tccc asm
Tactical Combat Casualty Care for All Service Members (TCCC ASM, Tier 1): Care Under Fire/Threat, Tactical Field Care (bleeding, airway, chest wounds, hypothermia, eye and burn care), pain medication, the DD Form 1380 TCCC Card, TACEVAC and the Tier 1 training rules. Sources: CoTCCC TCCC Guidelines 2026, DoDI 1322.24 (Change 1, 2022), Army TCCC tiered-training standard (Aug 2025), DD Form 1380 instructions (Jul 2025).
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01What is the TCCC All Service Members (ASM) course also called?
The TCCC Tier 1 training course. DoDI 1322.24 Change 1 calls the All Service Members course the Tier 1 course.
VERIFIED AGAINST THE SOURCE
“TCCC All Service Members training course, also referred to as the TCCC Tier 1 training course”
— DoDI 1322.24, Medical Readiness Training (16 Mar 2018, Change 1 15 Feb 2022), p. 4 ↗02Which Service members are considered Tier 1 and must complete TCCC ASM?
All officers and enlisted who have not completed Combat Lifesaver, Combat Medic/Corpsman, or Combat Paramedic/Provider training. They complete Tier 1 TCCC per the JTS skills list.
VERIFIED AGAINST THE SOURCE
“All Service members (officer and enlisted) that have not completed Combat Lifesaver Course, Combat Medic / Corpsman, or Combat Paramedic / Provider training are considered Tier 1 and will complete Tier 1 TCCC for Personnel IAW training and certification as outlined in the JTS's TCCC skills list”
— Army Standards for Executing DoD TCCC Tiered Training (14 Aug 2025), p. 3 ↗03What are the four role-based TCCC skill levels named in DoDI 1322.24?
All Service Members, combat lifesaver, combat medic/hospital corpsman/aerospace medicine technician, and combat paramedic/provider. Each Service member trains and certifies at the level that fits the role.
VERIFIED AGAINST THE SOURCE
“All Service members, combat lifesaver, combat medic/hospital corpsman/aerospace medicine technician, combat paramedic/provider”
— DoDI 1322.24, Medical Readiness Training (16 Mar 2018, Change 1 15 Feb 2022), p. 3 ↗04Under DoDI 1322.24, what does the All Service Member TCCC course replace?
The trauma skills the Services used to teach in first aid and self-aid buddy care courses. TCCC is the DoD standard of care for first responders, medical and non-medical.
VERIFIED AGAINST THE SOURCE
“All Service Member TCCC course replaces Service trauma skills currently taught in first aid and self-aid buddy care courses”
— DoDI 1322.24, Medical Readiness Training (16 Mar 2018, Change 1 15 Feb 2022), p. 3 ↗05How often must Service members retake TCCC ASM?
It depends on the Service. Change 1 of DoDI 1322.24 made ASM frequency a Service decision, as long as everyone is trained before deploying. The Army requires it every year for the Active Army and every two years for the Reserve and National Guard.
VERIFIED AGAINST THE SOURCE
“the TCCC-ASM recertification and refresher for Component (Compo) 1 Active Army is annually required, Compo 2 Reserve Component and Compo 3 National Guard requirement is biennial”
— Army Standards for Executing DoD TCCC Tiered Training (14 Aug 2025), p. 3 ↗06What are the prerequisites for the TCCC ASM course?
There are none. Any Service member can take it, but it is aimed mainly at non-medical personnel.
VERIFIED AGAINST THE SOURCE
“There are no prerequisites for this course. The course can be taught to all Service members, but is primarily intended for nonmedical personnel.”
— Army Standards for Executing DoD TCCC Tiered Training (14 Aug 2025), p. 4 ↗07How often must a TCCC ASM trainer complete the JTS train-the-trainer course?
Every three years. Trainers must also be TCCC certified themselves.
VERIFIED AGAINST THE SOURCE
“Be certified in TCCC and complete the appropriate JTS-developed train the trainer course every three years”
— Army Standards for Executing DoD TCCC Tiered Training (14 Aug 2025), p. 1 ↗08Which Army regulation sets the requirement for Tier 1 ASM certification?
