El objetivo de estas Guías no es otro que resumir de manera breve y concisa los pasos ideales (en ocasiones lo ideal no es lo real) para una valoración y manejo iniciales de las principales causa de muerte evitable, hasta la llegada de los Servicios de Emergencia, en los compañeros o ciudadanos heridos.
Se pretende que estas Guías aborden la asistencia inicial, en el contexto de una intervención o incidente donde exista un alto nivel de amenaza, en el que se vean involucrados los “policías de a pie”, puesto que ha quedado demostrado que son los primeros (y en ocasiones los únicos) en abordar inicialmente tanto al incidente en sí mismo, como a las víctimas si se han producido.
Un incidente con alto nivel de amenaza no se limita a sucesos como atentados terroristas con múltiples víctimas, si no que contempla también otro tipo de circunstancias como incidentes con individuos armados y/o, aglomeraciones populares con individuos violentos.
Toman como referencia las Directrices para Primeros Intervinientes con la Obligación de Asistir (First Responders with a Duty to Act) del Comité del Tactical Emergency Casualty Care que, al igual que estas Guías, son meras recomendaciones y no protocolos rígidos que deben adaptarse a la legislación vigente y, a las especificidades de cada Institución/Servicio/Organismo.
Con independencia de lo mencionado anteriormente, tienen como objetivo final estandarizar un lenguaje y unas actuaciones a nivel nacional dado que, están basadas en la evidencia científica “in vivo” y, en las lecciones aprendidas de muchos profesionales nacionales e internacionales. Estas recomendaciones/guías, no sustituirán el buen juicio clínico.
Por lo tanto, se espera que las recomendaciones que se presentan a continuación sirvan de ayuda para todo aquél personal policial que se pueda ver involucrado en un incidente con un nivel de amenaza elevado, a la hora de enfrentarse al manejo de las principales causas de muerte evitable que se producen en actuaciones con un alto nivel de amenaza.

75th Ranger Regiment Trauma Management Team (Tactical) Ranger Medic Handbook FREE pdf

Les esperamos en Nuestro Grupo en TELEGRAM 
Sociedad Iberoamericana de Emergencias https://t.me/joinchat/FpTSAEHYjNLkNbq9204IzA



SPECIAL OPERATIONS FORCES Medical Handbook Free PDF 

TACTICAL MEDICINE TACMED “Medicina Bona Locis Malis” tm. Good Medicine In Bad Places España by EMS Solutions International http://emssolutionsint.blogspot.com.es/2017/09/tactical-medicine-tacmed-espana-by-ems.html

Les esperamos en Nuestro Grupo en TELEGRAM
Sociedad Iberoamericana de Emergenciashttps://t.me/joinchat/FpTSAEHYjNLkNbq9204IzA
 


Related: 

TACTICAL MEDICINE TACMED “Medicina Bona Locis Malis” tm. Good Medicine In Bad Places España by EMS Solutions International



Bolin Chest Seal
TRAUMA DE TORAX: DOCENA DE LA MUERTE en trauma toracico

Updated Training on How To Apply and Use the Bolin Chest Seal, our valved pneumothorax chest dressing
#Trauma #Openwound #Shoot #wound #TCCC #TECC #CTECC #CoTCCC #NAEMT #TACMEDSpain #MedicinaTacticaEspaña #EETI #PeterPons #Tourniquet #Pneumothorax #NEUMOTORAX #BCON #PHTLS #ATLS #TCClefr #TC2 #TC3 #ESPAÑA #SOMA #EMSWORLD


Curso TECC TACTICAL EMERGENCY CASUALTY CARE http://emssolutionsint.blogspot.no/2012/01/tactical-combat-casualty-care-tccc.html

PHTLS


Todos Nuestros VIDEOS en YouTube https://www.youtube.com/c/RamonReyes2015 

Grupo en TELEGRAM Sociedad Iberoamericana de Emergencias
https://t.me/joinchat/FpTSAEHYjNLkNbq9204IzA


Balística de las heridas: introducción para los profesionales de la salud, del derecho, de las ciencias forenses, de las fuerzas armadas y de las fuerzas encargadas de hacer cumplir la ley http://emssolutionsint.blogspot.com/2017/04/balistica-de-las-heridas-introduccion.html
Guía para el manejo médico-quirúrgico de heridos en situación de conflicto armado by CICR http://emssolutionsint.blogspot.com/2017/09/guia-para-el-manejo-medico-quirurgico.html
CIRUGÍA DE GUERRA TRABAJAR CON RECURSOS LIMITADOS EN CONFLICTOS ARMADOS Y OTRAS SITUACIONES DE VIOLENCIA VOLUMEN 1 C. Giannou M. Baldan CICR http://emssolutionsint.blogspot.com.es/2013/01/cirugia-de-guerra-trabajar-con-recursos.html
Manual Suturas, Ligaduras, Nudos y Drenajes. Hospital Donostia, Pais Vasco. España http://emssolutionsint.blogspot.com/2017/09/manual-suturas-ligaduras-nudos-y.html
Técnicas de Suturas para Enfermería ASEPEYO y 7 tipos de suturas que tienen que conocer estudiantes de medicina http://emssolutionsint.blogspot.com/2015/01/tecnicas-de-suturas-para-enfermeria.html
Manual Práctico de Cirugía Menor. Grupo de Cirugia Menor y Dermatologia. Societat Valenciana de Medicina Familiar i Comunitaria http://emssolutionsint.blogspot.com/2013/09/manual-practico-de-cirugia-menor.html

