TECC EXAM ACTUAL EXAM –QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
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Core Domains:
- Direct Threat Care (Care Under Fire)
- Indirect Threat Care (Tactical Field Care)
- Evacuation Care (Tactical Evacuation Care)
- Massive Hemorrhage Control and Airway Management
- Respiration, Circulation, and Hypothermia Prevention
- Burn Management and Tactical Casualty Splinting
- Pediatric Tactical Emergency Casualty Care
- Medevac/Casevac Triaging and Coordination
- Ethical and Legal Dimensions of Tactical Medicine
Introduction
The Tactical Emergency Casualty Care (TECC) exam serves as a comprehensive assessment tool designed to evaluate a candidate's readiness to
provide high-quality medical intervention in high-threat, non-military environments. This examination rigorously measures critical knowledge and
rapid clinical decision-making skills required during dynamic, volatile situations. Structurally divided into multiple-choice and complex, scenario-based
questions, the assessment emphasizes the real-world application of evidence-based trauma care guidelines. Candidates must demonstrate
proficiency in threat assessment, resource prioritization, and life-saving interventions under extreme operational stress, ensuring compliance with
established protocols while balancing personal safety and patient stabilization priorities.
SECTION ONE: QUESTIONS 1–100
Question 1
A tactical responder is operating in an active shooter environment. The shooter is still active in the immediate vicinity, and the area is unsecure. What
is the primary medical priority for a casualty who is bleeding heavily from an extremity wound?
A. Apply a hemostatic dressing and pack the wound
B. Direct the casualty to apply self-tourniquet if able
C. Move to the casualty and perform a rapid trauma assessment
D. Initiate a needle decompression for suspected tension pneumothorax
🟢 Correct answer: B
,🔴 RATIONALE: In the Direct Threat Care phase, the primary medical priority is self-care or directing the casualty to perform life-saving
interventions if possible, minimizing the exposure of the responder to the threat.
Question 2
During a high-threat incident, a casualty is pulled into a secure hard structure (Indirect Threat Care phase) with a critical wound to the femoral artery.
A tourniquet was applied during the Direct Threat Care phase but is still allowing dark, oozing blood to escape. What is the next immediate step?
A. Remove the first tourniquet and reapply a new one higher up
B. Perform a full secondary assessment to check for other injuries
C. Apply a second tourniquet proximal to the first one
D. Convert the tourniquet to a pressure dressing immediately
🟢 Correct answer: C
🔴 RATIONALE: If the initial tourniquet does not completely stop the bleeding, a second tourniquet should be applied adjacent and proximal to the
first tourniquet to achieve complete occlusion of the vessel.
Question 3
While treating a casualty in an indirect threat environment, you observe the patient experiencing worsening respiratory distress, unilateral absent
breath sounds, and progressive jugular venous distention. Which intervention is indicated first?
A. Endotracheal intubation
B. Insertion of a nasopharyngeal airway
C. Immediate needle chest decompression
D. Administration of supplemental high-flow oxygen
🟢 Correct answer: C
🔴 RATIONALE: The signs describe a life-threatening tension pneumothorax, which requires immediate decompression using a large-bore needle or
angiocath to relieve pressure within the pleural space.
Question 4
,A tactical medical provider is selecting a site for needle chest decompression on a casualty with a suspected tension pneumothorax. According to
current guidelines, what is the preferred primary anatomical landmark?
A. Second intercostal space in the midclavicular line
B. Fifth intercostal space in the anterior axillary line
C. Fourth intercostal space in the midaxillary line
D. Third intercostal space in the parasternal line
🟢 Correct answer: A
🔴 RATIONALE: The second intercostal space in the midclavicular line remains a primary recommended site for needle chest decompression in
tactical medicine, though the fifth intercostal space at the anterior axillary line is also acceptable.
Question 5
What is the most appropriate initial method for managing a suspected open pneumothorax (sucking chest wound) in a Tactical Field Care
environment?
