TECC Test 2026/2027 Tactical Emergency Casualty Care – Detailed
Rationales | Graded A+ | Complete Exam-Style Questions – Pass
Guaranteed – A+ Graded
SECTION 1: DIRECT THREAT CARE / HOT ZONE (CARE UNDER FIRE)
— Questions 1–20
1. You are a tactical medic embedded with an assault element. During a high-risk
warrant service, an officer sustains a gunshot wound to the right proximal thigh. Active
arterial bleeding is visible. The threat has not been suppressed, and rounds are
impacting within 10 meters of your position. What is your immediate priority?
A. Apply a tourniquet high and tight over the trouser seam while kneeling
B. Return fire, then direct the casualty to apply self-aid tourniquet while you provide
covering fire
C. Move the casualty to a position of cover and begin wound packing with hemostatic
gauze
D. Establish an IV line with Hextend while behind ballistic shield cover
Correct Answer: B
Rationale: Under direct threat (Care Under Fire), the tactical medic's first action is to win
the firefight. CoTECC guidelines prioritize returning fire, taking cover, and directing the
casualty to self-apply a tourniquet. The medic does not delay the assault element or
become a secondary casualty by attempting interventions under fire.
,2. During an active shooter incident in a school hallway, you are operating as a solo
tactical medic with a contact team. A victim has a partial amputation of the left lower
extremity with massive hemorrhage. The shooter is in the adjacent classroom. What is
the most appropriate immediate action?
A. Apply a junctional tourniquet while the contact team enters the classroom
B. Drag the casualty to the nearest hard corner and apply a windlass tourniquet
C. Have the casualty apply direct pressure while you maintain security
D. Apply a tourniquet 2–3 inches above the injury site, then extract with the team
Correct Answer: D
Rationale: In Care Under Fire with massive extremity hemorrhage, the intervention is
rapid tourniquet application 2–3 inches above the wound (not over a joint) followed by
immediate extraction with the assault element. The tourniquet is applied before
movement only if it can be done without delaying extraction or exposing the medic to
undue risk.
3. [Ordered Response] Place the following Care Under Fire actions in the correct
sequence for a casualty with massive hemorrhage in an active threat environment:
1. Direct casualty to self-apply tourniquet
2. Return fire and take cover
3. Extract casualty to cover with assault element
4. Assess responsiveness and massive bleeding from cover
Correct Sequence: 2 → 4 → 1 → 3
,Rationale: The CoTECC CUF sequence is: (1) Engage threat/return fire and get to cover;
(2) From cover, assess responsiveness and identify life-threatening bleeding; (3) Direct
self-aid (tourniquet application); (4) Extract casualty with the team to indirect threat
care. The medic does not render care in the direct threat zone unless the casualty
cannot self-aid.
4. A SWAT team member is shot in the forearm during a barricaded suspect operation.
The suspect continues to fire intermittently from a fortified position. The casualty is
conscious, applying direct pressure with a gloved hand. The bleeding is not arterial but
is steady. What is the correct tactical decision?
A. Immediately apply a tourniquet to prevent any further blood loss
B. Apply an emergency trauma dressing and continue the mission
C. Wait until the threat is neutralized before applying any dressing
D. Apply a hemostatic gauze pack and pressure bandage when tactically feasible
Correct Answer: D
Rationale: In CUF, venous bleeding controlled by direct pressure does not mandate
tourniquet conversion if the casualty is conscious and the threat persists. The correct
action is to apply a hemostatic gauze pack and pressure dressing when tactically
feasible (during lulls or upon reaching cover), preserving the casualty's distal circulation
while maintaining mission momentum.
5. [Select All That Apply] Which of the following are appropriate actions during Care
Under Fire?
A. Moving a casualty to cover before rendering any intervention
, B. Applying a tourniquet over the knee joint for a distal lower leg amputation
C. Directing the casualty to drag themselves to a position of cover
D. Attempting endotracheal intubation behind a vehicle
E. Providing covering fire while the casualty applies self-aid
Correct Answers: A, C, E
Rationale: A is correct—extraction to cover is prioritized. C is correct—self-extraction is
encouraged in CUF. E is correct—covering fire enables self-aid. B is
incorrect—tourniquets must never be placed over joints; they must be placed 2–3 inches
above the wound on proximal skin. D is incorrect—airway interventions are deferred until
the indirect threat phase.
6. During a hostage rescue in an open warehouse, an operator is struck by
fragmentation in the left axilla. Bright red blood is spurting. The direct threat is
suppressed temporarily but the shooter is mobile and unlocated. What is the priority
intervention?