Protocolo de Atencion para Cirugia. Ministerio de Salud Publica Rep. Dominicana. Marzo 2016 http://emssolutionsint.blogspot.com/2016/09/protocolo-de-atencion-para-cirugia.html
Manual de esterilización para centros de salud. Organización Panamericana de la Salud http://emssolutionsint.blogspot.com/2016/07/manual-de-esterilizacion-para-centros.html
Libre de Mantenimiento 
El mas ECONOMICO
Vendemos en España y Rep. Dominicana
Hacemos entrega del Sistema Completo



eeiispain@gmail.com

“UNA VIDA NO TIENE PRECIO”

TELEFUNKEN AED DISPONIBLE EN TODA AMERICA 6 AÑOS DE GARANTIA (ECONOMICO) http://goo.gl/JIYJwk

Follow me / INVITA A TUS AMIGOS A SEGUIRNOS

Contactos:


eeiispain@gmail.com


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Twitter: @DrtoleteMD

Instagram: https://www.instagram.com/drtolete/

¿Por qué el Desfibrilador TELEFUNKEN?

El DESFIBRILADOR de Telefunken es un DESFIBRILADOR AUTOMÁTICO sumamente avanzado y muy fácil de manejar.

Fruto de más de 10 años de desarrollo, y avalado por TELEFUNKEN, fabricante con más de 80 años de historia en la fabricación de dispositivos electrónicos.

El desfibrilador TELEFUNKEN cuenta con las más exigentes certificaciones.

Realiza automáticamente autodiagnósticos diarios y mensuales.

Incluye bolsa y accesorios.

Dispone de electrodos de "ADULTO" y "PEDIÁTRICOS".
Tiene 6 años de garantía.
Componentes kit de emergencias
Máscarilla de respiración con conexión de oxígeno.
Tijeras para cortar la ropa
Rasuradora.
Guantes desechables.

¿ Qué es una Parada Cardíaca?

Cada año solo en paises como España mueren más de 25.000 personas por muerte súbita.

La mayoría en entornos extrahospitalarios, y casi el 80-90 % ocasionadas por un trastorno eléctrico del corazón llamado"FIBRILACIÓN VENTRICULAR"

El único tratamiento efectivo en estos casos es la "Desfibrilación precoz".

"Por cada minuto de retraso en realizar la desfibrilación, las posibilidades de supervivencia disminuyen en más de un 10%".

¿ Qué es un desfibrilador ?

El desfibrilador semiautomático (DESA) es un pequeño aparato que se conecta a la víctima que supuestamente ha sufrido una parada cardíaca por medio de parches (electrodos adhesivos).

¿ Cómo funciona ?

SU FUNDAMENTO ES SENCILLO:

El DESA "Desfibrilador" analiza automáticamente el ritmo del corazón. Si identifica un ritmo de parada cardíaca tratable mediante la desfibrilación ( fibrilación ventricular), recomendará una descarga y deberá realizarse la misma pulsando un botón.

SU USO ES FÁCIL:

El desfibrilador va guiando al reanimador durante todo el proceso, por medio de mensajes de voz, realizando las órdenes paso a paso.

SU USO ES SEGURO:

Únicamente si detecta este ritmo de parada desfibrilable (FV) y (Taquicardia Ventricular sin Pulso) permite la aplicación de la descarga. (Si por ejemplo nos encontrásemos ante una víctima inconsciente que únicamente ha sufrido un desmayo, el desfibrilador no permitiría nunca aplicar una descarga).

¿Quién puede usar un desfibrilador TELEFUNKEN?

No es necesario que el reanimador sea médico, Enfermero o Tecnico en Emergencias Sanitarias para poder utilizar el desfibrilador.

Cualquier persona (no médico) que haya superado un curso de formación específico impartido por un centro homologado y acreditado estará capacitado y legalmente autorizado para utilizar el DESFIBRILADOR (En nuestro caso la certificacion es de validez mundial por seguir los protolos internacionales del ILCOR International Liaison Committee on Resuscitation. y Una institucion de prestigio internacional que avale que se han seguido los procedimientos tanto de formacion, ademas de los lineamientos del fabricante como es el caso de eeii.edu

TELEFUNKEN en Rep. Dominicana es parte de Emergency Educational Institute International de Florida. Estados Unidos, siendo Centro de Entrenamiento Autorizado por la American Heart Association y American Safety and Health Institute (Por lo que podemos certificar ILCOR) Acreditacion con validez en todo el mundo y al mismo tiempo certificar el lugar en donde son colocados nuestros Desfibriladores como Centros Cardioprotegidos que cumplen con todos los estanderes tanto Europeos CE como de Estados Unidos y Canada

DATOS TÉCNICOS

Dimensiones: 220 x 275 x 85mm

Peso: 2,6 Kg.

