Tactical combat casualty care ( TCCC )

[MediTech]

I think it's very important that everybody have first aid training.  I watched a video of my troop's training.  While the Service Batallion was waiting for us to come onto the scene they decided that they'd try and drag all of the people out of the truck and killed all the soldiers with spinal injuries.  If they had some training they would have known to leave them there.  Not only can first aid be used to save lives, it can also be used to prevent you from killing people.

 

[Staff Weenie]

All right folks, let's get a few things absolutely straight here.

First off - I work right next to some of these people in the HQ, and currently there is a great degree of upset over the fact that the article does not reflect the interview that was done. If I heard correctly, the quote, and headline, were taken from a document obtained under ATI, and are not reflective of the tone of the interview.

Second - The two Doctors involved in the article make me feel like a freaking useless newbie with all the tour ribbons they have - it's embarrassing to be in DEU beside them. These are extremely experienced clinicians who have deployed many times in more than a few crap holes. I know of some of the situations they've handled, they've punched their ticket......many times over!

Third - I'm part of the Standing Committee on Operational Medicine Review - I'm the Admin O (Staff Weenie). The Combat Casualty Care Working Group has only one non-clinician, non-deployed person on it - me! And I'm only there to book the rooms and handle the staffing of the results. The LCdr in the interview has stressed the need to have input from folks (medical and TCCC Cbt Arms) recently in  Kandahar to ensure that we remain up-to-date, and can adapt the training as rapidly as possible.

These decisions aren't being made by career desk jockeys.

Overall, prior to Afghanistan, the Army has had a pathetic approach to maintaining even St John's MSFA. Now, they've woken up - and as noted, they want everything, often times without understanding the full spectrum of the issue.

But here's the thing - everything is a matter of balance - do we teach everybody TCCC - even when we know that some of the skills could be dangerous in the hands of somebody that can't/doesn't maintain them? Do we blindly accept that yes, some of the folks on the course were there to fill spaces? How do we address the fact that CF H Svcs Gp is so tapped out right now, that providing the additional staff would be difficult at best? I've got no problem with 2x TCCC per Section - it's just a matter of ensuring that we are delivering the skills and knowledge to the right folks, and that we can actually support the training ourselves.

The folks that go on the course should be intelligent and motivated. That will ensure that they understand the material, and the need to keep themselves skilled.

 

[proudnurse]

Why does this come to mind: 

This "sign" in the picture was made by these Troops in reference to a speech that Senator Kerry had made, belittleing the Troops. He stated in a speech for Americans to "Get their Education or they would end up stuck in Iraq". He angered alot of people by what he had said. The Troops from this Minnesota National Guard Unit... thought that they would send him a "Message"  I've included the "Statement" from his speech also. Courtesy of U Tube

http://www.youtube.com/watch?v=vLuMWiQ6r2o

~Rebecca

 

[medaid]

Hehehehe Colin P, our medtechs were taught that a sign of 'unwarranted erection' was sometimes a way to check/confirm that the casualty had a head/spinal injury.  ;D

I've asked this question once and twice and over and over again, but WHEN are we going to move AWAY from St Johns?! It's really GREAT that St Johns has a great 'history' with the forces but honestly, the AMFR2 is not really recognized by anyone except the St Johns and us. Why dont we move to the EMR for our Reserve QL3 MedTechs so that they actually be EMPLOYED on the civi side if Para Medecine is something they would like to do? I mean we're always stressing about recruitment and retention, yet from my point of view, we cant offer many people anything if we give them AMFR2 and then tell them to wait a few years and maybe there's a chance on getting their PCP with the PRes. But sorry I digress.

Seems like StaffWennie we're only getting a portion of the story and once again the media is printing what sells. Oh well. But since we're on the topic of TCCC and stuff, I've got a question. Recently there were a few msgs asking for volunteers to take TCCC from the PRes Fd Ambs, yet one of the pre-reqs was PCP. Here's my question, WHY, if we could take motivated cbt arms soldiers and train them to do TCCC do we need to have MedTechs  who have MORE medical training then they do, have PCP in order to take the TCCC? Isn't the nature of such a course Combat Fist-Aid, to be FIRST AID? This ties into alot of the arguments here that you know... hmmm... shouldnt anyone with motivation, drive and willingness be able to take the course?