A. Apply a standard 4x4 gauze pad secured on all four sides
B. Apply a vented chest seal
C. Perform immediate surgical cricothyroidotomy
D. Pack the wound tightly with hemostatic gauze
🟢 Correct answer: B
🔴 RATIONALE: A vented chest seal is preferred for open chest wounds because it allows air to escape from the pleural cavity during expiration but
prevents air from entering during inspiration, reducing the risk of a tension pneumothorax.
Question 6
During the Indirect Threat Care phase, a casualty presents with an altered mental status due to severe hemorrhagic shock. What is the preferred
fluid for volume resuscitation in tactical trauma management?
A. Normal Saline (0.9% NaCl)
B. Lactated Ringer's solution
, C. Fresh whole blood or balanced blood components
D. 5% Dextrose in water (D5W)
🟢 Correct answer: C
🔴 RATIONALE: Whole blood or balanced blood components (1:1:1 plasma, platelets, and packed red blood cells) are preferred for resuscitation in
hemorrhagic shock to restore oxygen-carrying capacity and clotting factors without causing hemodilution.
Question 7
A casualty has sustained deep blast injuries to the neck and face, causing significant airway disruption and bleeding into the oropharynx. The patient
is unconscious and unable to maintain their airway. Nasopharyngeal airway insertion has failed. What is the next most definitive tactical airway
intervention?
A. Perform a surgical cricothyroidotomy
B. Attempt a blind digital intubation
C. Place the patient in the recovery position and wait for evacuation
D. Insert a supraglottic airway device
🟢 Correct answer: A
🔴 RATIONALE: In cases of severe maxillofacial trauma where standard airway adjuncts fail and the airway is obstructed by blood or structural
damage, a surgical cricothyroidotomy is the definitive technique to secure the airway.
Question 8
When managing an injured operational K9 unit during a tactical deployment, what is a primary legal and operational consideration for the tactical
medical provider?
A. K9 units must always receive medical priority over human civilian casualties
B. Providers should perform interventions within their scope and training as authorized by agency protocol
C. Veterinary medicine protocols completely override human tactical medicine directives in all zones
D. K9 physical restraint should never be applied due to animal welfare acts
🟢 Correct answer: B
DOWNLOAD PDF.
Core Domains:
- Direct Threat Care (Care Under Fire)
- Indirect Threat Care (Tactical Field Care)
- Evacuation Care (Tactical Evacuation Care)
- Massive Hemorrhage Control and Airway Management
- Respiration, Circulation, and Hypothermia Prevention
- Burn Management and Tactical Casualty Splinting
- Pediatric Tactical Emergency Casualty Care
- Medevac/Casevac Triaging and Coordination
- Ethical and Legal Dimensions of Tactical Medicine
Introduction
The Tactical Emergency Casualty Care (TECC) exam serves as a comprehensive assessment tool designed to evaluate a candidate's readiness to
provide high-quality medical intervention in high-threat, non-military environments. This examination rigorously measures critical knowledge and
rapid clinical decision-making skills required during dynamic, volatile situations. Structurally divided into multiple-choice and complex, scenario-based
questions, the assessment emphasizes the real-world application of evidence-based trauma care guidelines. Candidates must demonstrate
proficiency in threat assessment, resource prioritization, and life-saving interventions under extreme operational stress, ensuring compliance with
established protocols while balancing personal safety and patient stabilization priorities.
SECTION ONE: QUESTIONS 1–100
Question 1
A tactical responder is operating in an active shooter environment. The shooter is still active in the immediate vicinity, and the area is unsecure. What
is the primary medical priority for a casualty who is bleeding heavily from an extremity wound?
A. Apply a hemostatic dressing and pack the wound
B. Direct the casualty to apply self-tourniquet if able
C. Move to the casualty and perform a rapid trauma assessment
D. Initiate a needle decompression for suspected tension pneumothorax
🟢 Correct answer: B
,🔴 RATIONALE: In the Direct Threat Care phase, the primary medical priority is self-care or directing the casualty to perform life-saving
interventions if possible, minimizing the exposure of the responder to the threat.
Question 2
During a high-threat incident, a casualty is pulled into a secure hard structure (Indirect Threat Care phase) with a critical wound to the femoral artery.