Clase de equipo: IIb

ESPECIFICACIONES

Temperatura: 0° C – + 50° C (sin electrodos)

Presión: 800 – 1060 hPa

Humedad: 0% – 95%

Máximo Grado de protección contra la humedad: IP 55

Máximo grado de protección contra golpes:IEC 601-1:1988+A1:1991+A2:1995

Tiempo en espera de las baterías: 3 años (Deben de ser cambiadas para garantizar un servicio optimo del aparato a los 3 años de uso)

Tiempo en espera de los electrodos: 3 años (Recomendamos sustitucion para mantener estandares internacionales de calidad)

Número de choques: >200

Capacidad de monitorización: > 20 horas (Significa que con una sola bateria tienes 20 horas de monitorizacion continua del paciente en caso de desastre, es optimo por el tiempo que podemos permanecer en monitorizacion del paciente posterior a la reanimacion)

Tiempo análisis ECG: < 10 segundos (En menos de 10 seg. TELEFUNKEN AED, ha hecho el diagnostico y estara listo para suministrar tratamiento de forma automatica)

Ciclo análisis + preparación del shock: < 15 segundos

Botón información: Informa sobre el tiempo de uso y el número de descargas administradas durante el evento con sólo pulsar un botón

Claras señales acústicas y visuales: guía por voz y mediante señales luminosas al reanimador durante todo el proceso de reanimación.

Metrónomo: que indica la frecuencia correcta para las compresiones torácicas. con las Guias 2015-2020, esto garantiza que al seguir el ritmo pautado de compresiones que nos indica el aparato de forma acustica y visual, podremos dar RCP de ALTA calidad con un aparato extremadamente moderno, pero economico.

Normas aplicadas: EN 60601-1:2006, EN 60601-1-4:1996, EN 60601-1:2007, EN 60601-2-4:2003

Sensibilidad y precisión:

Sensibilidad > 90%, tip. 98%,

Especificidad > 95%, tip. 96%,

Asistolia umbral < ±80μV

Protocolo de reanimación: ILCOR 2015-2020

Análisis ECG: Ritmos cardiacos tratables (VF, VT rápida), Ritmos cardiacos no tratables (asistolia, NSR, etc.)

Control de impedancia: Medición9 de la impedancia continua, detección de movimiento, detección de respiración

Control de los electrodos : Calidad del contacto

Identificación de ritmo normal de marcapasos

Lenguas: Holandés, inglés, alemán, francés, español, sueco, danés, noruega, italiano, ruso, chino

Comunicación-interfaz: USB 2.0 (El mas simple y economico del mercado)

Usuarios-interfaz: Operación de tres botones (botón de encendido/apagado , botón de choque/información.

Indicación LED: para el estado del proceso de reanimación. (Para ambientes ruidosos y en caso de personas con limitaciones acusticas)

Impulso-desfibrilación: Bifásico (Bajo Nivel de Energia, pero mayor calidad que causa menos daño al musculo cardiaco), tensión controlada

Energía de choque máxima: Energía Alta 300J (impedancia de paciente 75Ω), Energía Baja 200J

(impedancia de paciente 100Ω)





Saber mas sobre @TACMEDEspaña  

TACTICAL MEDICINE TACMED España by EMS Solutions International


http://emssolutionsint.blogspot.co.uk/2017/09/tactical-medicine-tacmed-espana-by-ems.html



Rapid Access Modular Medical Panel  

Designed by ARSOF medical operators, the RAMMP system is a fully customizable panel for trauma care and sick care providers working in fixed or temporary facilities as well as ground/air platforms.Key Features:
• Fully customizable medical panel
• Zippered center allows panel to be split in two
• Removable interchangeable pouches
• Modular pouches can accommodate mission specific customization of medical supplies
• Bridges the gap between aid bags and larger storage containers
• Comes with interchangeable high visibility labels allow for easy supply category recognition
• Folds in half for easy storage
• Material: 1000D Cordura® Nylon
• Lifetime Warranty
• Made in the USA
• Weight: 9.6lbs











ACTIVE SHOOTER MASS CASUALTY PACK W/ FREE TRAINING MODULE https://www.officersurvivalsolutions.com/products/active-shooter-kit-detail.html

The OSS Active Shooter Mass Casualty ( soft ) is a mass casualty kit containing ten (10 Individual throw kits used to treat multiple victims when involved in any penetrating trauma injury such as gunshot/s wound/s.

