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ForwardTactical Combat Casualty Care Tier 4 Combat Paramedic/Provider
This seven-day, 62-hour intensive clinical activity provides advanced medical providers—including Physicians, Physician Assistants, Nurse Practitioners, and Paramedics—with the specialized skills required to manage life-threatening trauma in high-threat, resource-constrained environments. Grounded in the latest evidence-based guidelines from the Committee on Tactical Combat Casualty Care (CoTCCC) and the Joint Trauma System (JTS), this course bridges the gap between hospital-based trauma care and the point of injury.
The curriculum follows the MARCH-PAWS treatment hierarchy (Massive Hemorrhage, Airway, Respiration, Circulation, Head/Hypothermia – Pain, Antibiotics, Wounds, Splinting). Participants engage in high-fidelity simulations that challenge clinical decision-making during the three distinct phases of combat care: Care Under Fire (CUF), Tactical Field Care (TFC), and Tactical Evacuation (TACEVAC).
Target Audience
This activity provides continuing education for physicians, nurses, and physician associates/physician assistants and physician associates/physician assistants across the Military Health System (MHS). A certificate of attendance is available for other attendees.
Learning Objectives
- Identify the mission and purpose of the Joint Trauma System and its role in combat casualty care at the unit level.
- Perform Tactical Field Care in accordance with CoTCCC Guidelines within a given combat or noncombat scenario.
- Describe the use of individual medical equipment components in accordance with Committee on Tactical Combat Casualty Care (CoTCCC) Guidelines.
- Perform Care Under Fire in accordance with CoTCCC Guidelines within a given combat or noncombat scenario.
- Describe the principles, advantages, and disadvantages of one-person drag/carry or two-person drag/carry in Care Under Fire.
- Describe the principles, roles, responsibilities, planning considerations, and management of a casualty collection point.
- Demonstrate wound packing and pressure dressing application.
- Identify any evidence-based medicine, best practices, casualty data, and Subject Matter Expert consensus on the aggressive use of tourniquets and hemorrhage control devices.
- Describe shock assessment in Tactical Field Care in accordance with CoTCCC Guidelines.
- Identify the importance of level of consciousness and radial pulse as indicators of shock in Tactical Field Care.
- Identify the signs, symptoms, and external forces that cause head injuries in Tactical Field Care.
- Identify the indications for performing a Military Acute Concussive Evaluation 2 (MACE 2) for a casualty with a suspected head injury.
- Describe cardiopulmonary resuscitation (CPR) in Tactical Field Care within a given combat or noncombat scenario.
- Identify the leading causes of preventable death due to traumatic injuries and the corresponding interventions to help increase chances of survival.
- Perform a Tactical Trauma Assessment in accordance with Committee on Tactical Combat Casualty Care (CoTCCC) Guidelines within a given combat or noncombat scenario.
- Perform massive hemorrhage control during Tactical Field Care (TFC) in accordance with Committee on Tactical Combat Casualty Care (CoTCCC) Guidelines within a given combat or noncombat scenario.
- Perform airway management during Tactical Field Care in accordance with CoTCCC Guidelines within a given combat or noncombat scenario.
- Perform assessment and management of respiration and chest trauma during Tactical Field Care in accordance with CoTCCC Guidelines.
- Perform hemorrhage control during Tactical Field Care in accordance with Co TCCC Guidelines within a given combat or noncombat scenario.
- Perform intravenous or intraosseous access on a trauma casualty during Tactical Field Care in accordance with CoTCCC Guidelines within a given combat or noncombat scenario.
- Perform tranexamic acid administration on a bleeding trauma casualty in accordance with CoTCCC Guidelines within a given combat or noncombat scenario.
- Perform fluid resuscitation as part of the management of hemorrhagic shock on a trauma casualty during Tactical Field Care in accordance with CoTCCC Guidelines within a given combat or noncombat scenario.
- Perform hypothermia prevention measures on a trauma casualty during Tactical Field Care and Tactical Evacuation Care in accordance with CoTCCC Guidelines within a given combat or noncombat scenario.
