FMF - Fleet Marine Force Tactical Combat Casualty Care Questions and Answers 1 — Questions and Answers
Question 1: During the Care Under Fire (CUF) phase of TCCC, what is the primary medical priority if tactically feasible?
- Applying a hasty tourniquet to control massive extremity hemorrhage. (Correct answer)
- Establishing a definitive airway with a nasopharyngeal airway (NPA).
- Performing needle decompression for a suspected tension pneumothorax.
- Initiating an IV for fluid resuscitation.
Correct answer: Applying a hasty tourniquet to control massive extremity hemorrhage.
In the Care Under Fire phase, the immediate priority is gaining fire superiority. The only medical intervention that should be performed, if the tactical situation allows, is to stop life-threatening external hemorrhage with a limb tourniquet. Other interventions like airway management and treating chest wounds are deferred to the Tactical Field Care phase.
Question 2: A Marine in your platoon is injured and you have moved them to a covered position, out of the direct line of enemy fire. You are now in the Tactical Field Care (TFC) phase. According to the MARCH algorithm, what is the first assessment and intervention you should perform?
- Airway: Check for obstructions and apply an NPA if needed.
- Respirations: Assess for chest wounds and perform a needle decompression if necessary.
- Circulation: Check for shock and establish IV/IO access.
- Massive Hemorrhage: Perform a blood sweep and control any life-threatening bleeding. (Correct answer)
Correct answer: Massive Hemorrhage: Perform a blood sweep and control any life-threatening bleeding.
The MARCH algorithm, used in the Tactical Field Care phase, prioritizes interventions based on the leading causes of preventable combat death. 'M' stands for Massive Hemorrhage, which is the first priority. You must assess for and control any life-threatening bleeding before moving on to Airway, Respirations, Circulation, and Head Injury/Hypothermia.
Question 3: Which of the following distinguishes Tactical Evacuation Care (TACEVAC) from the first two phases of TCCC (Care Under Fire and Tactical Field Care)?
- It is the only phase where tourniquets are used.
- It is the first time a casualty assessment is performed.
- Additional medical personnel and more advanced equipment may become available. (Correct answer)
- The primary goal is to return fire and gain fire superiority.
Correct answer: Additional medical personnel and more advanced equipment may become available.
The TACEVAC phase involves moving the casualty to a higher level of care. During this phase, additional medical equipment and personnel may be available on the evacuation platform (ground vehicle, aircraft, etc.), allowing for more advanced interventions than what is available in the field.
Question 4: You are applying a deliberate tourniquet during the Tactical Field Care phase. Which of the following is the correct procedure?
- Place the tourniquet directly over a joint to maximize pressure.
- Apply the tourniquet loosely over the uniform, 5-6 inches below the wound.
- Apply the tourniquet directly to the skin, 2-3 inches above the wound, and tighten until the distal pulse is absent. (Correct answer)
- Remove the tourniquet after 30 minutes to allow for reperfusion regardless of bleeding.
Correct answer: Apply the tourniquet directly to the skin, 2-3 inches above the wound, and tighten until the distal pulse is absent.
During Tactical Field Care, a hasty tourniquet applied over the uniform should be reassessed and replaced with a deliberate tourniquet. The correct procedure is to apply it directly to the skin, 2-3 inches proximal (above) the wound, and tighten it until both the bleeding stops and the distal pulse is no longer palpable.
Question 5: Which phase of TCCC involves rendering care while still under effective hostile fire, where medical equipment is limited to what is carried by the individual and the medic?
- Tactical Field Care (TFC)
- Care Under Fire (CUF) (Correct answer)
- Tactical Evacuation Care (TACEVAC)
- Combat Life Saver (CLS)
Correct answer: Care Under Fire (CUF)
Care Under Fire (CUF) is the phase where care is rendered at the point of injury while under effective hostile fire. The extreme danger and tactical constraints mean that medical equipment is limited to what is immediately available on the casualty or the responder.
Question 6: A casualty has an altered mental status after an explosion but no obvious external injuries. In the Tactical Field Care phase, after addressing the MARCH algorithm, what is a critical first step for the safety of the team?
- Administer a high dose of ketamine for pain.
- Disarm the casualty and secure their communications equipment. (Correct answer)
- Immediately begin fluid resuscitation with Hextend.
- Leave the casualty's weapon with them for self-defense.
Correct answer: Disarm the casualty and secure their communications equipment.
TCCC guidelines explicitly state that any casualty with an altered mental status should be disarmed immediately and have their communications equipment secured. This is a critical safety step to protect the casualty and other team members, as a person with a head injury or in shock may act unpredictably.
FMF - Fleet Marine Force Tactical Combat Casualty Care Questions and Answers 1
During the Care Under Fire (CUF) phase of TCCC, what is the primary medical priority if tactically feasible?