The OSS Active Shooter Mass Casualty Kit ( soft ) is a mass casualty kit containing ten (10 Individual throw kits used to treat multiple victims when involved in any penetrating trauma injury such as gunshot/s wound/s. This kit is contained in a compact, soft readily identifyable red pack to be deployed into the field as a sling pack or backpack by any officer, agent or rescue personnel .The pockets are set up to allow instant and immediate access to all the critical medical items.The throw kits contain a tourniquet, an OSS Combat Compression bandage, Sterile Packing Gauze, a set of nitrile gloves and a field instruction/casualty card. These individual kits can be dropped, kicked or thrown to individual victims in or around a mass casualty scene. The critical lifesaving medical items are typically used by medical staff to treat life threatening injuries such a those incurred by a single or multiple gunshots or penetrating trauma injuries resulting in massive and uncontrolled bloss loss. This Active Shooter / Mass Casualty ( soft ) is currently in use by several federal, state and local Law Enforcement, EMS, Fire Rescue and scholastic agencies and departments worlds-wide.

This Pack is also a complete training center contained in the front cover pouch. It has an individual Training Module that is removable and deployable into any environment. It has everything you need to teach any and all staff that may have to deploy these lifesaving items into a critical incident. It also comes with a Training Powerpoint to aid those learning about the use of these kits. A typical training class can take as little as under 30 minutes for most buisnesses training 25 or more individuals. 

** More Complete Training Programs available from OSS, please see Training Section in our menu on this website or contact us directly at (760) 696-0120 **

ASMC Contents;
 10 Individual Pocket Packs;
        10 Tourniquets 
        10 OSS Combat Compression Bandages
        10 Sterile Packing Gauze Packs
        10 Pair of Nitrile Glove
        10 Field Instruction / Casualty Cards
4 - Sets of Emergency Rescue Shears
4- Cohesive Bandage Wraps
4- Cloth Tapes 1'
4- Emergency Blankets
1 Complete OSS Training Module;
        4 Tourniquets
        4 OSS Combat Compression Bandages
        4 Sterile Packing Gauze Packs
        4  Pair of Nitrile Glove
        4 Field Instruction / Casualty Cards





Description

In todays society Active Shooter and Mass Casualty events are being experienced at much greater frequency than before. The fact is that Emergency Services at its quickest reponse, is generally 6-11 minutes in most urban areas, you can bleed to death in under three (3). The first initial response to any such incidents is going to be other civilians and the general public. OSS has invented numerous Advanced Bleeding Control kits designed for use by the general public. These kits are currently being used in Airports, Malls, Public Transportation Centers and Schools throughout the nation. They are designed to aid in stopping the blood loss from the most severe injuries experienced at these mass casualty events.

At OSS we have used our decades of professional experience to put together a "civilian model" of our Combat Casualty Care course that we have been teaching for several years to our nations first responders and emergency services operations. We offer this to the general public to help teach the most innovative tactics on first aid and help educate the general public on what to do on scene, how to be prepared and how to recognize the threats before they occurr.

This is one of our most popular Advanced Bleeding Control Packs to date, it includes six (6) individual Advanced Bleeding Control kits that are velcroed to an insert pack thus easily removable and readily available. These compact packs contain tourniquets, compression gauze, sterile rolled gauze, cloth medic tape and compression bandages. All of which are included in the Field Application card also contained in each kit. these kits can be thrown, kicked or slid to injured people on any surface and has bi-lateral zippers to make it easy to open with little effort. The insert is contained in our subdued colored medic backpack with identifiable PVC Patches affixed to the front and rear for rapid identification and deployment. The main backpack/bag contains its own critical medical supplies to treat several victims at the site and still contain the Insert to handout to individuals to aid others.

This and all our kits are built to the guidelines and in support of the national Stop The Bleed campaign being advertised by our federal government.

The Main Pack Contains:
SWAT T Tourniquet x 2
3" Sterile Rolled Gauuze x 6
3" OSS Combat Compression Bandage x 2
1" Cloth Medic Tape x 2
4" Kerlix Bandage Roll x 2
3" Cohesive Wrap Bandage  x 2
7.5" Rescue Shears
Nitrile Gloves / Blue / Size Large - 6 pairs
Sterile Trauma Sheet
60"x80" Emergency Survival Blanket x 6

Each Individual Advanced Bleeding Control Kits ( total of 6 ) Contain:
SOF T Tourniquet
3" Sterile Compressed Gauze Bandage
3" OSS Combat Compression Bandage
1" Cloth Medic Tape
5.5" Rescue Shears
3" Sterile Rolled Gauze x 2
Nitrile Gloves / Blue / Size Large x 2




 El curso Tactical Emergency Casualty Care (TECC) de NAEMT está basado en los principios del Tactical Combat Casualty Care (TCCC) y cumple con las guías establecidas por el Comité de Cuidado Táctico en Emergencias (C-TECC). Este curso enseña a los técnicos de emergencias médicas a cómo responder a un evento de tiroteo activo (“active shooter”) o de múltiples víctimas de trauma.

El curso de TECC está diseñado para primeros respondedores a un incidente de múltiples víctimas. Medicina Bona Locis Malis = medicina buena en lugares peligrosos.

Se describen las fases de manejo en situaciones tacticas por parte de los Rescue Task Force TFR.