- Perform assessment and initial treatment of penetrating eye trauma during Tactical Field Care in accordance with CoTCCC Guidelines within a given combat or noncombat scenario.
- Perform analgesia administration during Tactical Field Care in accordance with CoTCCC Guidelines within a given combat or noncombat scenario.
- Perform antibiotic administration during Tactical Field Care in accordance with CoTCCC Guidelines within a given combat or noncombat scenario.
- Perform documentation of care during Tactical Field Care in accordance with CoTCCC Guidelines within a given combat or noncombat scenario.
- Perform assessment and initial treatment of burns during Tactical Field Care in accordance with CoTCCC Guidelines within a given combat or noncombat scenario.
- Perform assessment and initial treatment of fractures during Tactical Field Care in accordance with CoTCCC Guidelines within a given combat or noncombat scenario.
- Perform monitoring of a trauma casualty during Tactical Field Care in combat in accordance with CoTCCC Guidelines within a given combat or noncombat scenario.
- Perform communication during Tactical Field Care in accordance with CoTCCC Guidelines within a given combat or noncombat scenario.
- Perform documentation of care during Tactical Field Care in accordance with CoTCCC Guidelines within a given combat or noncombat scenario.
Andrew J. Naumann, IDMT/P. Presenter has no relevant financial or non-financial relationship(s) relating to the course content or with ineligible companies to disclose.
Grigorii G. Bouldo, DO. Presenter has no relevant financial or non-financial relationship(s) relating to the course content or with ineligible companies to disclose.
Robert Sikorski, MD. Presenter has no relevant financial or non-financial relationship(s) relating to the course content or with ineligible companies to disclose.
John Hoover, IDMT/P. Presenter has no relevant financial or non-financial relationship(s) relating to the course content or with ineligible companies to disclose.
Kaylin Hicks, IDMT/P. Presenter has no relevant financial or non-financial relationship(s) relating to the course content or with ineligible companies to disclose.
Disclosure: DHA J-7 staff, planners, authors, faculty, and content reviewers for this educational activity have no relevant financial or non-financial relationship(s) relating to the course content or with ineligible companies to disclose.
Available Credit
- 62.00 AAPA
DHA J-7 CEPO has been authorized by the American Academy of Physician Associates (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 62.00 hours of AAPA Category 1 CME credits. Approval is valid until Saturday, June 27, 2026 - 11:59pm ET. PAs should only claim credit commensurate with the extent of their participation.
- 62.00 ACCME Non-Physician CME Credit
DHA J-7 CEPO is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing education. ACCME Non-Physician CME Credit providers will be provided a certificate of participation for educational activities certified for AMA PRA Category 1 Credit™. ACCME Non-Physician CME Credit providers may receive a maximum of 62.00 hours for completing this activity.
- 62.00 AMA PRA Category 1 Credit™
DHA J-7 CEPO is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
DHA J-7 CEPO designated this Course for a maximum of 62.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
- 62.00 ANCC
DHA J-7 CEPO is accredited by the Joint Accreditation/Interprofessional Continuing Education (IPCE) to provide this Continuing Nursing Education Course for a maximum of 62.00 ANCC contact hours. Nurses should only claim credit commensurate with the extent of their participation in the activity.
- 62.00 Attendance
- 62.00 IPCE
In support of improving patient care, DHA J-7 CEPO is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. This activity was planned by and for the healthcare team, and learners will receive 62.00 Interprofessional Continuing Education (IPCE) credits for learning and change.
Requirements: CE/CME certificates are awarded to MHS participants who fully complete the activity, successfully submit the evaluation survey, and pass the posttest with a minimum score of 80% unless noted otherwise. The deadline to claim credit is Jun 27, 2026.
Access Code/Accommodations: Some activities require an access code to register or claim CE/CME credit. For inquiries regarding the access code or accommodations, please email MSgt Andrew J. Naumann at [email protected] .
For technical support, email [email protected].