Managing combat trauma on the modern battlefield represents challenges that are scarcely encountered within the civilian community. The advent of tactical combat casualty care (TCCC) represented a fundamental paradigm shift from the care of casualties (CAX) that evolved in the late 1970s. Special operations forces (SOF) engaged in combat operations, removed from conventional forces (CF) and with austere logistical support, represent a set of unique challenges, as well. The limited amount of equipment and medical supplies, coupled with delays in evacuation, add to what is already a frightening experience. Being wounded also generates great fear and anxiety in the CAX. Special operations medics, exposed to hostile fire while caring for CAX, become likely targets, resulting in the special operations medic unintentionally becoming “part of the problem, not the solution” and forcing CAX to care for themselves. The conditions associated with this type of environment demand specialized training for all SOF. We refer to this specialized training as SOF combat casualty care.
Tactical combat casualty care (TCCC) is the pre-hospital care rendered to a casualty in a tactical, combat environment. The principles of TCCC are fundamentally different from those of traditional civilian trauma care where most medical providers and medics train. These differences are based on both the unique patterns and types of wounds that are suffered in combat and the tactical conditions medical personnel face in combat. Unique combat wounds and tactical conditions make it difficult to determine which intervention to perform at what time. Besides addressing a casualty’s medical condition, responding medical personnel must also address the tactical situation faced while providing casualty care in combat. A medically correct intervention performed at the wrong time may lead to further casualties. Put another way, “good medicine may be bad tactics,” which can get the rescuer and casualty killed. To successfully navigate these issues, medical providers must have skills and training oriented to combat trauma care, as opposed to civilian trauma care.