Section 1: Tactical Combat Casualty Care (TCCC) Phases
1. What are the three phases of TCCC?
Answer: Care Under Fire, Tactical Field Care, and Tactical Evacuation Care (TACEVAC).
2. In which phase should you apply a tourniquet to a limb with major hemorrhage?
Answer: Care Under Fire (immediate life threats are addressed while minimizing risk to provider
and patient).
3. What is the first step in Care Under Fire?
Answer: Return fire and take cover (ensure mission and safety first).
4. During Tactical Field Care, when should you check for a tension pneumothorax?
Answer: During the secondary survey or when the casualty has progressive respiratory distress.
5. What is the MARCH algorithm used for?
Answer: A systematic assessment in Tactical Field Care: Massive hemorrhage, Airway,
Respiration, Circulation, Head injury/hypothermia.
Section 2: Hemorrhage Control
6. Name three types of tourniquets approved for use in TCCC.
Answer: CAT (Combat Application Tourniquet), SOF-T (Special Operations Forces Tourniquet),
and EMT (Emergency Military Tourniquet).
7. Where should a tourniquet be placed?
Answer: High and tight on the limb, 2-3 inches above the wound (avoid joints).
8. How tight should a tourniquet be?
Answer: Until bleeding stops and the distal pulse is no longer palpable.
9. What is the maximum time a tourniquet can be left on before risking limb loss?
Answer: Up to 2 hours; beyond that, risk increases, but saving life takes priority.
10. If a tourniquet does not stop bleeding, what should you do?
Answer: Apply a second tourniquet side-by-side or above the first.
11. What is a junctional hemorrhage?
Answer: Bleeding from areas where limbs meet the torso (groin, axilla, neck).
, 12. What device is commonly used for junctional hemorrhage control in the groin?
Answer: Junctional Emergency Treatment Tool (JETT) or Combat Ready Clamp (CRoC).
13. When should hemostatic dressings be used?
Answer: For compressible hemorrhage not controlled by pressure or in junctional areas.
14. Name two hemostatic agents used in TCCC.
Answer: QuikClot Combat Gauze and Celox Gauze.
15. What is hypovolemic shock?
Answer: Shock due to significant blood loss leading to inadequate perfusion.
Section 3: Airway Management
16. What is the first step in airway management if a casualty is unconscious?
Answer: Chin lift or jaw thrust (if no spinal injury suspected).
17. When should you use a nasopharyngeal airway (NPA)?
Answer: For unconscious or semi-conscious casualties without severe head/facial trauma.
18. When is an NPA contraindicated?
Answer: Suspected basilar skull fracture or severe facial trauma.
19. What is the preferred advanced airway in TCCC for a casualty in respiratory failure?
Answer: Cricothyrotomy (surgical airway) if basic measures fail.
20. How do you confirm correct placement of an endotracheal tube?
Answer: Auscultation over the lungs and epigastrium, end-tidal CO2 detector, chest rise
symmetry.
21. What is the recovery position used for?
Answer: To maintain airway in an unconscious, breathing casualty without spinal injury.
Section 4: Respiratory Trauma
22. What are signs of a tension pneumothorax?
Answer: Respiratory distress, tracheal deviation (late sign), distended neck veins, absent breath
sounds on one side.
23. How is a tension pneumothorax treated in TCCC?
Answer: Needle decompression with a 14-gauge needle, 2nd or 3rd intercostal space
midclavicular line.