TACTICAL EMERGENCY CASUALTY CARE TECC
Course # TE-18-04082-03 - Site ID# 5388
Santo Domingo, Distrito Nacional
Republica Dominicana
http://emssolutionsint.blogspot.com.es/2017/09/curso-tecc-espana-28-septiembre-2017.html

Contactos:
Dr. Ramon Reyes, MD
eeiispain@gmail.com

Alex Pacheco
809 849 9295
eeiird@gmail.com

19-20 de Mayo 2018

****CUPOS LIMITADOS****

Nos reservamos el derecho de admision

Inicio inscripcion:
01 Mayo 2018

Fin Inscripcion:
10 Mayo 2018

Cupos Limitados

Precio US$190 (156 Euros) Equivalentes Pesos Dominicanos
Deposito Cuenta Banco Popular Dominicano
RD$ Nº 759765241 (Enviar Recibo para asegurar el cupo)

Rescue Task Force RTF? / FUERZAS de TAREA de RESCATE

Guatemala military/medic special ops team. Art byDansun Photos @DansunPhotos

Todos Nuestros VIDEOS en YouTubehttps://www.youtube.com/c/RamonReyes2015

Grupo en TELEGRAM Sociedad Iberoamericana de Emergencias https://t.me/joinchat/FpTSAEHYjNLkNbq9204IzA

http://emssolutionsint.blogspot.com.es/2018/03/tactical-medics-vs-rescue-task-force.html






What is Tactical Emergency Casualty Care? by CTECC 

Tactical Emergency Casualty Care (TECC) is a set of evidenced-based and best practice trauma care guidelines for civilian high-threat pre-hospital environments.  The TECC guidelines are built upon the critical medical lessons learned by US and allied military forces over the past 15 years of conflict and codified in the doctrine of Tactical Combat Casualty Care (TCCC). Using the military TCCC guidelines as a starting point, the Committee creates the civilian high threat medical guidelines through a process of literature research, evidence evaluation, expert discussion, and civilian best practices review. The TECC guidelines are built upon the foundations of TCCC but are different to meet the unique needs of the civilian medical and operational environments.  The differences address civilian specific language, provider scope of practice, population, civilian liability, civilian mission and operational constraints, logistics, and resource acquisition.


How are TECC and TCCC similar?

Tactical Emergency Casualty Care is a set of civilian medical guidelines for high threat operations. Tactical Combat Casualty Care is a set of military medical guidelines for care of the wounded during military combat operations. The two sets of guidelines are naturally related, but each with a necessary difference in language, scope, applicability and flexibility.

There are two key unifying principles of TCCC and TECC.  First is the process of guideline development.  Both Committees are comprised of medics, physicians, academics and operational leaders.  Both Committees began with prior operational and medical lessons learned- for CoTCCC this was Vietnam and Somalia, for C-TECC this was TCCC and OIF/OEF- and rapidly evolved their recommendations based on immediate lessons learned.  Second is an understanding that success requires developing and deploying a SYSTEM of care.  In the military, TCCC’s success fundamentally lies in the fact that all personnel deploying to a combat theater were trained in the principles of TCCC.  The operational and trauma care systems were built around this training. 

This second fact is also the main limiting factor for the deployment of TCCC in the civilian setting.  As a system, TCCC cannot be deployed in the civilian setting because many recommendations run counter to civilian scope of practice and medical standards (e.g. use of hextend for resuscitation, pre-hospital antibiotics, needle decompression practiced by non medical personnel, etc.).
 

How are TECC and TCCC different?

Tactical Emergency Casualty Care is the civilian evolution and application of the military Tactical Combat Casualty Care guidelines. When discussing the differences between the two, it is important to emphasize that TECC and TCCC are not in competition with each other; although, as the pictures from the recent Boston Marathon bombing demonstrate, the bullets and explosives may be similar in civilian settings as in military combat, this does not make the military guidelines directly applicable for civilian applications.

The two sets of guidelines are naturally related, but each with a necessary difference in language, scope, applicability and flexibility.  There are three primary differences between TECC and TCCC: guideline terminology, trauma care recommendations and operational focus.

Terminology/ Language:  TCCC was written by the military special operations community to specifically address the specificities and conditions surrounding combat operations. These guidelines are researched, developed, and written with the assumption that the patient is an otherwise healthy 18-45yo soldier and that the provider is working under the military defined scope of practice.  The TCCC guidelines assume a military medical support system, military rules of engagement, and military legal precedent.  While individual recommendations such as tourniquet use are valid, TCCC as a system has limited application in the civilian setting. The TCCC courses currently being taught were not intended for civilian application. The Pre-Hospital Trauma Life Support TCCC course comes from the military PHTLS textbook, a version that was specifically written for the military medical community because the civilian PHTLS textbook had a different focus and application.

All leaders with operational experience understand that the language changes in TECC are critical.  As with the Incident Command System (ICS), common operating language is important for interagency response to complex threats.  For example, “Care Under Fire”, has variable meanings across the Fire (e.g. actual fire), EMS (e.g. fire or gunshots- but a non operational zone) and Law Enforcement (e.g. active gunfire in the area) communities. Tactical Emergency Casualty Care was created to address these system limitations and specific scope of practice challenges related to TCCC.  The C-TECC members, many of whom are active and past CoTCCC members, worked with civilian leaders to codify threat based guidelines (the core of TCCC) in a way that was easily applicable to civilian operations, legal and liability limitations and scope of practice, and in a way that is broadly applicable to the entirety of the civilian patient population.

