February 15, 2023

Updates from C-TECC

Jeremy Ackerman, MD, PhD, FACEP

C-TECC is the Committee for Tactical Emergency Casualty Care which writes and maintains the guidelines that popular courses like NAEMT’s TECC course are based on.

Two significant changes to the TECC guidelines will be released later this year. The first will be a set of pediatric guidelines. We all know that “children are not just small adults” but many of the priorities found in the TECC guidelines apply equally to children. Our initial priorities – avoiding additional injuries, hemorrhage control and basic airway management are unchanged. For indirect threat care and evacuation there are some changes including differences in airway and hypothermia management. One item that the pediatric working group felt was important which was a surprise was treatment and monitoring for hypoglycemia.

The other major change is a shift in verbiage and a preamble to be more consistent with the intended philosophy. While much of the application of TECC has been in tactical or near tactical spaces, that was never the intent. TECC guidelines were meant to establish a framework for tactical medical decision making – tactical in the sense that there is an imminent external threat. In that spirit TECC guidelines should be appropriate to diverse “all-threat” environments rather than just active shooters and terrorists. The parallels between TECC and TCCC and the focus of many of the course teaching application of the TECC guidelines have driven the misperception that “TECC is just civilian TCCC” and the tendency for many to talk about and teach TECC and TCCC interchangeably.

During the discussion of the proposed pediatric guidelines at the working session in December, the group identified words and phrases which are (or at least sound) specific to military and SWAT settings. The use of specific words like “mission” and “casualty” were considered in the context of whether they were appropriate to other settings. The committee came to refer to these changes as “de-Velcroing” the guidelines – that is moving away from the equipment of military and tactical teams.

Once the Guidelines committee has approved the new guidelines, the preamble and the revision, they plan to have all the current guidelines reviewed by a technical writer to ensure that the language is consistent across all the guidelines and they will be published later this year.

All the C-TECC meetings are open meetings. There is always more work to be done and you can join by volunteering. In the spring of the year, usually at the Special Operations Medical Association (SOMA) Special Operations Medicine Scientific Assembly (SOMSA) the committee meets and identifies priorities for the coming year. This might include new guidelines to write or area of existing guidelines that need review or revision. Working groups are formed and in the fall there is a longer meeting where new guidelines and revisions are reviewed in depth. A third meeting is usually held in January at the National Emergency Medical Systems Physician meeting (NAEMSP) to do additional review if needed. You can get on the C-TECC email list to get announcements of upcoming meetings on their website.

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