AR 350-1. The Army standard says the Tier 1 ASM requirement was issued in AR 350-1.
VERIFIED AGAINST THE SOURCE
“The Army has issued a requirement for Tier 1 ASM certification in AR 350-1.”
— Army Standards for Executing DoD TCCC Tiered Training (14 Aug 2025), p. 3 ↗09Where does the Army record TCCC certifications?
In the Digital Training Management System (DTMS). Units record every initial certification and recertification there.
VERIFIED AGAINST THE SOURCE
“Units will record all assigned Service member and DoD-EC TCCC certifications (initial and recertification) in the Army Digital Training Management System (DTMS)”
— Army Standards for Executing DoD TCCC Tiered Training (14 Aug 2025), p. 4 ↗10A Soldier finishes initial entry training without TCCC ASM certification. What happens?
The Soldier gets certified at the first unit of assignment.
VERIFIED AGAINST THE SOURCE
“If, for any reason, a Soldier is not certified within IET or IMT, the Soldier will receive certification at their first unit of assignment.”
— Army Standards for Executing DoD TCCC Tiered Training (14 Aug 2025), p. 3 ↗11In Care Under Fire/Threat, what is the first step when a unit member is wounded?
Return fire and take cover. Winning the firefight comes before any casualty care.
VERIFIED AGAINST THE SOURCE
“Basic Management Plan for Care Under Fire/Threat 1. Return fire and take cover.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 1 ↗12During Care Under Fire, what should a wounded Service member who can still fight be told to do?
Stay engaged as a combatant, if appropriate. The guidelines say to direct or expect the casualty to keep fighting.
VERIFIED AGAINST THE SOURCE
“Direct or expect casualty to remain engaged as a combatant if appropriate.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 1 ↗13During Care Under Fire, how should a casualty who can move get to cover?
Tell the casualty to move to cover and apply self-aid. If the casualty cannot, move or drag them to cover when it is tactically feasible.
VERIFIED AGAINST THE SOURCE
“Direct casualty to move to cover and apply self-aid if able or when tactically feasible, move or drag casualty to cover.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 1 ↗14What should you do for a casualty inside a burning vehicle during Care Under Fire?
Get them out and move them to relative safety, and do what is necessary to stop the burning.
VERIFIED AGAINST THE SOURCE
“Casualties should be extracted from burning vehicles or buildings and moved to places of relative safety. Do what is necessary to stop the burning process.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 1 ↗15What is the only medical treatment done during Care Under Fire, and when?
Stopping life-threatening external bleeding, and only if it is tactically feasible. Airway care waits for Tactical Field Care.
VERIFIED AGAINST THE SOURCE
“Airway management is generally best deferred until the Tactical Field Care phase.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 1 ↗16During Care Under Fire, where do you put a limb tourniquet?
Over the uniform, clearly above (proximal to) the bleeding site.
VERIFIED AGAINST THE SOURCE
“Apply the limb tourniquet over the uniform clearly proximal to the bleeding site(s).”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 1 ↗17During Care Under Fire, where does the tourniquet go if you cannot see where the bleeding is coming from?
High and tight: as far up the injured limb as possible. Then move the casualty to cover.
VERIFIED AGAINST THE SOURCE
“place the tourniquet high and tight (as proximal as possible) on the injured limb and move the casualty to cover”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 1 ↗18What is the first step when you move from Care Under Fire into Tactical Field Care?
Set up a security perimeter using unit SOPs or battle drills, and keep tactical situational awareness.
VERIFIED AGAINST THE SOURCE
“Establish a security perimeter in accordance with unit tactical standard operating procedures and/or battle drills. Maintain tactical situational awareness.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 2 ↗19In Tactical Field Care, where is a limb tourniquet applied?
Directly on the skin, 2 to 3 inches above the bleeding site. This differs from Care Under Fire, where it goes over the uniform.
VERIFIED AGAINST THE SOURCE
“Apply directly to the skin 2-3 inches above the bleeding site.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 2 ↗20The first tourniquet does not stop the bleeding. What do you do?
Apply a second tourniquet side by side with the first.