Trauma care guidelines:  TECC and TCCC trauma recommendations are closely related. TECC places less emphasis on pre-hospital antibiotics, hextend as a resuscitation fluid, and specific product solutions.  The TECC guidelines place more emphasis on interagency communication, integrated operations between EMS, Fire and Law Enforcement, casualty extraction and evacuation, and care of non-combatant civilians. Additionally, as the civilian high threat focus continues with the results of on-going study and medical data, the recommendations of TECC will necessarily diverge in small ways from TCCC. One recent example is the 2013 pediatric TECC guidelines. Children are not accounted for in the TCCC guidelines as they are not in the military deployable population. As such, the C-TECC specifically examined the research and data specific to the pediatric population and created a specific set of recommendations for children.

Operational:  The fundamental mission difference between the military and civilian high threat operations is important.  In general, military operations focus on clearing, holding, and/or gaining territory with an emphasis on domination of enemy forces.  By definition, civilian operations are rescue operations with the key missions of limiting civilian morbidity and mortality.  Civilian first responders are sworn to “serve and protect”.  Any guidelines must acknowledge this important difference and account for rescue operations, limitations in use of force, and other regional operational requirements.
 

How can I get certified in TECC?

The TECC guidelines are open source and non-proprietary with the exception of the TECC logo.  There are currently no “official TECC courses” or a certified TECC provider/instructor.

The C-TECC believes that, though there are universal “principles” of high threat response, the application must be tailored for individual agencies based upon local resources, political climate, budget and operational experience. “Cookie cutter” or standardized courses and applications for high threat operations fail to account for the differences among first responders that vary widely jurisdiction to jurisdiction, region to region, state to state, etc. As such, the concepts and skills in these classes have to be ‘un-learned’ or ‘ignored’ because they do not fit into the specific agency SOP or scope.

TECC is not dogma, and the principles are meant to be applied uniquely by each agency that uses it, depending  on that agency's provider levels, scope of practice, culture, patient population, risk assessment, etc. We consider the TECC guidelines to be a pile of bricks; take only the bricks that fit into your operational culture and build a response program that is unique to you. Just don’t change the individual bricks! Overall, the principles of TECC are not difficult to teach – the actual medical interventions such as pressure dressings and tourniquets are now commonplace for everyday trauma. What is unique about high threat medical principles is less about what is done medically and more about when it is done, what injuries on focused on, and what can be excluded.

There are training entities that offer TECC courses. The Committee does not require any of these as your application of TECC is unique to your agency. If you cannot develop your own training, several of these companies offer a solid foundation of training. In the future, those companies and institutions that meet the principles of TECC guidelines instruction as set forth by the Committee may display a special C-TECC logo and be listed on the C-TECC.org website; until then, if you take a TECC class, make sure you check into the background and experience of the instructors first, and make sure that they are not teaching you TCCC and calling it TECC!


How can I become a TECC instructor?

There is currently no C-TECC sanctioned certification or classification as a ‘TECC instructor.” If you have the operational and educational experience to teach in your agency, if you have experience as an educator, or you are recognized by your agency as an instructor, you can take the open source TECC guidelines and create a course of instruction specific to your agency’s SOPs.


I am a certified TCCC instructor. Can I teach TECC? 

Sure, although it is certainly not required. Knowledge of TCCC is helpful as TCCC is the starting point for TECC. You must understand however that the two are not the same, and must be clear on the differences between the two.  Please also refer to the TECC skill set; at no point should skills outside of scope of practice be taught to students as a part of TECC. For example, although TECC includes needle decompression of a chest, this skill set should NOT be taught to providers if it is not specifically included in their scope of practice.  Other than that, if you are familiar with instruction of the military combat medical guidelines, then your understanding of how to instruct the civilian high threat medical guidelines should be solid!

 How can my department or agency start a TECC program? 

Implementing the TECC guidelines into your agency’s standard operations for high threat response is not as ‘heavy a lift’ or difficult as one would think. If you have an operational plan for deployment of assets and operations during situations of high threat, the medical guidelines will fit in easily. The individual TECC guidelines, such as applying a tourniquet or using hemostatic gauze, are becoming common place in everyday pre-hospital management of trauma. Remember that TECC is less about what you do and more about when you do it. Teaching the TECC guidelines to your agency should be done in a way that is specific to your agency’s culture, scope, and approach to operational training.

The Committee for Tactical Emergency Casualty Care is committed to assisting all response agencies and first responders who wish to utilize the guidelines. We have, and are working on, a variety of resources to assist you. Currently, we can provide a variety of educational articles and plenty of advice on how to get started. In the near future, we will be distributing a standard slide deck to get you started in teaching the guidelines. Feel free to contact the Committee with any questions or request for assistance.
 

