TCCC Combat Casualty Care – Key Vocabulary

A comprehensive set of vocabulary flashcards summarizing the critical Combat Tactical Combat Casualty Care (TCCC) concepts presented in the lecture, including far-forward blood transfusion, hypothermia prevention, eye trauma management, battlefield analgesia, antibiotics, burn care, and related guidelines.

Fresh Whole Blood (FWB)

Unseparated blood collected and transfused shortly after donation; used far-forward when component therapy is unavailable.

ROLO Program

75th Ranger Regiment system that pre-screens Type O, low-titer donors to provide fresh whole blood on the battlefield.

Type O, Low-Titer Whole Blood

Universal donor whole blood with low anti-A/anti-B antibodies, minimizing hemolytic risk during emergency transfusion.

1:1:1 Resuscitation

Damage-control transfusion ratio of plasma, platelets, and red cells given in equal units to treat hemorrhagic shock.

FDA-Compliant Blood Products

Blood components collected, processed, and tested under FDA standards; theater-collected whole blood and apheresis platelets are not.

TCCC Hypothermia Prevention

Guidelines mandating early, aggressive measures to stop heat loss and add external warmth to trauma and burn casualties.

Insulation Material

Padding placed between casualty and cold ground to reduce conductive heat loss.

Active Heating Blanket

Battery-powered warming device placed on anterior torso/axillae; never applied directly to skin to avoid burns.

Hypothermia Enclosure System

Impermeable bag or shell that encapsulates casualty; upgraded with sleeping bag or additional insulation when possible.

IV Fluid Warmer

Battery device that heats resuscitation fluids to 38 °C at up to 150 mL/min to prevent infusion-induced hypothermia.

Coagulopathy of Hypothermia

Impaired blood clotting caused by even small drops in core temperature, raising bleeding-to-death risk.

Penetrating Eye Trauma

Open-globe injury requiring visual acuity check, rigid eye shield, antibiotics, and avoidance of pressure.

Visual Acuity Field Test

Rapid assessment asking casualty to read print, count fingers, detect hand motion, or perceive light.

Rigid Eye Shield

Hard protective cup placed over injured eye to prevent external pressure and extrusion of ocular contents.

Retrobulbar Hemorrhage

Bleeding within the orbit causing pain, proptosis, and vision loss; treated definitively by lateral canthotomy.

Lateral Canthotomy

Emergency procedure that cuts lateral canthal ligament to relieve orbital compartment pressure.

Combat Wound Medication Pack (CWMP)

Blister pack containing 400 mg moxifloxacin, 15 mg meloxicam, and 1 g acetaminophen XR for self-administered care.

Triple-Option Analgesia

TCCC pain control model: (1) CWMP for mild-moderate pain, (2) OTFC for severe pain without shock, (3) Ketamine for pain with shock risk.

Oral Transmucosal Fentanyl Citrate (OTFC)

800 µg fentanyl lozenge placed between cheek and gum for rapid, IV-free analgesia; may repeat once after 15 min.

Ketamine

NMDA-antagonist anesthetic providing analgesia/dissociation with minimal respiratory depression; given IM, IN, IV, or IO.

Ketamine Safety Profile

Wide therapeutic margin; even 10-fold overdoses usually result in prolonged but complete recovery.

Morphine & Fentanyl Contraindications

Do not use in hypovolemic shock, respiratory distress, unconsciousness, or severe head injury.

Naloxone (Narcan)

0.4 mg opioid antagonist given IV/IM for opioid-induced respiratory depression.

AVPU Scale

Mental status tool (Alert, responds to Voice, Pain, Unresponsive) documented before giving opioids or ketamine.

Ondansetron ODT

4 mg orally dissolving tablet antiemetic; repeat once in 15 min; preferred over promethazine.

NSAID Platelet Inhibition

Aspirin, Motrin, and Toradol impair platelet function for 7–10 days—avoid in combat zones.

Mobic (Meloxicam)

Selective NSAID that does not inhibit platelets; included in CWMP.

Fresh Trauma Antibiotics

Moxifloxacin 400 mg PO or Ertapenem 1 g IV/IM daily for all open combat wounds.

Ertapenem

Broad-spectrum carbapenem antibiotic; IV 30-min infusion or IM with lidocaine when PO meds can’t be taken.

Type I Burn (Superficial)

First-degree burn affecting only epidermis; excluded from TBSA calculations.

Rule of Nines

Method estimating burn total body surface area in 10% increments per body region.

USAISR Rule of Ten

Field formula: initial IV fluid rate = %TBSA × 10 mL/hr; add 100 mL/hr per 10 kg above 80 kg.

Heat-Reflective Shell / Blizzard Blanket

Hypothermia kit items used to cover extensive burns (>20% TBSA) and limit heat loss.

Abdominal Evisceration Care

Control bleeding, cover bowel with moist sterile dressing or impermeable barrier; single gentle reduction attempt allowed.

Hypothermia Prevention Kit

Issued set containing vapor-barrier bag, insulation, and heat sources for casualty temperature control.

Battery-Powered Monitoring

Advanced electronic vital-sign devices initiated when available per TCCC monitoring guidelines.

Sniffing Position

Airway posture—neck flexed, head extended—used if opioid/ketamine sedation reduces respirations.

Promethazine Discontinuation

CoTCCC replaced promethazine with ondansetron due to better safety and side-effect profile.

Drug Allergy Screening

Pre-deployment evaluation identifying personnel allergic to meds like NSAIDs, fluoroquinolones, or beta-lactams.

Pressure Patch (Eye)

Contraindicated covering that exerts force on injured eye; may expel ocular contents.

Tactical Eyewear

Ballistic eye protection that can serve as improvised shield and prevent eye injuries in the first place.

Compartment Syndrome of the Orbit

Analogous to extremity syndrome; pressure from bleeding threatens optic nerve and vision.

Active External Heat

Use of battery blankets or chemical packs integrated into hypothermia enclosure systems.