in these classes have to be ‘un-learned’ or ‘ignored’ because they do not fit into the specific agency SOP or scope.

TECC is not dogma, and the principles are meant to be applied uniquely by each agency that uses it, depending  on that agency's provider levels, scope of practice, culture, patient population, risk assessment, etc. We consider the TECC guidelines to be a pile of bricks; take only the bricks that fit into your operational culture and build a response program that is unique to you. Just don’t change the individual bricks! Overall, the principles of TECC are not difficult to teach – the actual medical interventions such as pressure dressings and tourniquets are now commonplace for everyday trauma. What is unique about high threat medical principles is less about what is done medically and more about when it is done, what injuries on focused on, and what can be excluded.

There are training entities that offer TECC courses. The Committee does not require any of these as your application of TECC is unique to your agency. If you cannot develop your own training, several of these companies offer a solid foundation of training. In the future, those companies and institutions that meet the principles of TECC guidelines instruction as set forth by the Committee may display a special C-TECC logo and be listed on the C-TECC.org website; until then, if you take a TECC class, make sure you check into the background and experience of the instructors first, and make sure that they are not teaching you TCCC and calling it TECC!


How can I become a TECC instructor?

There is currently no C-TECC sanctioned certification or classification as a ‘TECC instructor.” If you have the operational and educational experience to teach in your agency, if you have experience as an educator, or you are recognized by your agency as an instructor, you can take the open source TECC guidelines and create a course of instruction specific to your agency’s SOPs.


I am a certified TCCC instructor. Can I teach TECC? 

Sure, although it is certainly not required. Knowledge of TCCC is helpful as TCCC is the starting point for TECC. You must understand however that the two are not the same, and must be clear on the differences between the two.  Please also refer to the TECC skill set; at no point should skills outside of scope of practice be taught to students as a part of TECC. For example, although TECC includes needle decompression of a chest, this skill set should NOT be taught to providers if it is not specifically included in their scope of practice.  Other than that, if you are familiar with instruction of the military combat medical guidelines, then your understanding of how to instruct the civilian high threat medical guidelines should be solid!

 How can my department or agency start a TECC program? 

Implementing the TECC guidelines into your agency’s standard operations for high threat response is not as ‘heavy a lift’ or difficult as one would think. If you have an operational plan for deployment of assets and operations during situations of high threat, the medical guidelines will fit in easily. The individual TECC guidelines, such as applying a tourniquet or using hemostatic gauze, are becoming common place in everyday pre-hospital management of trauma. Remember that TECC is less about what you do and more about when you do it. Teaching the TECC guidelines to your agency should be done in a way that is specific to your agency’s culture, scope, and approach to operational training.

The Committee for Tactical Emergency Casualty Care is committed to assisting all response agencies and first responders who wish to utilize the guidelines. We have, and are working on, a variety of resources to assist you. Currently, we can provide a variety of educational articles and plenty of advice on how to get started. In the near future, we will be distributing a standard slide deck to get you started in teaching the guidelines. Feel free to contact the Committee with any questions or request for assistance.
 

Is TECC only for law enforcement and SWAT operations?

Absolutely not!!! Yes, it does have the word ‘tactical’ in its name but do not think that implies that the guidelines are for use only in law enforcement or tactical medical operations. Although the word ‘tactical’ in common use implies law enforcement associated operations, every first responder utilizes ‘tactics’ on every call every day. The Committee uses the word tactical to refer to the operational decisions that are made during response.  Every one of these operational decisions has an effect on medical care and the competing priorities of operations and medical care need to be considered in real time. TECC allows you to do just this.

TECC has applications for ALL high risk operations, where there is a real and on-going risk to both the patient and provider. Examples of high risk operations include, but are not limited to:
  • Active shooter response
  • Wilderness medicine
  • Confined space, rope and other technical rescue operations
  • Law enforcement ‘officer down’ response
  • SWAT medical support
  • Response to explosive mass casualty
  • All other mass casualty response


How can I become involved with the Committee?

The development of the TECC guidelines was a grassroots effort by a group of operational medical personnel who identified the gap when applying military medical guidelines to a non-military population and operation. We remain a grassroots effort and thus all of our meetings are open to the public and everything we produce is available to all at no charge.

Anyone can participate in the discussion regarding the TECC guidelines. We want your opinions and involvement as the guidelines are intended for all to use, not for just a few with special “certifications.’ We have two meetings a year: every December in conjunction with the Special Operations Medical Association conference in Tampa, FL, and a spring meeting at a different location every year. As a whole, about two months prior, we publish the information and logistics for our next meeting on the C-TECC website.

As a 501c3, we have bylaws that outline the different committees, the number of members on each committee, the requirements for members and the process by which one becomes an official member. Part of that process is attending at least one meeting in person. If you are interested in becoming an official member, feel free to attend a meeting, and then contact us directly and submit a CV. In the meantime, be a part of the grassroots that is our foundation. Submit comments and questions on line – all will be heard and considered!
 

Are the Committee’s meetings open to the public?

As discussed in the question regarding how to become a member, all Committee meetings are open to the public. TECC is founded on a grassroots effort to address the operational gap that exists in high threat medical operations; as such, we want and encourage your opinions and involvement.