Is TECC only for law enforcement and SWAT operations?

Absolutely not!!! Yes, it does have the word ‘tactical’ in its name but do not think that implies that the guidelines are for use only in law enforcement or tactical medical operations. Although the word ‘tactical’ in common use implies law enforcement associated operations, every first responder utilizes ‘tactics’ on every call every day. The Committee uses the word tactical to refer to the operational decisions that are made during response.  Every one of these operational decisions has an effect on medical care and the competing priorities of operations and medical care need to be considered in real time. TECC allows you to do just this.

TECC has applications for ALL high risk operations, where there is a real and on-going risk to both the patient and provider. Examples of high risk operations include, but are not limited to:
  • Active shooter response
  • Wilderness medicine
  • Confined space, rope and other technical rescue operations
  • Law enforcement ‘officer down’ response
  • SWAT medical support
  • Response to explosive mass casualty
  • All other mass casualty response


How can I become involved with the Committee?

The development of the TECC guidelines was a grassroots effort by a group of operational medical personnel who identified the gap when applying military medical guidelines to a non-military population and operation. We remain a grassroots effort and thus all of our meetings are open to the public and everything we produce is available to all at no charge.

Anyone can participate in the discussion regarding the TECC guidelines. We want your opinions and involvement as the guidelines are intended for all to use, not for just a few with special “certifications.’ We have two meetings a year: every December in conjunction with the Special Operations Medical Association conference in Tampa, FL, and a spring meeting at a different location every year. As a whole, about two months prior, we publish the information and logistics for our next meeting on the C-TECC website.

As a 501c3, we have bylaws that outline the different committees, the number of members on each committee, the requirements for members and the process by which one becomes an official member. Part of that process is attending at least one meeting in person. If you are interested in becoming an official member, feel free to attend a meeting, and then contact us directly and submit a CV. In the meantime, be a part of the grassroots that is our foundation. Submit comments and questions on line – all will be heard and considered!
 

Are the Committee’s meetings open to the public?

As discussed in the question regarding how to become a member, all Committee meetings are open to the public. TECC is founded on a grassroots effort to address the operational gap that exists in high threat medical operations; as such, we want and encourage your opinions and involvement.

We have two meetings a year: every December in conjunction with the Special Operations Medical Association conference in Tampa, FL, and a spring meeting at a different location every year. As a whole, about two months prior, we publish the information and logistics for our next meeting on the C-TECC website.


How can I get more information on the Committee?

Just ask! We will do all we can to answer your questions and support your operational use of the TECC guidelines. Currently on our website, under the resources tab, there are several articles on TECC and C-TECC that you can access.
 

Are there approved TECC courses?

Currently, there is no course approval or certification for TECC. As a whole, you do not need a course in TECC. We recommend that you use the in-house training staff and operational experts in your agency to create an operational paradigm and training program that is specific to your agency. That being said, there are many companies and training programs that state they teach TECC courses. Many of these are very good, but several teach military TCCC and just call it TECC. The two sets of guidelines are similar and related, but definitely different! So, if you cannot do it in-house for whatever reason and instead are seeking a TECC course, buyer beware! Do your due diligence to ensure that the content is consistent with TECC guidelines, that the instruction is matched to the students scope of practice, and that the instructional cadre has the expertise and TECC experience that they claim. In the near future, companies that agree to meet and adhere to the principles of TECC guidelines instruction being created by the Committee will be able to display a special C-TECC logo and be listed on our website to denote that the course of instruction is consistent with the TECC guidelines.


How can I get my TECC course approved?

Currently there is no ‘course approval’ process for TECC instruction. Feel free to create your TECC course utilizing the TECC guidelines as they are written. However, you must adhere to the principles of TECC – do not teach procedures outside of your student’s scope of practice, do not refer to equipment or supplies as ‘approved’ or ‘preferred’ or ‘recommended’, and do not change the language or intent of the guidelines.   

In the near future, the Committee will have a simple ‘principles of guidelines instruction’ that is an agreement between the Committee and the educational entity that will allow the course to display a special C-TECC logo to denote proper use and instruction of the guidelines.


What equipment is TECC approved?

None! The civilian patient population, the supply and equipment acquisition process, the budget and logistics of civilian response agencies and providers is completely different than the military. Just because a product is used or recommended by the military does NOT mean it is the best for civilian use. The military ‘recommended’ products are just that, recommended for the military population. These products do not take into account the aspects of civilian use including body and limb size, anticoagulation profiles, resources available, and the need for open bid acquisition.

The Committee also will not endorse products as such endorsements may be misconstrued as unethical or done with impropriety.  The C-TECC will discuss and offer existing evidence for products that have been tested and demonstrated effective, but does not specifically endorse any product.

We recommend that every agency should explore the different product solutions available and make an agency specific decision based on available unbiased scientific data as well as agency and provider preference.


Why are so many TCCC courses being taught to civilians?

