Tactical Pre-Hospital Care Course

Lesson 1 • Tactical Medicine Overview

Defines tactical medicine and its distinction from conventional EMS. Grounds students in the mission priorities that shape all subsequent clinical decisions.

Lesson 2 • Care Under Fire Principles

Introduces the first phase of tactical care, where threat suppression precedes treatment. Students learn to balance self-preservation with immediate life-saving actions.

Lesson 3 • Legal and Ethical Foundations

Examines duty of care, scope of practice, and ethical obligations in austere settings. Students apply ethical reasoning to triage and resource allocation decisions.

Lesson 4 • Tactical Evacuation Care

Addresses care during casualty movement to definitive medical facilities. Students understand how transport mode and duration affect treatment priorities.

Lesson 1 • Musculoskeletal and Vascular Anatomy

Identifies major vessels, bones, and junctional zones relevant to traumatic injury patterns. Students use anatomical landmarks to guide tourniquet and wound-packing placement.

Lesson 2 • Cardiovascular System Essentials

Reviews cardiac anatomy, blood volume, and circulatory physiology relevant to hemorrhage and shock. Provides the physiological basis for hemorrhage control interventions.

Lesson 3 • Pathophysiology of Trauma

Synthesizes multi-system responses to traumatic injury, including the lethal triad. Students predict physiological deterioration to prioritize interventions before symptoms worsen.

Lesson 4 • Neurological System Basics

Introduces brain, spinal cord, and peripheral nerve anatomy as it relates to traumatic brain injury and altered mental status. Students interpret neurological signs in field assessments.

Lesson 1 • Reassessment and Tourniquet Conversion

Covers ongoing hemorrhage monitoring and the decision to convert tourniquets to pressure dressings. Students apply clinical criteria to safely transition care when conditions allow.

Lesson 2 • Junctional Hemorrhage Control

Addresses bleeding at the groin, axilla, and neck where tourniquets cannot be applied. Students use junctional devices and manual pressure to control high-risk bleeds.

Lesson 3 • Tourniquet Application

Covers correct tourniquet selection, placement, and tightening for extremity hemorrhage. Students practice one-handed self-application and application on unresponsive casualties.

Lesson 4 • Wound Packing and Pressure

Teaches hemostatic agent use and direct wound packing for non-tourniquet-accessible wounds. Students apply consistent pressure techniques to achieve effective hemorrhage control.

Lesson 1 • Surgical Airway Techniques

Trains needle and surgical cricothyrotomy for complete airway obstruction. Students perform the procedure on task trainers and recognize indications for immediate intervention.

Lesson 2 • Supraglottic Airway Devices

Introduces supraglottic devices as intermediate airway options when intubation is not feasible. Students practice insertion and confirm placement under simulated field conditions.

Lesson 3 • Basic Airway Adjuncts

Covers nasopharyngeal and oropharyngeal airway insertion for maintaining patency. Students select and size adjuncts based on casualty responsiveness and anatomy.

Lesson 4 • Airway Assessment and Positioning

Teaches rapid airway patency assessment and positioning techniques for unconscious casualties. Students integrate airway status into the overall casualty evaluation sequence.

Lesson 1 • Finger Thoracostomy Technique

Introduces finger thoracostomy as a definitive field decompression for intubated casualties. Students perform the procedure on task trainers and confirm successful decompression.

Lesson 2 • Chest Seal Application

Covers vented and non-vented chest seal selection and application for open chest wounds. Students practice rapid one-handed application and monitor for seal failure.

Lesson 3 • Needle Thoracostomy

Teaches needle decompression for tension pneumothorax at the second intercostal space and lateral sites. Students identify clinical deterioration requiring immediate decompression.

Lesson 4 • Hemothorax and Rib Fracture Management

Addresses field management of hemothorax and rib fractures affecting ventilation. Students apply supportive interventions and recognize when evacuation is the priority.

Lesson 1 • Shock Classification and Recognition

Differentiates hemorrhagic, obstructive, distributive, and cardiogenic shock by mechanism and signs. Students apply rapid field assessment to classify shock type and severity.

Lesson 2 • Tranexamic Acid Administration

Covers TXA mechanism, dosing, timing, and contraindications for hemorrhagic shock. Students apply the three-hour administration window and recognize contraindications.

Lesson 3 • Monitoring and Reassessment of Shock

Trains ongoing shock monitoring using clinical signs and field-available tools. Students adjust resuscitation based on reassessment findings and changing casualty status.

Lesson 4 • Vascular Access in the Field

Covers peripheral IV and intraosseous access techniques for fluid and medication delivery. Students establish access rapidly on simulated casualties in degraded conditions.

Lesson 1 • Traumatic Brain Injury Assessment

Trains rapid TBI recognition using the Glasgow Coma Scale and AVPU scale in the field. Students identify signs of herniation and prioritize oxygenation and perfusion.

Lesson 2 • Fracture Assessment and Splinting

Covers open and closed fracture identification and field splinting techniques for extremities. Students apply traction splints and improvised splints to reduce pain and prevent further injury.

Lesson 3 • Amputation and Degloving Management

Addresses traumatic amputation hemorrhage control and wound care in the field. Students apply tourniquet and dressing techniques specific to amputation injury patterns.

Lesson 4 • TBI Field Management

Covers airway protection, positioning, and hyperosmolar therapy considerations for TBI. Students apply management priorities that prevent secondary brain injury during evacuation.

Lesson 1 • Team Coordination in Mass Casualty

Trains role assignment, communication, and task delegation within a tactical medical team. Students practice structured handoffs and maintain situational awareness across the team.

Lesson 2 • Pediatric and Special Population Triage

Adapts triage and treatment priorities for pediatric, geriatric, and pregnant casualties. Students apply modified assessment tools and dosing adjustments for special populations.

Lesson 3 • Triage Principles and Systems

Introduces triage philosophy and compares field triage systems used in tactical environments. Students apply the START and SALT triage algorithms to simulated multi-casualty scenarios.

Lesson 4 • After-Action Review and Documentation

Covers systematic after-action review processes and field documentation standards post-incident. Students extract lessons learned and apply them to improve future tactical medical responses.