Here's another strange point,p before TCCC came out, we used to say St John's MSFA was good enough for al the troops. Uh... did we prove our selves wrong now? Just my frustrated, thrown in, two rupees.

 

[MG34]

2x TCCCs per Section!! We deployed with 2 per Platoon! As far as most Infantry NCOs are concerned everyone in the Section should be TCCC qualified,but that is a pipe dream. The question is why cannot an Infantry NCO who is TCCC qualified not get the Instructor course,or at least open more slots for the non medical branch types. Then the burden on the med system would be lessened by the units conducting their own training with the unit MO as the Med Director. It seems pretty simple to me,after all it isn't brain surgery, of course once you throw in the respective kingdoms and secret keepers it gets complicated.

 

[GINge!]

There seems to be some confusing regarding Standard First Aid, Combat Related First Aid, TCCC, and TacMed (formerly Med TCCC). Suffice to say they are all different courses and the SME's are better at describing the content than I.

I would like to see some evidence that shows what skills taught on which course resulted in life saving or injury mitigation. I'm not sure this evidence has been collected, but if it is out there, it would be interesting to determine what percentage of injuries required CRFA skills and what percentage required TCCC skills to be applied. As most of the skills taught on CRFA are also taught on TCCC, how many of the preventable deaths treated required the additional 2 techniques taught on TCCC? 

As for everyone having TCCC, I ask this: Would it be nice to require all the anesthesiologists to qualify PWT Level 3? Sure. Would it be good to have all the LAV Gunners qualified to insert a chest tube? You bet. Somewhere in that facetious example there needs to be a balance that meets our "train to need". The thing is, TCCC is an ARMY course that is supported by MedTechs ( 3 x QL5, 3 x QL3, 1 x MO). If the Army wants 2 per section trained in TCCC, then that's what we will endeavour to support. If the Army wants 100% of the TF trained TCCC, we will try to support that, but I guarantee you it will be hugely taxing on the medical community, possibly at the cost of other training. I think the current path of 100% CRFA and 2 TCCC qual per section strikes that balance of need and what we can realistically sp.

 

[one_speed]

My Reserve unit has just recieved a call for clinicians to take the TCCC instructor course through 1 Health Service Group this May to support the Reg Force Instructor Cadre.
I've seen a lot of discussion about TCCC on this forum from over the last couple of years, and obviously the course has been developed and is being run.

Does anyone have any new info about this course, ie curriculum etc.  We have the timings for each serial being run this summer (10 days - 5 classroom 5 field).

Where does this training sit in the grand sceme of things (relative to say a civi first response course) for skills taught etc. ?

Thanks,

Ian

 

[Southern Boy]

Everyone should be taught Advanced First Aid. Hey, that idiot next to you may end up being the guy who saves your hide.

 

[HItorMiss]

Hmmm I can't believe I missed this thread when it was active....

As someone here who actively used TCCC under contact (I am not the only one on the board I am sure, just the most vocal advocate) I can say without a doubt that there were not are not enough of us on the battle field. I spent the majority of a large TIC running back and forth like an idiot just to make sure some sort of medical assistance was available all over the place. I used just about everything on that course )minus treating a Tension Pneumothorax) from getting vitals to setting up a CCP to running triage. I completely agree we need more people with this course. I also agree that it is a skill that needs to be taught to those that want to learn it not space fillers. That being said the "space fillers" on my course all walked away really intrested in what they had learned so perhaps they were converted.

As for Med.Techs comment about spinal well if that vehicle is on fire or taking enemy fire I'm moving the cas ASAP cause I might kill him but I know for sure that the flames or the bullets will. We also don't do C-Spine control because once you start you cannot stop, TCCC medicine is basically quick and dirty stabilization or as near to it as you can get till the medic of the cas evac gets there to take over.

I seriously advocate TCCC as a QL4 course or as close to that as possible, it's a must have in a combat zone for as many people as possible.

 

[aesop081]

As for Med.Techs comment .....

