Combat Life Saver

Question 1

What are the 3 goals and Tactical Casualty-Combat Course?

What are the 3 Phases and goals of CLS

Answer 1

Goals of TCCC
1) Treat the casualty
2) Prevent additional casualties
3) Complete the mission

Phase I: Care Under Fire (CUF)
Prevent further casualties while controlling life-threatening bleeding. Stop massive bleeding and get out of the kill zone.

Phase II: Tactical Field Care (TFC)
Initiate or provide additional lifesaving care once no longer under effective fire. Stabilize the casualty and prevent deterioration.

Phase III: Tactical Evacuation (TACEVAC)
Safely evacuate the casualty to higher medical care while continuing treatment. Maintain stability and deliver the casualty to definitive care.

Question 2

What are the steps when conducting Tactical Field Care (TFC/Phase II)?

What is the goal for each step

Answer 2

Massive Bleeding: Control the MASSIVE bleeding with TQ and 2nd TQ

Airway: Conscious and Breathing (HTCL/NPA)

Respiratory: (Chest Seal and Identify Tension pneumothorax)

Circulation: (Ensure blood flow through 2nd TQ, Wound package + Pulse, 1380)

Hypothermia/Head Injury: (Prevent Hypothermia and ID head injury)

Question 3

What are the steps when conducting Tactical Evacuation (TACEVAC/Phase III)?

Answer 3

• Initiate 9 line, if not already done
  -Start the initial evacuation process
  -1380 or MIST
  -Constantly assess-reassess casualty

Question 4

Perform Care Under Fire (CUF)

Answer 4

-Return fire and take cover
-Direct casualty to remain engaged, move to cover, apply self aid (if able)
-Suppress fire
**Perform drag/carry to move to unresponsive/immobile casualty either cover or secure site as the tactical situation permitted
-Take out TQ from JFAK and secure weapons
-Apply High and Tight tourniquet over the uniform using casualties JFAK

Example of when someone gets shot
*Take cover and say
Hey shoot back and find cover!
I said find cover so you can do self aid!
Nothing… damn we gotta get him. Can’t do anything until we suppress the enemy.

Question 5

What do you do before Tactical Field Care?

Answer 5

Establish security perimeter/maintained tactical situational awareness
Triaged casualties as required
Took weapons/communication equipment from casualties with altered mental status
Verbalize to do MARCH PAWS

Question 6

What are the performance steps of M in MARCH PAWS

Answer 6

**Assess and treat Massive Hemorrhage (High and Tight TQ if not already done)
***Blood sweap (Neck, Armpits, Groin) unrecognized hemorrhage and controlled all sources of bleeding
**Apply additional TQ directly to the skin to the skin, 2-3 inches above bleeding sight (side by side bleeding sight if not controlled)
-Appy junctional hemorrhage control techniques using hemostatic dressing(s) (hemorrhages notes TQ amendable)

Question 7

What are the performance steps of A in MARCH PAWS

Answer 7

-AVPU Test unconscious
-Allow conscious casualty to assume any breathing position of comfort/airway.
**Use Head-Tilt-Chin-Lift to see if breathing
**Insert NPA if unconscious (could get litter)

Question 8

What are the performance steps of R in MARCH

Answer 8

Respirations
**Look for Chest front
**look for Exit back wounds
**(If yes, wipe & apply seal)
-Litter & Re-Assess
-Assess for tension pneumothorax (See if lung if larger)
-Use needle in 2nd/5th intercostal space

Question 9

What are the performance steps of C in MARCH

Answer 9

Circulation
-TQ and wound dressings/1380 for TQ Application
**Assess for Hemorrhagic shock (Check Radial Pulse, then carotid pulse)

Question 10

What are the performance steps of H in MARCH

Answer 10

Hypothermia/Head
Blanket for Hypothermia (already off the ground)
Eye Shield

Question 11

When do you call 9 Line?
What are the Lines 3, 4, 5.

Answer 11

Pref after MARCH/After treating Hypothermia

Line 3: 1A (One Casualty, Urgent)
Line 4: NPA, TQ on X limb, Dressing on, Eye shield, etc (Special/Life Support Equipment
Line 5: 1L (One Casualty that can’t walk)

Question 12

What is PAWS and when do you start this?

Answer 12

Start it after you’ve treated all the primary MARCH

Pain AVPU
Antibiotics AVPU
Wounds
Splint

Question 13

What is shock?

How do you know if shock?

How do you manage it?

Answer 13

Inadequate bloodflow to body tissues.

*Absent or very weak radial pulse mainly.
*Mental confusion secondary
*If in shock, AVPU every 15m to best monitor if condition worsens

Best to prevent it.
Place in recovery

-Remember to annotate 1380