Facebook
Twitter
LinkedIn
Forward
Facebook
X
LinkedIn
ForwardTier 4 Tactical Combat Casualty Care-Combat Paramedic/Provider
In order to avoid preventable deaths on the battlefield due to combat injuries it is essential to provide life saving medical interventions immediately at the point of injury within the tactical environment. The Defense Health Agency (DHA), in coordination with subject matter experts from the Joint Trauma System’s (JTS) Committee on Tactical Combat Casualty Care (CoTCCC), developed a standardized training curriculum to provide evidence-based, lifesaving techniques and strategies for combat casualty care. Tier 4 Combat Paramedic and Provider (CPP) TCCC represents the most advanced level of TCCC training. Tier 4 CPP TCCC has been specifically designed for paramedics and medical providers responsible for providing advanced life-saving medical interventions at the point of injury. It is required training for all Navy physicians, physician assistants, nurses, independent duty corpsman and naval special warfare combat paramedics. This curriculum is presented with a focus on evidence based interventions and application of evidence based decision making with simulated casualty management and critical skills competency development. The course takes place over 8 days providing more than 62 hours of didactic and practical skills training with a faculty of subject matter experts from all of the target audience disciplines. Participants who complete the course and pass an online knowledge assessment (80%) along with a practical skills assessment will be certified as a TCCC-CPP medical provider.
Target Audience
This activity provides continuing education for physicians, nurses, physician assistants/associates and dental professions. 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.
Cory Gaconnet, MD
LCDR Tyrone Nagapoollay, MPAS, MSC
Hideaki Leo Tanaka, MD, FACEP
LCDR Alexandre D. Nguyen, MD
HMC Marcus Sanders
LT Cassandra Jones, BSN, RN, CEN
LCDR Jesse Wang, LCDR, MC
Disclosure: DHA J-7 staff, planners, authors, faculty, and content reviewers for this educational activity have no relevant financial or non-financial relationship(s) 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 Wednesday, August 6, 2025 - 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 Course activity.
- 62.00 ADA CERP
DHA, J-7, CEPO is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education (CDE). ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to the Commission for Continuing Education Provider Recognition at ADA.org/CERP.
DHA, J-7, CEPO designates this activity for 62.00 continuing education credits.
- 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 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 health care 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 participants who fully complete the activity, successfully submit the evaluation survey, and pass the posttest. The deadline to claim credit is Aug 6, 2025.
Access Code: Some activities require an access code to register or claim credit. Please contact the organization providing the activity for the access code. The Continuing Education Program Office (CEPO) does not provide access codes.
Accommodations: Please contact the course instructor to inquire about accommodations. For additional technical support, email [email protected].