CCA 68W Course
3 Phases of the Combat Casualty Assessment - Answers-1. Care Under Fire
2. Tactical Field Care (Primary Assessment)
3. Tactical Evacuation Care
First Step of Care Under Fire - Answers-Return fire to gain fire superiority
Second Step of Care Under Fire - Answers-Direct Casualty to return fire, move to cover, apply self-aid,
and play dead
Third Step of Care Under Fire - Answers-Ask the Tactical Team leader if you have fire superiority, if so,
instruct security to move past your casualty and instruct security to wave the medic to move forward
when set.
Fourth Step of Care Under Fire - Answers-As the medic moves towards the casualty perform a visual
blood sweep and control any major life-threatening extremity bleeding using a HASTY TQ. Then, instruct
security to help you move the casualty off the "X" and onto cover.
Step 1 of Tactical Field Care - Answers-Gloves.
Step 2 of Tactical Field Care - Answers-Check for Responsiveness, feeling for a carotid pulse and breath
sounds.
, Step 3 of Tactical Field Care - Answers-Perform blood sweep from head to toe and address any bleeding
with a deliberate tq or hemostatic agent. In this step you will also check the effectiveness of previous
tqs.
Step 4 of Tactical Field Care - Answers-AIRWAY. Open the airway using the head tilt chin lift (look, listen,
feel) and secure it in place with an NPA
Step 5 of Tactical Field Care - Answers-BREATHING. Remove flick, iba, and top to expose the chest and
check for penetrating trauma to the chest. Check for equal rise and fall. Check shoulder girdles, clavicles,
sternum and ribs.
Step 6a of Tactical Field Care - Answers-CIRCULATION.
Treat any significant non-pulsating bleeding, turn any HASTY tq into deliberate or other form of bleeding
control. Reassess any packing on wounds.
Step 6b of Tactical Field Care - Answers-CIRCULATION
Need for Vascular Access. Check radial pulses, if absent, check carotid.
Step 6b of Tactical Field Care
What do you give a casualty with significant injuries, present radial pulses and normal mental status -
Answers-Saline Lock
Step 6b of Tactical Field Care
What do you give a casualty with significant injuries, absent radial pulses and altered mental status -
Answers-Saline Lock followed by TXA infusion (1GM TAX in 100mL of IV solution (NS or LR over 10 min),
then flush with 5cc of NS and administration of blood products or HEXTEND.
IO placed for casualty that required fluid resuscitation after 2nd saline lock attempt was unsuccessful.
Initiate 500 mL blood product (type 0 low titer whole blood) or Hextend wide open. Continue CCA.
3 Phases of the Combat Casualty Assessment - Answers-1. Care Under Fire
2. Tactical Field Care (Primary Assessment)
3. Tactical Evacuation Care
First Step of Care Under Fire - Answers-Return fire to gain fire superiority
Second Step of Care Under Fire - Answers-Direct Casualty to return fire, move to cover, apply self-aid,
and play dead
Third Step of Care Under Fire - Answers-Ask the Tactical Team leader if you have fire superiority, if so,
instruct security to move past your casualty and instruct security to wave the medic to move forward
when set.
Fourth Step of Care Under Fire - Answers-As the medic moves towards the casualty perform a visual
blood sweep and control any major life-threatening extremity bleeding using a HASTY TQ. Then, instruct
security to help you move the casualty off the "X" and onto cover.
Step 1 of Tactical Field Care - Answers-Gloves.
Step 2 of Tactical Field Care - Answers-Check for Responsiveness, feeling for a carotid pulse and breath
sounds.
, Step 3 of Tactical Field Care - Answers-Perform blood sweep from head to toe and address any bleeding
with a deliberate tq or hemostatic agent. In this step you will also check the effectiveness of previous
tqs.
Step 4 of Tactical Field Care - Answers-AIRWAY. Open the airway using the head tilt chin lift (look, listen,
feel) and secure it in place with an NPA
Step 5 of Tactical Field Care - Answers-BREATHING. Remove flick, iba, and top to expose the chest and
check for penetrating trauma to the chest. Check for equal rise and fall. Check shoulder girdles, clavicles,
sternum and ribs.
Step 6a of Tactical Field Care - Answers-CIRCULATION.
Treat any significant non-pulsating bleeding, turn any HASTY tq into deliberate or other form of bleeding
control. Reassess any packing on wounds.
Step 6b of Tactical Field Care - Answers-CIRCULATION
Need for Vascular Access. Check radial pulses, if absent, check carotid.
Step 6b of Tactical Field Care
What do you give a casualty with significant injuries, present radial pulses and normal mental status -
Answers-Saline Lock
Step 6b of Tactical Field Care
What do you give a casualty with significant injuries, absent radial pulses and altered mental status -
Answers-Saline Lock followed by TXA infusion (1GM TAX in 100mL of IV solution (NS or LR over 10 min),
then flush with 5cc of NS and administration of blood products or HEXTEND.
IO placed for casualty that required fluid resuscitation after 2nd saline lock attempt was unsuccessful.
Initiate 500 mL blood product (type 0 low titer whole blood) or Hextend wide open. Continue CCA.
