Prolonged Field Care Podcast

#1 of 2025 Top Ten: TCCC Updates

Jan 4, 2026
Dive into the latest updates on Tactical Combat Casualty Care guidelines. The hosts discuss the vital role of the TTC Committee and how literature reviews shape trauma care algorithms. Discover the shift to prioritize resuscitation over decompression in emergencies. Changes to the MARCH algorithm are on the table, along with a major overhaul of analgesics due to supply concerns. Learn about the simplified antibiotic recommendations and the importance of triage in mass casualty situations. They emphasize the need for innovative solutions and robust training for new practices.
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INSIGHT

How TCCC Update Process Works

  • TCCC updates follow focused working groups that combine literature review, AARs, and operational experience to propose changes.
  • Proposals are debated, revised, and voted before being published on Deployed Medicine.
INSIGHT

Prioritize Resuscitation Over Decompression

  • The committee favors prioritizing resuscitation because hemorrhagic shock is far more common than tension pneumothorax on the battlefield.
  • Blood and fluid resuscitation have mortality benefits within a critical early timeframe (around 15–36 minutes).
ADVICE

Swap R and C In MARCH To Reflect Priorities

  • Keep MARCH as the mnemonic but consider swapping R (resuscitation) and C (chest interventions) to emphasize fluids before chest decompression.
  • Train medics on the new sequence to avoid rigid algorithm-following that misses common causes of hypotension.
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