,TCCC Tier 3 CMC Exam – Tactical Combat
Casualty Care – Q&A (2026) | NAEMT
1. A combat medic is treating a casualty who is still under effective hostile fire.
What is the most essential treatment task to perform during this phase?
A) Applying a limb tourniquet to control massive extremity hemorrhage
B) Performing a needle decompression for a suspected tension pneumothorax
C) Establishing a surgical airway via cricothyroidotomy
D) Administering IV fluids for hypovolemic shock
Correct Answer: A) Applying a limb tourniquet to control massive extremity
hemorrhage
Rationale: During Care Under Fire (CUF), the priority is stopping life-threatening
extremity hemorrhage, as it is the leading cause of preventable death. The
tactical situation dictates only the most critical, time-sensitive interventions.
Tourniquet application is the primary action, with other interventions deferred
to the Tactical Field Care phase.
2. According to TCCC guidelines, which of the following is the leading cause of
preventable death on the battlefield?
A) Airway obstruction
B) Hemorrhage
C) Tension pneumothorax
D) Traumatic brain injury
Correct Answer: B) Hemorrhage
,Rationale: Massive hemorrhage from extremity and junctional wounds is the
primary cause of preventable death in combat trauma. TCCC protocols are
specifically designed to address this through early hemorrhage control. Airway
obstruction and tension pneumothorax are significant but rank behind
hemorrhage as leading causes.
3. What is the primary objective of the Tactical Evacuation Care (TACEVAC)
phase?
A) To return fire and suppress the enemy
B) To provide care while the casualty is being transported to a higher level of
medical care
C) To perform a comprehensive head-to-toe assessment under cover
D) To sort casualties based on their survivability
Correct Answer: B) To provide care while the casualty is being transported to a
higher level of medical care
Rationale: TACEVAC is the third phase of TCCC, focusing on continuing and
monitoring care during evacuation. It involves more deliberate assessment and
pre-evacuation procedures to ensure the casualty is stabilized for transport. This
phase bridges point-of-injury care and definitive medical treatment.
4. A casualty in the Tactical Field Care (TFC) phase presents with altered mental
status. What is the most likely cause of this finding according to TCCC principles?
A) Traumatic brain injury
B) Hypoxia
C) Hypovolemia
, D) Hypoglycemia
Correct Answer: C) Hypovolemia
Rationale: Studies have shown that hypovolemia (shock) is the likely cause of
altered mental status in trauma casualties on the battlefield. While traumatic
brain injury and hypoxia can also cause altered mental status, blood loss leading
to hypovolemia is the most common etiology in this setting.
5. Which factors influence the application of TCCC according to the guidelines?
(Select the single best answer that encompasses all)
A) Hostile fire, tactical considerations, wounding patterns, environmental
factors, training level, equipment, and evacuation delays
B) Only hostile fire and tactical considerations
C) Only wounding patterns and environmental factors
D) Only training level and equipment constraints
Correct Answer: A) Hostile fire, tactical considerations, wounding patterns,
environmental factors, training level, equipment, and evacuation delays
Rationale: Multiple factors influence TCCC, including all options listed. These
factors shape the application of TCCC principles in a dynamic combat
environment. The guidelines are designed to be flexible and adaptable to these
unique challenges.
6. What does the "A" in the MARCH PAWS algorithm stand for?
A) Airway
Casualty Care – Q&A (2026) | NAEMT
1. A combat medic is treating a casualty who is still under effective hostile fire.
What is the most essential treatment task to perform during this phase?
A) Applying a limb tourniquet to control massive extremity hemorrhage
B) Performing a needle decompression for a suspected tension pneumothorax
C) Establishing a surgical airway via cricothyroidotomy
D) Administering IV fluids for hypovolemic shock
Correct Answer: A) Applying a limb tourniquet to control massive extremity
hemorrhage
Rationale: During Care Under Fire (CUF), the priority is stopping life-threatening
extremity hemorrhage, as it is the leading cause of preventable death. The
tactical situation dictates only the most critical, time-sensitive interventions.
Tourniquet application is the primary action, with other interventions deferred
to the Tactical Field Care phase.
2. According to TCCC guidelines, which of the following is the leading cause of
preventable death on the battlefield?
A) Airway obstruction
B) Hemorrhage
C) Tension pneumothorax
D) Traumatic brain injury
Correct Answer: B) Hemorrhage
,Rationale: Massive hemorrhage from extremity and junctional wounds is the
primary cause of preventable death in combat trauma. TCCC protocols are
specifically designed to address this through early hemorrhage control. Airway
obstruction and tension pneumothorax are significant but rank behind
hemorrhage as leading causes.
3. What is the primary objective of the Tactical Evacuation Care (TACEVAC)
phase?
A) To return fire and suppress the enemy
B) To provide care while the casualty is being transported to a higher level of
medical care
C) To perform a comprehensive head-to-toe assessment under cover
D) To sort casualties based on their survivability
Correct Answer: B) To provide care while the casualty is being transported to a
higher level of medical care
Rationale: TACEVAC is the third phase of TCCC, focusing on continuing and
monitoring care during evacuation. It involves more deliberate assessment and
pre-evacuation procedures to ensure the casualty is stabilized for transport. This
phase bridges point-of-injury care and definitive medical treatment.
4. A casualty in the Tactical Field Care (TFC) phase presents with altered mental
status. What is the most likely cause of this finding according to TCCC principles?
A) Traumatic brain injury
B) Hypoxia
C) Hypovolemia
, D) Hypoglycemia
Correct Answer: C) Hypovolemia
Rationale: Studies have shown that hypovolemia (shock) is the likely cause of
altered mental status in trauma casualties on the battlefield. While traumatic
brain injury and hypoxia can also cause altered mental status, blood loss leading
to hypovolemia is the most common etiology in this setting.
5. Which factors influence the application of TCCC according to the guidelines?
(Select the single best answer that encompasses all)
A) Hostile fire, tactical considerations, wounding patterns, environmental
factors, training level, equipment, and evacuation delays
B) Only hostile fire and tactical considerations
C) Only wounding patterns and environmental factors
D) Only training level and equipment constraints
Correct Answer: A) Hostile fire, tactical considerations, wounding patterns,
environmental factors, training level, equipment, and evacuation delays
Rationale: Multiple factors influence TCCC, including all options listed. These
factors shape the application of TCCC principles in a dynamic combat
environment. The guidelines are designed to be flexible and adaptable to these
unique challenges.
6. What does the "A" in the MARCH PAWS algorithm stand for?
A) Airway
