TCCC: A Highly Valuable Acronym

Tactical Combat Casualty Care or “Tee Triple See” (TCCC) is a term coined by the military and now being adopted by law enforcement to designate immediate medical care given to trauma victims, but doing so under fire.


Tactical Combat Casualty Care or “Tee Triple See” (TCCC) is a term coined by the military and now being adopted by law enforcement to designate immediate medical care given to trauma victims, but doing so under fire.  This is a skill set that should be learned by everyone who regularly carries a firearm, but it’s training that’s not normally made available to non-military or non-law enforcement gun-toters.  For that very reason, the Commonwealth Criminal Justice Academy in Fredericksburg, Virginia opened its doors and recently held an “open enrollment” TCCC course.

Understand as you read this that I’ve worn one uniform or the other (military or law enforcement) for more than 30 years.  In that time I’ve had plenty of basic and advanced first-aid training, CPR, etc. I’ve also attended my fair share of SWAT schools, high risk entry schools, vehicle assault schools and more.  However, in all that time I’d never been to a school that required me to not only “handle the threat,” but also tend to the wounded.

In today’s world of terrorist attacks, active shooters in schools (or malls or office buildings), workplace violence and other threats, all of which we’ve seen in the past twelve months, it behooves us to prepare ourselves to do more than just shoot back.  Don’t get me wrong.  Shooting back is good.  In fact, superior firepower is the first best step in TCCC performance.  That said, we have to recognize reality: sometimes the needed trauma / emergency first-aid care doesn’t involve having to shoot back first.  The example I’d give you is the Boston Marathon bombing incident.  Plenty of people needed emergency medical care – but as far as anyone knew, there was no attacker to shoot back at.  No shots had been fired.

What do you do in such a situation? Do you know?  If you KNOW what to do, do you regularly carry the necessary tools and supplies to perform the emergency medical functions?

Like I said, I’ve had plenty of first-aid training across the years and I felt fairly confident (going into the class) that I’d know what to do if someone needed emergency medical assistance for whatever reason.  For years I’ve carried a small trauma pack with what I felt were the necessary supplies; and I was right about those necessary supplies if I based my judgment on the movies or what I was taught 30 years ago.  A lot has changed in 30 years and NOTHING in the movies… well, very little in the movies is ever portrayed accurately.

Now, before I go into some of the basics of what we learned, let me throw out a few caveats:

First, a TCCC course doesn’t make you an EMT or a combat medic.  It’s not meant to.

Second, SHOOTING is an intricate part of the course, so if you haven’t mastered basic marksmanship skills, then do that before taking a TCCC course.

Third, be honest with yourself: If you aren’t going to have the motivation and take the initiative to help someone (or yourself) in a high threat situation, don’t take up a space in this class that someone else could use.

Fourth, vet your instructor(s).  I was fortunate in that I already personally knew Mr. Tom Perroni, the owner/operator of the Commonwealth Criminal Justice Academy, and I am well aware of his emergency medical training and operations background.  His instructor cadre is top notch and they all teach with a passion that is obvious.  I know other instructors though, that went and took a 2-day TCCC course someplace else and then added TCCC to the list of schools they teach.  BE CAREFUL about where you get your training.

Now, with that out of the way, let me share a small piece of what I learned.  As I said, I’ve had my share of first-aid training over the years.  “A-B-C” was always an easy acronym to remember.  Airway – Bleeding – Circulation.  Make sure the patient/victim could breath, stop/control any bleeding and make sure the blood still in them as circulating (they had a heartbeat or you were performing CPR).

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