HCB 103.5 – Tactical Combat Casualty Care Vocabulary

A set of vocabulary flashcards covering key terms and concepts from the HCB 103.5 Tactical Combat Casualty Care lecture notes.

Care Under Fire (CUF)

Initial care rendered while still under effective hostile fire; focuses mainly on returning fire and controlling massive extremity bleeding.

Tactical Field Care (TFC)

Second phase of TCCC when direct threat has subsided; more time and resources available to treat casualties.

MARCH Algorithm

TCCC treatment sequence: Massive hemorrhage, Airway, Respiration, Circulation, Head injury/Hypothermia.

Massive Hemorrhage

Life-threatening bleeding that must be controlled immediately with tourniquet or hemostatic measures.

Airway (MARCH)

Step to establish and maintain a patent airway after bleeding is controlled.

Respiration (MARCH)

Step addressing open chest wounds and tension pneumothorax; includes needle decompression.

Circulation (MARCH)

Step to gain IV/IO access and give fluids or blood products to treat shock.

Head Injury/Hypothermia

Final MARCH step: prevent hypoxia, hypotension, and heat loss to limit secondary brain injury.

Committee on TCCC (CoTCCC)

DoD body that researches and sets guidelines for battlefield trauma care.

Tourniquet

Mechanical device applied 2–3 inches above a wound to stop life-threatening extremity bleeding.

Combat Application Tourniquet (C.A.T.)

CoTCCC-approved windlass limb tourniquet widely issued to U.S. forces.

Junctional Tourniquet

Device designed to stop bleeding at groin, axilla, or neck base where limb tourniquets cannot be used.

Combat Ready Clamp (CROC)

CoTCCC-recommended junctional tourniquet that compresses large vessels at groin or axilla.

Junctional Emergency Treatment Tool (JETT)

Belt-style junctional tourniquet that uses inflatable bladders for vascular compression.

SAM Junctional Tourniquet (SJT)

Junctional tourniquet with mechanical screw pads for iliac or axillary vessel compression.

Hemostatic Dressing

Gauze or device impregnated with a clot-promoting agent for bleeding control when direct pressure alone is insufficient.

Combat Gauze

3 in × 4 yd kaolin-impregnated gauze; first-choice CoTCCC hemostatic dressing requiring 3 min direct pressure.

Celox Gauze

Chitosan-based hemostatic gauze alternative effective independent of coagulation cascade.

ChitoGauze

Muco-adhesive chitosan dressing used when Combat Gauze is unavailable.

XStat

Syringe-like applicator that injects expanding mini-sponges into deep narrow wounds to tamponade bleeding.

iTClamp

Skin-closure clamp that pinches wound edges together to create temporary hematoma and stop external head/neck bleeding.

Direct Pressure

Manual compression of a wound to halt bleeding; requires firm continuous force until other measures applied.

Junctional Hemorrhage

Bleeding where limbs join the torso (groin, axilla, buttock, perineum, proximal extremity, neck base).

Dismounted Complex Blast Injury (DCBI)

High-thigh amputations with genital and other injuries from low-buried IEDs; often causes junctional bleeding.

Hemorrhagic Shock

State of inadequate tissue perfusion from severe blood loss; signs include altered mental status and weak radial pulse.

Nasopharyngeal Airway (NPA)

Flexible tube inserted through the nostril at 90° to maintain airway in conscious or unconscious casualties.

Extraglottic Airway (i-gel)

Supraglottic device with gel cuff that seals laryngeal inlet without inflation; used in deeply unconscious casualties.

Surgical Cricothyroidotomy

Emergency surgical airway created through the cricothyroid membrane when other airway methods fail.

Cric-Key Technique

Preferred cricothyrotomy method using a curved bougie-style introducer and 5.0 cuffed Melker cannula.

Bougie-Aided Open Technique

Cricothyrotomy using a bougie to guide placement of a flanged cuffed cannula <10 mm OD.

Tension Pneumothorax

Progressive build-up of pleural air that collapses lung and shifts mediastinum, impairing breathing and circulation.

Needle Decompression (NDC)

Insertion of 14–10 g, 3.25-inch needle into chest to relieve tension pneumothorax.

5th Intercostal Space (Anterior Axillary Line)

Preferred lateral site for NDC; located at nipple level in males or infra-mammary fold in females.

2nd Intercostal Space (Mid-Clavicular Line)

Alternate anterior site for NDC; 2–3 finger-widths below mid-clavicle, never medial to nipple line.

Vented Chest Seal

Occlusive dressing with one-way vents allowing air to escape pleural space while preventing ingress; prevents tension pneumothorax.

Sucking Chest Wound

Open pneumothorax in which air moves through chest wall defect, causing lung collapse and audible sucking sound.

Pulse Oximetry

Non-invasive monitoring of hemoglobin oxygen saturation and heart rate; helps detect hypoxia and assess decompression success.

Recovery Position

Lateral posture for unconscious casualties to maintain airway and reduce aspiration risk.

Altered Mental Status

Change in cognition from TBI, shock, hypoxia, or drugs; necessitates removal of weapons and comms gear.

Shock Assessment (Weak Radial Pulse)

Absence or weakness of radial pulse indicates possible hemorrhagic shock requiring fluid resuscitation.

Burping a Chest Seal

Lifting edge of occlusive dressing briefly to release trapped pleural air when tension pneumothorax is suspected.

Primary Blast Injury

Damage from blast over-pressure that can cause lung injury and tension pneumothorax without external wounds.

3-Minute Direct Pressure Rule

Minimum time hemostatic gauze must be compressed against bleeding source to achieve clot formation (not needed for XStat).

Wound Packing

Filling wound cavity tightly with gauze directly on bleeding source before applying pressure dressing.

Hypoxia

Low tissue oxygen levels; exacerbates TBI and shock, necessitating airway management and oxygen when possible.

Traumatic Cardiac Arrest

Cardiac arrest from trauma mechanisms such as tension pneumothorax or exsanguination; treat reversible causes first.

Cervical Spine Stabilization (in Penetrating Trauma)

Generally unnecessary in isolated penetrating injuries, allowing faster airway access.

Mini-Sponges (XStat)

Compressed cellulose pellets that expand on contact with blood to create internal pressure and clotting.

Kaolin

Clot-activating clay impregnated in Combat Gauze to accelerate coagulation.

Chitosan

Crustacean-derived polymer in Celox/ChitoGauze providing muco-adhesive clotting independent of normal coagulation.