VERIFIED AGAINST THE SOURCE
“If bleeding is not controlled with the first tourniquet, apply a second tourniquet side-by-side with the first.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 2 ↗21Which injury always gets a limb tourniquet in Tactical Field Care, even if bleeding looks controlled?
Any traumatic amputation. Tourniquets are for life-threatening limb bleeding or any traumatic amputation.
VERIFIED AGAINST THE SOURCE
“limb tourniquet to control life-threatening external hemorrhage that is anatomically amenable to tourniquet use or for any traumatic amputation”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 2 ↗22What is the CoTCCC hemostatic dressing of choice for bleeding a tourniquet cannot reach?
Combat Gauze. It is used for compressible bleeding that is not suited to a limb tourniquet.
VERIFIED AGAINST THE SOURCE
“use Combat Gauze as the CoTCCC hemostatic dressing of choice”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 2 ↗23After packing a wound with a hemostatic dressing, how long do you hold direct pressure?
At least 3 minutes.
VERIFIED AGAINST THE SOURCE
“Hemostatic dressings should be applied with at least 3 minutes of direct pressure”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 2 ↗24What are the signs of hemorrhagic shock that TCCC teaches you to check for?
Altered mental status without a head injury, and/or a weak or absent radial (wrist) pulse.
VERIFIED AGAINST THE SOURCE
“altered mental status in the absence of brain injury and/or weak or absent radial pulse”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 3 ↗25A casualty's tourniquet has been on for 90 minutes. Under the 2026 Guidelines, what is the time limit for an ASM-trained responder to convert it?
2 hours after it was applied. ASM and CLS personnel should not try to convert a tourniquet after that unless advanced medical personnel direct it. Every effort is made to convert in under 2 hours if other means can control the bleeding.
VERIFIED AGAINST THE SOURCE
“Every effort should be made to convert tourniquets in less than 2 hours if bleeding can be controlled with other means.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 6 ↗26After how many hours should a tourniquet not be removed unless close monitoring and lab capability are available?
6 hours.
VERIFIED AGAINST THE SOURCE
“Do not remove a tourniquet that has been in place more than 6 hours unless close monitoring and lab capability are available.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 6 ↗27A conscious casualty with a facial wound wants to sit up and lean forward. What should you do?
Let them. A conscious casualty may take any position that best protects the airway, including sitting up or leaning forward.
VERIFIED AGAINST THE SOURCE
“Allow a conscious casualty to assume any position that best protects the airway, to include sitting up and/or leaning forward.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 3 ↗28How should an unconscious casualty be positioned to protect the airway?
In the recovery position, head tilted back and chin away from the chest.
VERIFIED AGAINST THE SOURCE
“Place unconscious casualty in the recovery position, head tilted back; chin away from chest.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 3 ↗29Does a casualty with only a penetrating wound need cervical spine stabilization?
No. The guidelines say it is not necessary for casualties with only penetrating trauma.
VERIFIED AGAINST THE SOURCE
“Cervical spine stabilization is not necessary for casualties who have sustained only penetrating trauma.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 3 ↗30How do you treat an open or sucking chest wound?
Put a vented chest seal over the hole right away. If you do not have a vented seal, use a non-vented one.
VERIFIED AGAINST THE SOURCE
“All open and/or sucking chest wounds should be treated by immediately applying a vented chest seal to cover the defect. If a vented chest seal is not available, use a non-vented chest seal.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 5 ↗31After you seal a chest wound, what condition must you watch for?
Tension pneumothorax. Watch for increasing trouble breathing, low oxygen or low blood pressure.
VERIFIED AGAINST THE SOURCE
“Monitor the casualty for the potential development of a subsequent tension pneumothorax. If the casualty develops increasing hypoxia, respiratory distress, or hypotension and a tension pneumothorax is suspected, treat by burping or removing the dressing or by needle decompression.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 5 ↗32A casualty with a chest seal gets worse and you suspect tension pneumothorax. What is the first thing to do with the seal?
Burp it or remove it. The guidelines list needle decompression as the other treatment.
