Navy Medicine Readiness and Training Command (NMRTC) Patuxent River [Patuxent River, MD]
Hospital Corpsman Third Class (HM3) Andrew Conklin, HM3 McKellen Jaramillo, and HM3 Rickey Samuels recently led a Tactical Combat Casualty Care (TCCC) course for fellow sailors at NMRTC Patuxent River. TCCC is a pre-hospital trauma care system specifically designed for the tactical environment. The program emphasizes rapid assessment and treatment of life-threatening injuries under stress, while minimizing the risk to the rescuer. The course covered a range of critical skills, including hemorrhage control, airway management, breathing stabilization, and shock treatment.

The sailors were guided through hands-on scenarios, simulations, and lectures throughout the week. Jaramillo reflected on the importance of the TCCC training; “We’re not just teaching a skill-we’re forging lifesaving instincts. As corpsman, understanding and mastering TCCC is not an option; it is one of the most vital responsibilities we carry.”

"Pressure reveals the truth and no matter how much training you get, our reactions under stress vary, especially in TCCC. That’s why, as instructors, we treat this duty with absolute seriousness,” added Samuels.

Participants learned to work together to quickly assess and treat casualties, prioritizing life-saving interventions as the course emphasized the importance of teamwork and communication in a high-stress environment. The main components of the TCCC course are built around three phases of care:

Care Under Fire (CUF): CUF phase focuses on the immediate actions taken while under effective enemy fire. The emphasis is on suppressing enemy fire, returning fire as directed, and taking cover. Life-saving interventions are limited to directing or performing rapid control of life-threatening extremity bleeding if feasible.

Tactical Field Care (TFC): TFC phase begins once the casualty and rescuer are no longer under effective hostile fire. This phase involves a more thorough assessment and treatment of injuries known as MARCH which address:
* Massive hemorrhage control
* Airway management- ensure a patient airway
* Respiration - assess and support breathing
* Circulation – check for and treat shock
* Hypothermia prevention
Other interventions under TFC include pain management, antibiotic administration, and wound packing.

Tactical Evacuation Care (TEC): TEC phase focuses on the care provided while the casualty is transported to a higher level of care. This phase includes:
* Continued monitoring and reassessment of the casualty's condition
* Management of any changes in the casualty's status
* Preparation for handover to the next level of medical care

Conklin is assigned to NMRTC Patuxent River and works with the Patuxent Naval Air Station Search and Rescue (SAR) squadron. He spoke about his SAR role and participating in the TCCC training, “We (SAR) extend the principles of TCCC beyond the immediate point of injury. We become the critical link, providing continuous care and ensuring seamless communication throughout the evacuation process to bridge the gap to definitive medical treatment.” Conklin enjoys the opportunity to train and feels the experience enhances his effectiveness as a rescuer.

The course ensures sailors are better equipped to provide immediate and effective medical care in tactical settings, increasing the survivability of battlefield injuries. Hospital Corpsman First Class (HM1) Walter Nitterauer was involved in the course to recertify and stated, “I think TCCC is very important not only in combat but also in a wide range of environments such as aboard ships or during field training exercises. Its principles teach all medical personnel how to provide immediate lifesaving care regardless of the situation.”

NMRTC Patuxent River offers the TCCC course monthly, ensuring sailors maintain their qualifications, as certification expires every three years.