Battlefield medicine

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An illustration showing a variety of wounds from the Feldbuch der Wundarznei (Field manual for the treatment of wounds) by Hans von Gersdorff, (1517); illustration by Hans Wechtlin.

Battlefield medicine, also called field surgery and later combat casualty care, is the treatment of wounded combatants and non-combatants in or near an area of combat. Civilian medicine has been greatly advanced by procedures that were first developed to treat the wounds inflicted during combat. With the advent of advanced procedures and medical technology, even polytrauma can be survivable in modern wars. Battlefield medicine is a category of military medicine.

Chronology of medical advances on the battlefield[edit]

A US Army soldier, wounded by a Japanese sniper, undergoes surgery during the Bougainville Campaign in World War II.
  • The establishment of fully equipped and mobile field hospitals such as the Mobile Army Surgical Hospital was first practiced by the United States in World War II. It was succeeded in 2006 by the Combat Support Hospital.
  • The use of helicopters as ambulances, or MEDEVACs was first practiced in Burma in 1944. The first medivac under fire was done in Manila in 1945 where over 70 troops were extracted in five helicopters, one and two at a time.
  • The extension of emergency medicine to prehospital settings through the use of emergency medical technicians.
  • The use of Remote physiological monitoring devices on soldiers to show vital signs and biomechanical data to the medic and MEDEVAC crew before and during trauma. This allows medicine and treatment to be administered as soon as possible in the field and during extraction.

Current battlefield medicine used by the U.S military[edit]

Over the past decade combat medicine has improved drastically. Everything has been given a complete overhaul from the training to the gear. In 2011, all enlisted military medical training for the U.S. Navy, Air Force, and Army were located under one command, the Medical Education and Training Campus (METC). After attending a basic medical course there (which is similar to a civilian EMT course), the students go on to advanced training in Tactical Combat Casualty Care.[2]

Tactical Combat Casualty Care[edit]

Today, TCCC is becoming the standard of care for the tactical management of combat casualties within the Department of Defense and is the sole standard of care endorsed by both the American College of Surgeons and the National Association of EMT's for casualty management in tactical environments.[3]

TCCC is built around three definitive phases of casualty care:

  1. Care Under Fire: Care rendered at the scene of the injury while both the medic and the casualty are under hostile fire. Available medical equipment is limited to that carried by each operator and the medic. This stage focuses on a quick assessment, and placing a tourniquet on any major bleed.
  2. Tactical Field Care: Rendered once the casualty is no longer under hostile fire. Medical equipment is still limited to that carried into the field by mission personnel. Time prior to evacuation may range from a few minutes to many hours. Care here may include advanced airway treatment, IV therapy, etc. The treatment rendered varies depending on the skill level of the provider as well as the supplies available. This is when a corpsman/medic will make a triage and evacuation decision.
  3. Tactical Evacuation Care (TACEVAC): Rendered while the casualty is evacuated to a higher echelon of care. Any additional personnel and medical equipment pre-staged in these assets will be available during this phase.[4][5]

Since "90% of combat deaths occur on the battlefield before the casualty ever reaches a medical treatment facility" (Col. Ron Bellamy) TCCC focuses training on major hemorrhaging, and airway complications such as a tension-pneumothorax. This has driven the casualty fatality rate down to less than 9%.[6][7]

See also[edit]


  1. ^ Solé & Camarasa 2015, p. 38-39.
  2. ^ "METC Online". Retrieved 29 December 2014. 
  3. ^
  4. ^ "Tactical Combat Casualty Care (TCCC)". Archived from the original on 31 January 2016. Retrieved 29 December 2014. 
  5. ^ Holcomb JB, McMullin NR, Pearse L, Caruso J, Wade CE, Oetjen-Gerdes L, Champion HR, Lawnick M, Farr W, Rodriguez S, Butler FK (2007). "Causes of Death in U.S. Special Operations Forces in the Global War on Terrorism". Ann. Surg. 245: 986–91. doi:10.1097/01.sla.0000259433.03754.98. PMC 1876965Freely accessible. PMID 17522526. 
  6. ^
  7. ^ "Tactical Combat Casualty Care (TCCC)". Archived from the original on 31 January 2016. Retrieved 29 December 2014. 


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