VERIFIED AGAINST THE SOURCE
“If the casualty has a chest seal in place, burp or remove the chest seal.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 4 ↗33Which injuries should make you suspect tension pneumothorax?
Significant torso trauma or primary blast injury, together with signs such as severe or worsening breathing trouble.
VERIFIED AGAINST THE SOURCE
“Severe or progressive respiratory distress”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 3 ↗34Why does TCCC stress hypothermia prevention for trauma casualties?
Because heat loss must be stopped early and aggressively, adding outside heat when possible. This applies to trauma and severely burned casualties.
VERIFIED AGAINST THE SOURCE
“Take early and aggressive steps to prevent further body heat loss and add external heat, when possible, for both trauma and severely burned casualties.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 8 ↗35A casualty is lying on cold, wet ground. What hypothermia steps come first?
Put insulation between the casualty and the cold ground as soon as possible, and replace wet clothing with dry clothing if you can.
VERIFIED AGAINST THE SOURCE
“Replace wet clothing with dry clothing, if possible, and protect from further heat loss.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 8 ↗36Where do you place an active heating blanket, and where must it never go?
On the front of the torso and under the arms. Never put a heat source directly on the skin or wrap it around the torso, because it can burn the casualty.
VERIFIED AGAINST THE SOURCE
“to prevent burns, do not place any active heating source directly on the skin or wrap around the torso”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 8 ↗37How do you cover a suspected penetrating eye injury?
With a rigid eye shield, not a pressure patch. Do a quick field test of vision first and write down what you find.
VERIFIED AGAINST THE SOURCE
“Cover the eye with a rigid eye shield (NOT a pressure patch).”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 10 ↗38How should a casualty with burns and other wounds be treated?
As a trauma casualty with burns, not a burn casualty with injuries.
VERIFIED AGAINST THE SOURCE
“Assess and treat as a trauma casualty with burns and not burn casualty with injuries.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 12 ↗39A casualty has facial burns from a fire inside a closed building. What extra danger should you watch for?
Inhalation injury to the airway. Watch the airway and oxygen level closely.
VERIFIED AGAINST THE SOURCE
“Facial burns, especially those that occur in closed spaces, may be associated with inhalation injury.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 12 ↗40What method does TCCC use to estimate the burned body surface area?
The Rule of Nines, estimated to the nearest 10%.
VERIFIED AGAINST THE SOURCE
“Estimate total body surface area (TBSA) burned to the nearest 10% using the Rule of Nines.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 12 ↗41What do you cover burns with in Tactical Field Care?
Dry, sterile dressings.
VERIFIED AGAINST THE SOURCE
“Cover the burn area with dry, sterile dressings.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 12 ↗42A wounded Service member can stay in the fight. How is pain medication given?
The casualty takes the TCCC Combat Wound Medication Pack (CWMP), self-administered or given by TCCC personnel.
VERIFIED AGAINST THE SOURCE
“TCCC Combat Wound Medication Pack (CWMP)”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 10 ↗43What medications are in the TCCC Combat Wound Medication Pack in the 2026 Guidelines?
Acetaminophen, meloxicam and suzetrigine. The 2026 list gives acetaminophen every 8 hours, meloxicam once a day and suzetrigine every 12 hours after the first dose.
VERIFIED AGAINST THE SOURCE
“Suzetrigine – 100 mg PO once (2 x 50 mg tablets) then 50 mg PO every 12 hours”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 10 ↗44Should CPR be done on the battlefield for a blast or penetrating trauma casualty with no pulse, no breathing and no other signs of life?
No. The guidelines say it will not be successful and should not be attempted.
VERIFIED AGAINST THE SOURCE
“Resuscitation on the battlefield for victims of blast or penetrating trauma who have no pulse, no ventilations, and no other signs of life will not be successful and should not be attempted.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 13 ↗45What should you communicate to the casualty during care?
Talk to them if possible: encourage, reassure and explain the care.
VERIFIED AGAINST THE SOURCE
“Communicate with the casualty if possible. Encourage, reassure and explain care.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 13 ↗46On what form is TCCC care documented, and where does it go?
