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Federal and civilian tactical and emergency medical response teams now stand at the same crossroads the military special operations medical community stood at in the early 1990s. Implementing TCCC guidelines as written into civilian protocols has the same fundamental flaws as utilizing civilian ATLS principles for battlefield treatment of combat wounded. This practice is essentially basing medical care on a doctrine designed to address the specific environment and restrictions of the military battlefield, not the civilian setting.
TCCC is written for the combat medic operating in a combat theater, not for the civilian tactical medic operating in a crack house in downtown Washington, DC. There is no doubt that the weapons and wounds are similar between the two settings, and there is no doubt that federal and civilian tactical teams are indeed in combat. But, just as ATLS did not address many of the unique factors specific to the military combat environment, TCCC does not address the differences in the military setting, the federal or civilian provider, and the non-military environment.
Civilian First Care Providers are empowered and trained community members who can serve a critical role during the initial moments after complex and dynamic disasters. These FCPs often have immediate access to severely injured victims and can provide time-sensitive, life-saving interventions; the FCP is the first link in the trauma chain of survival.
Designed for non-EMS responders including government, corporate, industry, lifeguards, security personnel, law enforcement, corrections personnel and other individuals who are not EMS or healthcare providers but desire or require advanced training in dealing with casualties stemming from active shooter or bombing incidents.
This course examines and addresses the unique and challenging requirements of administering point of wounding medical care by Fire/Rescue/EMS personnel to patients during a high-threat event. Fire/Rescue/EMS providers will learn to distinguish between life-saving and secondary interventions, and when they should be applied based on the prevailing threat to responders and patients.
As Recognized C-TECC Educational Content Providers, the training delivered by our company is in full accordance with the TECC guidelines, we teach how it was meant to be taught, according to the provider skill level. We do not deviate from acceptable standards of care nor do we teach our own version of the guidelines based on our comfort level.
We teach you the how's and why's, followed by the evidence-based tactical medicine research which justifies it. We show you all different kinds of gear and equipment and how they are best applied. We have numerous different types of tourniquets, bandages, hemostatic agents, stretchers, sleds, and training tools for you to evaluate.
Each course includes time for a full gear shake out, we will show you what you have that is worth keeping, what is junk, and what you need to be purchasing.
This is a "tactical medical course", not a "run-and-gun" or "edutainment" course, it is designed to enhance your medical skill set. Courses that include significant live fire tactical training in a 1 or 2 day format really take away from the medical didactic component.
We want you to really understand the subject matter and will dedicate as long as it takes for every student to leave with the confidence needed to act during a time of crisis.
1. The scope of practice and liability:
Federal and civilian medical responders must practice under State and local scope of practice and protocols, and are subject to both negligence and liability that the military provider is not.
2. Patient population to include geriatrics and pediatrics:
TCCC data and research was heavily based off of an 18-30-year-old population, not all age groups as represented in civilian operations.
TCCC was written primarily to address the wounded combatant and does not address high threat care for innocent non-combatants.
3. Distance, the time required, resources available for evacuation to definitive care
Most civilian cities have multiple definitive medical facilities, many with Level 1 Trauma centers, within a short distance, and both ground and air medical assets are readily available in most civilian and federal settings.
4. Differences in barriers to evacuation and care:
In civilian settings, there is far less need for concern for secondary hits or armed resistance to evacuation. In general, once clear of the immediate scene, security in the civilian setting can be assumed.
5. Baseline health of the population:
The TCCC combatant population is relatively healthy and physically fit without the high incidence of chronic medical illness that exists in the civilian population.
6. Wounding patterns:
Although the weapons are similar between military and civilian scenarios, the wounding patterns differ given the prevalence of and differences in protective ballistic gear, as well as the use of and strength of improvised explosive devices in the military setting.
7. Chronic medication use in the injured:
TCCC fails to account for and address the effects of chronic medication use, such as beta blockers and especially anti-coagulants.
Special populations including pregnant patients, mentally and physically handicapped
Special populations are prevalent in the civilian setting and the required differences in their care should not be a battlefield adjustment.
We tailor our courses to suit the specific didactic and practical needs of the unit being trained, however, all courses include variations of the following components:
The takeaway from this page, logically then, is that blind implementation of TCCC doctrine by federal and civilian first responders without consideration for these subtle differences will result in a practice that will not be as effective and potentially may be detrimental in some populations.
Similar to what TCCC did for the medical care in the military combat setting, civilian and federal first responders needed a new paradigm, a framework that defined the environment and resource constraints, and provided guidance that would allow best evidence-based management of patients to accomplish the life-saving mission.
To address this need, a diverse group of first responder experts called the Committee for Tactical Emergency Casualty Care (C-TECC) was formed and, in May 2011, held their inaugural meeting to create the Tactical Emergency Casualty Care guidelines (TECC).
These TECC guidelines, as a result, are a set of best practice recommendations for casualty management during high threat civilian tactical and rescue operations and the standard for modern pre-hospital tactical emergency medical support.
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