
Prolonged Field Care Podcast PFC Podcast: Arctic TCCC
Nov 13, 2025
Thomas Trust Have, a consultant in anesthesiology and critical care and founder of BrightBird, shares insights from his extensive experience in Arctic medicine. He discusses unique challenges like hypothermia prevention and alterations to Tactical Combat Casualty Care (TCCC) procedures in extreme cold. The conversation includes the importance of team roles, effective warming strategies, and the necessity of training with clothing on. Thomas emphasizes the critical need for proper gear, shelter considerations, and prioritizing patient warmth and safety in austere environments.
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Cold Changes The Rules Of TCCC
- Practicing medicine in extreme cold requires changes to standard TCCC because hypothermia threatens patients and teams faster than in temperate zones.
- Teamwork, scenario-based training, and gear selection become decisive factors for survival in Arctic tactical care.
Train Tourniquets With Gloves On
- Do practice hemorrhage control and tourniquet application while wearing thick gloves and multiple clothing layers to ensure competence under real conditions.
- Avoid removing gloves in extreme cold because exposed hands can get frostbite in minutes.
Rehearse Rapid Shelter And Warming Routines
- Do rehearse and assign clear team roles for rapid tent erection, stove operation, and warming medical kits so you can create a semi-controlled heated shelter within minutes.
- Start active heat sources immediately and warm IV lines, drugs, and batteries before unpacking or using them.