The TCCC Card, DD Form 1380. It records assessments, treatments and changes in status, and it travels with the casualty to the next level of care.
VERIFIED AGAINST THE SOURCE
“Forward documentation with the casualty to the next level of care.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 13 ↗47When preparing a casualty for evacuation, what do you secure?
The completed TCCC Card to the casualty, all loose ends of bandages and wraps, hypothermia wraps, and litter straps as needed.
VERIFIED AGAINST THE SOURCE
“Secure litter straps as required.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 14 ↗48What is the minimum information to pass to TACEVAC personnel?
Whether the casualty is stable or unstable, the injuries found, and the treatments given.
VERIFIED AGAINST THE SOURCE
“The minimum information communicated should include stable or unstable, injuries identified, and treatments rendered.”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 15 ↗49What two kinds of evacuation does Tactical Evacuation (TACEVAC) include?
Casualty Evacuation (CASEVAC) and Medical Evacuation (MEDEVAC).
VERIFIED AGAINST THE SOURCE
“The term Tactical Evacuation includes both Casualty Evacuation (CASEVAC) and Medical Evacuation (MEDEVAC)”
— CoTCCC, TCCC Guidelines 2026 (01 May 2026), p. 15 ↗50What format does the DD Form 1380 TCCC Card use to record care?
MIST: Mechanism of injury, Injuries, Signs and symptoms, and Treatments.
VERIFIED AGAINST THE SOURCE
“using a MIST format (Mechanisms of injury; Injuries; Signs & Symptoms; and Treatments)”
— Instructions: DD Form 1380, TCCC Card (Jul 2025), p. 1 ↗51Who is the DD Form 1380 designed to be filled out by?
All first responders, including non-medical personnel.
VERIFIED AGAINST THE SOURCE
“It is designed for use by all first responders, including non-medical personnel.”
— Instructions: DD Form 1380, TCCC Card (Jul 2025), p. 1 ↗52Where should a blank DD Form 1380 be carried?
In the individual/improved first aid kit (IFAK) and other first aid kits. Medics and corpsmen carry several blank copies.
VERIFIED AGAINST THE SOURCE
“DD Form 1380 will be a component of the individual/improved first aid kit (IFAK)”
— Instructions: DD Form 1380, TCCC Card (Jul 2025), p. 1 ↗53How is the Battle Roster number written on a DD Form 1380?
First initial, last initial, then the last four of the SSN. John Doe 123-12-1234 becomes JD1234.
VERIFIED AGAINST THE SOURCE
“For example, John Doe 123-12-1234 is Battle Roster # JD1234”
— Instructions: DD Form 1380, TCCC Card (Jul 2025), p. 1 ↗54How is the time of injury written on a DD Form 1380?
In 24-hour time, marked local (L) or Zulu (Z).
VERIFIED AGAINST THE SOURCE
“Write 24-hour time of injury and indicate whether local (L) or zulu (Z) time.”
— Instructions: DD Form 1380, TCCC Card (Jul 2025), p. 1 ↗55What must you write on the DD Form 1380 when you apply a tourniquet?
The type of tourniquet and the time it was applied, on the limb where it was placed.
VERIFIED AGAINST THE SOURCE
“If a tourniquet is applied to the right arm, write type of tourniquet used and the time of tourniquet application.”
— Instructions: DD Form 1380, TCCC Card (Jul 2025), p. 2 ↗56What does AVPU stand for on the TCCC Card?
Alert, responds to Verbal stimulus, responds to Pain stimulus, Unresponsive. It records level of consciousness.
VERIFIED AGAINST THE SOURCE
“AVPU: Alert, responds to Verbal stimulus, responds to Pain stimulus, Unresponsive”
— Instructions: DD Form 1380, TCCC Card (Jul 2025), p. 2 ↗57What are the evacuation categories you mark on the DD Form 1380?
Urgent, Priority or Routine.
VERIFIED AGAINST THE SOURCE
“Mark an X on the casualty's evacuation priority/precedence (Urgent; Priority; or Routine).”
— Instructions: DD Form 1380, TCCC Card (Jul 2025), p. 1 ↗Know questions we're missing?
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