A tourniquet was applied during the Direct Threat Care phase but is still allowing dark, oozing blood to escape. What is the next immediate step?
A. Remove the first tourniquet and reapply a new one higher up
B. Perform a full secondary assessment to check for other injuries
C. Apply a second tourniquet proximal to the first one
D. Convert the tourniquet to a pressure dressing immediately
🟢 Correct answer: C
🔴 RATIONALE: If the initial tourniquet does not completely stop the bleeding, a second tourniquet should be applied adjacent and proximal to the
first tourniquet to achieve complete occlusion of the vessel.
Question 3
While treating a casualty in an indirect threat environment, you observe the patient experiencing worsening respiratory distress, unilateral absent
breath sounds, and progressive jugular venous distention. Which intervention is indicated first?
A. Endotracheal intubation
B. Insertion of a nasopharyngeal airway
C. Immediate needle chest decompression
D. Administration of supplemental high-flow oxygen
🟢 Correct answer: C
🔴 RATIONALE: The signs describe a life-threatening tension pneumothorax, which requires immediate decompression using a large-bore needle or
angiocath to relieve pressure within the pleural space.
Question 4
,A tactical medical provider is selecting a site for needle chest decompression on a casualty with a suspected tension pneumothorax. According to
current guidelines, what is the preferred primary anatomical landmark?
A. Second intercostal space in the midclavicular line
B. Fifth intercostal space in the anterior axillary line
C. Fourth intercostal space in the midaxillary line
D. Third intercostal space in the parasternal line
🟢 Correct answer: A
🔴 RATIONALE: The second intercostal space in the midclavicular line remains a primary recommended site for needle chest decompression in
tactical medicine, though the fifth intercostal space at the anterior axillary line is also acceptable.
Question 5
What is the most appropriate initial method for managing a suspected open pneumothorax (sucking chest wound) in a Tactical Field Care
environment?
A. Apply a standard 4x4 gauze pad secured on all four sides
B. Apply a vented chest seal
C. Perform immediate surgical cricothyroidotomy
D. Pack the wound tightly with hemostatic gauze
🟢 Correct answer: B
🔴 RATIONALE: A vented chest seal is preferred for open chest wounds because it allows air to escape from the pleural cavity during expiration but
prevents air from entering during inspiration, reducing the risk of a tension pneumothorax.
Question 6
During the Indirect Threat Care phase, a casualty presents with an altered mental status due to severe hemorrhagic shock. What is the preferred
fluid for volume resuscitation in tactical trauma management?
A. Normal Saline (0.9% NaCl)
B. Lactated Ringer's solution
, C. Fresh whole blood or balanced blood components
D. 5% Dextrose in water (D5W)
🟢 Correct answer: C
🔴 RATIONALE: Whole blood or balanced blood components (1:1:1 plasma, platelets, and packed red blood cells) are preferred for resuscitation in
hemorrhagic shock to restore oxygen-carrying capacity and clotting factors without causing hemodilution.
Question 7
A casualty has sustained deep blast injuries to the neck and face, causing significant airway disruption and bleeding into the oropharynx. The patient
is unconscious and unable to maintain their airway. Nasopharyngeal airway insertion has failed. What is the next most definitive tactical airway
intervention?
A. Perform a surgical cricothyroidotomy
B. Attempt a blind digital intubation
C. Place the patient in the recovery position and wait for evacuation
D. Insert a supraglottic airway device
🟢 Correct answer: A
🔴 RATIONALE: In cases of severe maxillofacial trauma where standard airway adjuncts fail and the airway is obstructed by blood or structural
damage, a surgical cricothyroidotomy is the definitive technique to secure the airway.
Question 8
When managing an injured operational K9 unit during a tactical deployment, what is a primary legal and operational consideration for the tactical
medical provider?
A. K9 units must always receive medical priority over human civilian casualties
B. Providers should perform interventions within their scope and training as authorized by agency protocol
C. Veterinary medicine protocols completely override human tactical medicine directives in all zones
D. K9 physical restraint should never be applied due to animal welfare acts
🟢 Correct answer: B