Its ok...dont bother with anything he says

 

[HItorMiss]

Roger LOL

I just had to refute that little bit on nonsense in terms of TCCC medicine and the real world

 

[medaid]

Just remember brothers and sisters, that it is not I who say things like that  ;D

 

[Donut]

Perhaps you need to add a disclaimer to seperate you from the Island-dwelling variant 

And congrats to the GF...we'll have to go for drinks next month if you're in town.

 

[stealthylizard]

I have taken numerous first aid courses through out my life since I was young enough to be able to take them, as a civilian.  We have had people from all sorts of employment lines, sometimes even paramedics.  Constant training and retraining is necessary to retain the skills taught.  Some of the procedures for first aid change through the years, that are found more effective or safer for primary care.  Most people only re-certify when their ticket is about to expire, and if it hasn't been used, it is quickly forgotten.  I can't tell you how many times I have seen people, that are supposed to know first aid on a day to day basis, fail their re-certification.  It would be great for every member to be TCCC qualified, but they must consistently use the skill set, or it is forgotten.  Having a person do it once a year, isn't good enough, and that is what will most likely happen.  There either has to be a change in training to accommodate TCCC retention or it will be a "waste of time".

 

[medaid]

Perhaps you need to add a disclaimer to seperate you from the Island-dwelling variant 

And congrats to the GF...we'll have to go for drinks next month if you're in town.

Oh I'll be here... reasons for why in PM. Hmmm... I wander if we could just ask the Island-dwelling variant to change their handle? I don't want a disclaimer to be painted on my avatar  ;D

 

[medicineman]

There either has to be a change in training to accommodate TCCC retention or it will be a "waste of time".

Hmmm - trying to remember if this came up in the TCCC thread we had going awhile back - I'm pretty sure it did.  I was on the TPWB for the formalized course and we came up with retraining requirements for all providers to include refreshers while in theatre and to run the courses as close to deployments as possible to ensure the psychomotor retention.  There were also some required milestones to be met at various timelines vis a vis some of the important practical skills.

Since you're making that comment, can I assume that you are a TCCC provider that was on a locally developed/run course or took the new formalized version and weren't told about that?

MM

 

[stealthylizard]

Since you're making that comment, can I assume that you are a TCCC provider that was on a locally developed/run course or took the new formalized version and weren't told about that?

No, I am neither.  I was commenting based on other comments posted, some of which said the same thing I did.  I have just seen skills that are not practiced, in both the military and the civilian world.  When it comes time to actually utilize them, people are stuck trying to remember what to do, and how to do it.  We even had a medic in the oilfield that didn't know how to treat a heart attack, because it was not something she ever came across, except for her 2 year re certification practical.  If those skills are going to be of any use they must be constantly focused on.  It is kind of like 2nd language training, don't use it, lose it. 

I wasn't aware of it being brought up in a previous thread, I haven't read every single post on this site (I am still getting around to it.)  Since it was not mentioned on this one previously, it cannot be expected for all of us to know it.

 

[Greymatters]

I completely agree we need more people with this course. I also agree that it is a skill that needs to be taught to those that want to learn it not space fillers. That being said the "space fillers" on my course all walked away really intrested in what they had learned so perhaps they were converted.

If they see its relevant and useful, it tends to convert a lot of former 'space fillers'... 

 

[medicineman]

Was just wondering - we had a couple of extensive threads going on TCCC for a bit - here are a few:

http://forums.army.ca/forums/threads/39915.0.html

http://army.ca/forums/threads/26415.0.html (this one is rather lengthy).

As for people forgetting stuff, especially if it's a primary responsibility, well all I have to say is they should lose their ticket if they can't remember to refresh themselves periodically.  It's as much their own responsibility (more so in fact) to stay abreast of changes and to keep their knowledge base up as it is their employers' to make sure that they do.  There's no difference in the military - you put through the CoC that you're due for refresher and crack the books at the same time and if necessary, use some initiative and talk to someone to scare up some training or do it yourself somewhere else and claim it later (had to go that route many a time myself).

MM

 

[medicineman]

If they see its relevant and useful, it tends to convert a lot of former 'space fillers'...   

True enough - the problem is some of those space fillers are taking up spaces that people with more aptitude or who are much more motivated to do the course could be using.  Not that something like that ever happens in the CF...much  :.

MM