Entries by admin

TCCC for Law Enforcement Officers Part 1

Tactical Combat Casualty Care (TCCC) has become the standard for medical care within DOD. It is slowly being adopted by law enforcement throughout the USA as more departments are embracing the fact that the first line of medical care after a felonious assault rests with the officer. The transition in the mindset over the last […]

Triage From Afar: Star Trek and Emergency Medicine

Multiple casualties in the tactical environment or a disaster area that exceed both human and materiel resources require rescuers to triage rapidly, so the limited resources may be used for the most critical casualties. In the tactical environment, one may have to do so under fire, thereby increasing the chance of sustaining injury. In disaster […]

Needle Decompression Location Reviewed

We have discussed the changing thoughts regarding the sign and symptoms of Tension Pneumothorax in the past (see here: Rethinking Tension Pneumothorax). Although this study was broad, it did not address in detail the implications of different locations of one of the more popular treatments of tension pneumothorax: needle decompression. Due to an increased incidence […]

SOFTT Added to TCCC Instructions

The SOF Tactical Tourniquet has always been TCCC approved, but until recently, it has been overlooked when it comes to official TCCC instructions and guides. Here is the link to the most recent Care Under Fire PowerPoint produced by the TCCC board that outline the instructions. Furthermore, the second link below has many other training […]

How to:One-handed Tourniquet Application

A principal learning objective taught in many tactical medical training programs is self-application of tourniquets. Although reports from current battlefields estimate the frequency of one-handed application at less 1/10 of 1% (o.oo1), it is still a valuable drill for those working alone (i.e., law enforcement officers). Unfortunately, the technique taught is often incorrect, as most […]

Importance of Training Forward Life Saving Procedures and Future Blood Protocols

In a recent article published in the Journal of Trauma Injury, Infection, and Critical Care, the authors analyzed the effect of life-saving interventions (LSI) performed by combat medics and other forward providers. The medical practitioners in the study were arranged in an EMS style hierarchy under a medical director, with the majority of medics trained […]

Out-of-hospital Airway Management in the United States

The below abstract is from Resuscitation, Volume 82, available at Science Direct. It provides a detailed examination of out-of-hospital airway management, success rates, and complicating factors. The crux of the article for tactical medics is the need to maintain skills through training, because the low ratio of calls to the need for invasive airway interventions, […]

Rethinking Tension Pneumothorax

Rethinking Tension Pneumothorax An interesting article in the Emergency Medicine Journal, “Tension Pneumothorax–Time for a Re-think?,” questions the traditional signs and symptoms of tension pneumothorax (TPT). The authors independently compiled and analyzed previous research dating from 1966 to 2003 determine if “classic” signs of TPT exist, and, if so, the rate of diagnosis. Essentially, the […]

Standard Gauze versus Hemostaic Agents: A New Look

A recent article published by the Academic Emergency Medicine journal found that when compared to standard gauze, hemostatic agents showed no improvement in hemorrhage control and prevention of re-bleeding. The findings indicated that the training is the the most important aspect of hemorrhage control. Obviously, hemostatics have their place, but they are not magic fairy-dust […]