Tactical Combat Casualty Care is a great military medical innovation. These concepts have saved countless lives on the battlefield, and have provided a wealth of medical data for us to build upon. Until 2011, TCCC was the only existing set of high threat medical guidelines that existed. Multiple courses were developed to teach military personnel; these courses were made available to civilians as well. 

What is interesting, however, is that even prior to the development of TECC from the TCCC guidelines, civilian personnel who were trained in TCCC through these standard courses would bring the concepts back and have to alter or change what they were taught to fit the constraints of the civilian application. Essentially, what was being done was these civilian providers were taking TCCC and making into something appropriate for civilians. This is exactly how the efforts of the Committee for Tactical Emergency Casualty Care began, and is exactly what we have codified in the TECC guidelines. 

Courses in TCCC are still being offered and taught to civilians mainly because the infrastructure exists to do so; and these students are likely going back and changing what they learned to civilian appropriate for their agencies and application. As TECC continues to grow, the Committee will continue to distribute and emphasize the need for civilian specific and appropriate training through partnerships with federal agencies, civilian training entities such as PHTLS and ITLS, and future collaboration with professional pre-hospital, operational, and medical organizations.
 

How are the guidelines updated?

The Committee meets twice a year to discuss the guidelines and make changes based on current research and data. At these meetings, we review current research, data, and case reports that are relevant to the guidelines and raise questions as to where and what changes need to be made.

As a whole, the December full committee meeting opens the discussion on any aspect of the guidelines and sets agenda for discussion and voting for the spring full committee meeting. If overwhelming data becomes available in-between meetings that show that the application of any individual guideline could cause harm, the Board of Directors will consider and make the necessary changes in real-time with the input of the Guidelines Committee and our Board of Advisor experts. An example of this process was the changes made to the TECC guidelines regarding limiting the use of Hextend after the FDA’s warning on Hextend use in critically injured patients.
 

How can I submit a comment or an article for consideration?

Please by all means submit the reference through the website! We rely on all of the first response community to assist us in identifying relevant data and research that may affect the Guidelines.


How did TECC come to be included in the HSGP National Priorities, and how is it related to MCI preparedness?

Recent events such as the mass shootings in Aurora (CO), Newtown (CT) and the bombing at the Boston Marathon have solidified the recognition that a national capability gap exists in terms of pre-hospital trauma care. The life safety of our citizens is recognized as government’s highest duty, and FEMA has named MCI preparedness as a national priority in order to address this gap. Improved out-of-hospital trauma care is integral to the successful management of mass casualty events.


How did the TECC guidelines come about?

The Committee for Tactical Emergency Casualty Care (C-TECC) was formed in 2010 to formally translate military trauma lessons learned into the civilian high-threat pre-hospital community.  The C-TECC is modeled after the highly successful Committee on Tactical Combat Casualty Care (CoTCCC) – frequently credited as one of the major initiatives that has resulted in the lowest combat mortality rates in modern history.

C-TECC brings together SME’s from EMS, fire, law enforcement and DHS/FEMA, as well as physicians from emergency departments, trauma centers and the military to develop evidence-based, best-practice principles of high-threat pre-hospital medicine.


What does TECC address that other guidelines do not?

The TECC guidelines take into account the requirements of a civilian population. This includes pediatric, geriatric, and special needs patients, as well as considerations for underlying medical conditions common in a civilian population, the characteristics and limitations of civilian EMS, and the varied types of threats that responders face.

Military treatment guidelines were developed for a very specific purpose and population – fit and healthy 18-45 year olds in a combat environment. They have been extremely successful, but these guidelines cannot be directly carried over into the civilian population without taking these differences into account.


Is this a training curriculum or an equipment product line that is being marketed?

No – the TECC initiative was undertaken in order to advance the practice of trauma care in the pre-hospital civilian environment. To accomplish this, the guidelines are freely available to all. Training and equipment vendors are encouraged to incorporate the principles of TECC into their curricula and products.

C-TECC is a not-for-profit (501c3) organization composed of subject matter experts who volunteer their time in order to benefit the public. C-TECC doesn’t offer training courses or product lines, nor does it endorse specific vendors or products.


Does FEMA or any other federal agencies support or endorse TECC?

Several federal agencies (including FEMA, DHS–Office of Health Affairs and multiple federal law enforcement agencies) have a role in the work of C-TECC, and representation on the Committee. TECC is prominently featured in the Joint Counter Terrorism Workshop Series (JCTAWS) initiative, which helps prepare urban areas for major mass casualty events.

In order to support the efforts of implementing TECC into response paradigms, the FEMA Office of Counter Terrorism and Security Preparedness is sponsoring one-day seminars conducted by Technical Assistance teams composed of members from the C-TECC. The seminar is focused on providing an executive briefing on the development and uses of the guidelines, application design into existing and new response protocols, curriculum design and implementation strategies, and instructor train-the-trainer information.


How can my jurisdiction or agency get more information or an orientation to the TECC initiative?

The Committee is working on development of an orientation program that explains the foundations of the TECC principles, describes the medical evidence behind the guidelines and offers tips for implementation and training. 
http://www.c-tecc.org/about/faq



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