We have two meetings a year: every December in conjunction with the Special Operations Medical Association conference in Tampa, FL, and a spring meeting at a different location every year. As a whole, about two months prior, we publish the information and logistics for our next meeting on the C-TECC website.


How can I get more information on the Committee?

Just ask! We will do all we can to answer your questions and support your operational use of the TECC guidelines. Currently on our website, under the resources tab, there are several articles on TECC and C-TECC that you can access.
 

Are there approved TECC courses?

Currently, there is no course approval or certification for TECC. As a whole, you do not need a course in TECC. We recommend that you use the in-house training staff and operational experts in your agency to create an operational paradigm and training program that is specific to your agency. That being said, there are many companies and training programs that state they teach TECC courses. Many of these are very good, but several teach military TCCC and just call it TECC. The two sets of guidelines are similar and related, but definitely different! So, if you cannot do it in-house for whatever reason and instead are seeking a TECC course, buyer beware! Do your due diligence to ensure that the content is consistent with TECC guidelines, that the instruction is matched to the students scope of practice, and that the instructional cadre has the expertise and TECC experience that they claim. In the near future, companies that agree to meet and adhere to the principles of TECC guidelines instruction being created by the Committee will be able to display a special C-TECC logo and be listed on our website to denote that the course of instruction is consistent with the TECC guidelines.


How can I get my TECC course approved?

Currently there is no ‘course approval’ process for TECC instruction. Feel free to create your TECC course utilizing the TECC guidelines as they are written. However, you must adhere to the principles of TECC – do not teach procedures outside of your student’s scope of practice, do not refer to equipment or supplies as ‘approved’ or ‘preferred’ or ‘recommended’, and do not change the language or intent of the guidelines.   

In the near future, the Committee will have a simple ‘principles of guidelines instruction’ that is an agreement between the Committee and the educational entity that will allow the course to display a special C-TECC logo to denote proper use and instruction of the guidelines.


What equipment is TECC approved?

None! The civilian patient population, the supply and equipment acquisition process, the budget and logistics of civilian response agencies and providers is completely different than the military. Just because a product is used or recommended by the military does NOT mean it is the best for civilian use. The military ‘recommended’ products are just that, recommended for the military population. These products do not take into account the aspects of civilian use including body and limb size, anticoagulation profiles, resources available, and the need for open bid acquisition.

The Committee also will not endorse products as such endorsements may be misconstrued as unethical or done with impropriety.  The C-TECC will discuss and offer existing evidence for products that have been tested and demonstrated effective, but does not specifically endorse any product.

We recommend that every agency should explore the different product solutions available and make an agency specific decision based on available unbiased scientific data as well as agency and provider preference.


Why are so many TCCC courses being taught to civilians?

Tactical Combat Casualty Care is a great military medical innovation. These concepts have saved countless lives on the battlefield, and have provided a wealth of medical data for us to build upon. Until 2011, TCCC was the only existing set of high threat medical guidelines that existed. Multiple courses were developed to teach military personnel; these courses were made available to civilians as well. 

What is interesting, however, is that even prior to the development of TECC from the TCCC guidelines, civilian personnel who were trained in TCCC through these standard courses would bring the concepts back and have to alter or change what they were taught to fit the constraints of the civilian application. Essentially, what was being done was these civilian providers were taking TCCC and making into something appropriate for civilians. This is exactly how the efforts of the Committee for Tactical Emergency Casualty Care began, and is exactly what we have codified in the TECC guidelines. 

Courses in TCCC are still being offered and taught to civilians mainly because the infrastructure exists to do so; and these students are likely going back and changing what they learned to civilian appropriate for their agencies and application. As TECC continues to grow, the Committee will continue to distribute and emphasize the need for civilian specific and appropriate training through partnerships with federal agencies, civilian training entities such as PHTLS and ITLS, and future collaboration with professional pre-hospital, operational, and medical organizations.
 

How are the guidelines updated?

The Committee meets twice a year to discuss the guidelines and make changes based on current research and data. At these meetings, we review current research, data, and case reports that are relevant to the guidelines and raise questions as to where and what changes need to be made.

As a whole, the December full committee meeting opens the discussion on any aspect of the guidelines and sets agenda for discussion and voting for the spring full committee meeting. If overwhelming data becomes available in-between meetings that show that the application of any individual guideline could cause harm, the Board of Directors will consider and make the necessary changes in real-time with the input of the Guidelines Committee and our Board of Advisor experts. An example of this process was the changes made to the TECC guidelines regarding limiting the use of Hextend after the FDA’s warning on Hextend use in critically injured patients.
 

How can I submit a comment or an article for consideration?

Please by all means submit the reference through the website! We rely on all of the first response community to assist us in identifying relevant data and research that may affect the Guidelines.


How did TECC come to be included in the HSGP National Priorities, and how is it related to MCI preparedness?

Recent events such as the mass shootings in Aurora (CO), Newtown (CT) and the bombing at the Boston Marathon have solidified the recognition that a national capability gap exists in terms of pre-hospital trauma care. The life safety of our citizens is recognized as governme