A. Apply a junctional tourniquet (SAM Junctional Tourniquet) immediately
B. Pack the axillary wound with hemostatic gauze from an IFAK
C. Apply direct pressure and extract to the rally point
D. Place a chest seal over the axilla and begin rapid evacuation
Correct Answer: C
Rationale: In a dynamic CUF environment with a mobile, unlocated threat, the priority is
extraction to a secure location. Direct pressure is the only intervention that should be
Rationales | Graded A+ | Complete Exam-Style Questions – Pass
Guaranteed – A+ Graded
SECTION 1: DIRECT THREAT CARE / HOT ZONE (CARE UNDER FIRE)
— Questions 1–20
1. You are a tactical medic embedded with an assault element. During a high-risk
warrant service, an officer sustains a gunshot wound to the right proximal thigh. Active
arterial bleeding is visible. The threat has not been suppressed, and rounds are
impacting within 10 meters of your position. What is your immediate priority?
A. Apply a tourniquet high and tight over the trouser seam while kneeling
B. Return fire, then direct the casualty to apply self-aid tourniquet while you provide
covering fire
C. Move the casualty to a position of cover and begin wound packing with hemostatic
gauze
D. Establish an IV line with Hextend while behind ballistic shield cover
Correct Answer: B
Rationale: Under direct threat (Care Under Fire), the tactical medic's first action is to win
the firefight. CoTECC guidelines prioritize returning fire, taking cover, and directing the
casualty to self-apply a tourniquet. The medic does not delay the assault element or
become a secondary casualty by attempting interventions under fire.
,2. During an active shooter incident in a school hallway, you are operating as a solo
tactical medic with a contact team. A victim has a partial amputation of the left lower
extremity with massive hemorrhage. The shooter is in the adjacent classroom. What is
the most appropriate immediate action?
A. Apply a junctional tourniquet while the contact team enters the classroom
B. Drag the casualty to the nearest hard corner and apply a windlass tourniquet
C. Have the casualty apply direct pressure while you maintain security
D. Apply a tourniquet 2–3 inches above the injury site, then extract with the team
Correct Answer: D
Rationale: In Care Under Fire with massive extremity hemorrhage, the intervention is
rapid tourniquet application 2–3 inches above the wound (not over a joint) followed by
immediate extraction with the assault element. The tourniquet is applied before
movement only if it can be done without delaying extraction or exposing the medic to
undue risk.
3. [Ordered Response] Place the following Care Under Fire actions in the correct
sequence for a casualty with massive hemorrhage in an active threat environment:
1. Direct casualty to self-apply tourniquet
2. Return fire and take cover
3. Extract casualty to cover with assault element
4. Assess responsiveness and massive bleeding from cover
Correct Sequence: 2 → 4 → 1 → 3
,Rationale: The CoTECC CUF sequence is: (1) Engage threat/return fire and get to cover;
(2) From cover, assess responsiveness and identify life-threatening bleeding; (3) Direct
self-aid (tourniquet application); (4) Extract casualty with the team to indirect threat
care. The medic does not render care in the direct threat zone unless the casualty
cannot self-aid.
4. A SWAT team member is shot in the forearm during a barricaded suspect operation.
The suspect continues to fire intermittently from a fortified position. The casualty is
conscious, applying direct pressure with a gloved hand. The bleeding is not arterial but
is steady. What is the correct tactical decision?
A. Immediately apply a tourniquet to prevent any further blood loss
B. Apply an emergency trauma dressing and continue the mission
C. Wait until the threat is neutralized before applying any dressing
D. Apply a hemostatic gauze pack and pressure bandage when tactically feasible
Correct Answer: D
Rationale: In CUF, venous bleeding controlled by direct pressure does not mandate
tourniquet conversion if the casualty is conscious and the threat persists. The correct
action is to apply a hemostatic gauze pack and pressure dressing when tactically
feasible (during lulls or upon reaching cover), preserving the casualty's distal circulation
while maintaining mission momentum.
5. [Select All That Apply] Which of the following are appropriate actions during Care
Under Fire?
A. Moving a casualty to cover before rendering any intervention
, B. Applying a tourniquet over the knee joint for a distal lower leg amputation
C. Directing the casualty to drag themselves to a position of cover
D. Attempting endotracheal intubation behind a vehicle
E. Providing covering fire while the casualty applies self-aid
Correct Answers: A, C, E
Rationale: A is correct—extraction to cover is prioritized. C is correct—self-extraction is
encouraged in CUF. E is correct—covering fire enables self-aid. B is
incorrect—tourniquets must never be placed over joints; they must be placed 2–3 inches
above the wound on proximal skin. D is incorrect—airway interventions are deferred until
the indirect threat phase.
6. During a hostage rescue in an open warehouse, an operator is struck by
fragmentation in the left axilla. Bright red blood is spurting. The direct threat is
suppressed temporarily but the shooter is mobile and unlocated. What is the priority
intervention?
A. Apply a junctional tourniquet (SAM Junctional Tourniquet) immediately
B. Pack the axillary wound with hemostatic gauze from an IFAK
C. Apply direct pressure and extract to the rally point
D. Place a chest seal over the axilla and begin rapid evacuation
Correct Answer: C
Rationale: In a dynamic CUF environment with a mobile, unlocated threat, the priority is
extraction to a secure location. Direct pressure is the only intervention that should be
