Tactical Combat Casualty Care: Core Principles

This chapter explores the foundational principles and phased framework of Tactical Combat Casualty Care (TCCC)—a battlefield trauma model developed by the US military to reduce preventable deaths in combat. TCCC emphasizes practical, evidence-based interventions tailored to hostile environments, structured across three operational phases: Care Under Fire, Tactical Field Care, and Tactical Evacuation Care. It focuses on managing the three leading causes of combat fatalities: massive hemorrhage, airway obstruction, and tension pneumothorax—using simple, high-impact techniques like tourniquets, airway adjuncts, and needle decompression. The chapter also contextualizes TCCC within the Indian armed forces, detailing its adaptation for high-altitude warfare, counterinsurgency operations, and resource-constrained settings. Indian forces have begun incorporating TCCC elements such as self-aid/buddy-aid, prolonged field care, and hypothermia prevention to improve survival rates in remote and hostile terrains. Beyond military use, the chapter highlights the increasing adoption of TCCC in paramilitary and civilian emergency response in India, especially in disaster-prone or conflict-heavy zones. Through collaborative training and local customization, TCCC serves as a dynamic and scalable model for trauma care—bridging battlefield protocols with civilian preparedness and enhancing India’s trauma response capabilities across sectors.