TP-C key terms

A civilian adaptation of military casualty care guidelines that organizes treatment around the level of threat at the point of injury, emphasizing rapid hemorrhage control and airway management before extraction from a hostile scene.

The military evidence-based standard for prehospital trauma care in combat, divided into care under fire, tactical field care, and tactical evacuation care phases, and the conceptual foundation for civilian tactical medicine.

The first phase of tactical casualty care, delivered while the casualty is still under effective hostile fire, prioritizing return fire, self-protection, and moving the patient to cover with only minimal interventions such as a tourniquet.

The care phase occurring once the casualty and provider are no longer under direct fire but are not yet in a secure evacuation platform, permitting a fuller assessment and interventions such as airway control, chest seals, and additional hemorrhage control.

The phase of casualty care provided during transport to a higher level of care, where monitoring, advanced airway management, blood products, and continued reassessment are performed within the limits of the moving platform.

The movement of a casualty from the point of injury through a casualty collection point to definitive care, encompassing both medical evacuation by dedicated assets and casualty evacuation by non-medical platforms of opportunity.

A designated, defensible location where casualties are gathered, triaged, and stabilized before transport, chosen for cover, concealment, and access routes for evacuation assets.

A constricting device applied proximal to a limb wound to occlude arterial flow and stop life-threatening extremity hemorrhage, applied high and tight or 2 to 3 inches above the wound when the site is visible.

Bleeding from a wound at the junction between a limb and the torso, such as the groin, axilla, or neck, where a standard tourniquet cannot be applied and wound packing or a junctional device is required.

A gauze or sponge impregnated with a clotting agent such as kaolin or chitosan, packed directly into a bleeding wound cavity and held with firm direct pressure to promote clot formation in compressible hemorrhage.

The technique of inserting gauze or hemostatic dressing deep into a bleeding wound cavity until resistance is met, then applying sustained direct pressure, used for compressible hemorrhage in areas unsuitable for a tourniquet.

A prioritized casualty assessment sequence standing for massive hemorrhage, airway, respirations, circulation, and head injury or hypothermia, used to address the most immediately lethal problems first in a tactical setting.

A life-threatening accumulation of air in the pleural space that shifts mediastinal structures and impairs venous return, treated in tactical settings by needle decompression at the second intercostal space or lateral approach.

Insertion of a large-bore needle into the pleural space to relieve a suspected tension pneumothorax, performed at the second intercostal space midclavicular line or the fourth or fifth intercostal space anterior axillary line.

An occlusive or vented dressing applied over a penetrating chest wound to prevent air entry while allowing trapped air to escape, reducing the risk of developing a tension pneumothorax.

An open penetrating chest injury that draws air audibly into the pleural space during inspiration, requiring prompt occlusion with a chest seal and monitoring for signs of tension physiology.

A soft tube inserted through the nostril into the nasopharynx to maintain patency of the upper airway in a spontaneously breathing casualty, often used when an oropharyngeal airway is poorly tolerated.

An open surgical airway created through the cricothyroid membrane to establish oxygenation when the upper airway is obstructed or inaccessible and other airway maneuvers have failed.

Active and passive measures such as insulated blankets, warming packs, and removal from wet ground used to limit heat loss in trauma casualties, because hypothermia worsens coagulopathy and acidosis.

The self-reinforcing cycle of hypothermia, acidosis, and coagulopathy that markedly increases mortality in severely bleeding trauma patients, countered by warming, hemorrhage control, and volume resuscitation.

A strategy for major hemorrhage that minimizes crystalloid use, permits permissive hypotension until bleeding is controlled, and emphasizes blood products in balanced ratios to reduce dilutional coagulopathy.

Unseparated donor blood containing red cells, plasma, and platelets, increasingly used in tactical prehospital resuscitation because it delivers balanced clotting factors and oxygen-carrying capacity in a single product.

An antifibrinolytic medication given early after major trauma hemorrhage to inhibit clot breakdown, most effective when administered within the first few hours of injury.

The process of sorting casualties by injury severity and likelihood of benefit to set treatment and evacuation priorities, using a system such as the military or NATO triage categories.

A standardized nine-line radio format used to request medical evacuation, conveying location, radio frequency and call sign, patient count and precedence, special equipment needs, and scene security information.

The area exposed to hostile fire that a casualty or rescuer must cross or occupy, influencing decisions about whether to move the patient, return fire, or use cover during care under fire.

A law enforcement or military team member whose primary role is the mission rather than medical care, whose fitness and equipment constraints shape how the tactical paramedic delivers care.

A paramedic trained and equipped to operate within a tactical team, providing medical support during operations while integrating into team movement, communication, and command structures.

A portable barrier rated to stop firearm projectiles, used by tactical teams for approach and casualty extraction, and considered when planning protected movement of a patient under threat.

Physical trauma caused by an explosion, including primary blast-wave injury to air-filled organs, secondary penetrating fragmentation, tertiary displacement, and quaternary burns or inhalation injury.

The coordinated law enforcement and medical approach to a scene with an ongoing threat, in which rescue task forces operate under protective security to reach and treat casualties before the scene is declared secure.

A mixed team of law enforcement officers providing security and fire or EMS personnel providing medical care, deployed into a warm zone to rapidly triage and remove casualties during an active threat.

An area of a scene where a threat has been contained but not fully eliminated, requiring security escort and rapid casualty care, distinct from the hot zone and the cold zone.

A standardized documentation tool recording casualty data, injuries, interventions, and vital signs across care phases, improving handoff continuity from point of injury through evacuation.

A situation report delivered to command summarizing the tactical and medical picture, including casualty numbers, injuries, treatment rendered, and resource needs, to support evacuation and reinforcement decisions.

The reassessment and possible replacement of a tourniquet with a hemostatic dressing and pressure when evacuation is delayed and the limb can be safely monitored, reducing ischemic risk.

A resuscitation approach that accepts a lower-than-normal blood pressure until hemorrhage is surgically controlled, avoiding the disruption of formed clot by aggressive fluid administration.