BUCKLEY SPACE FORCE BASE, Colo. – Members of the 140th Medical Group, Colorado Air National Guard, participated in Tactical Combat Casualty Care at Buckley Space Force Base, Aurora, Colorado, Jan. 28-31, 2025.
TCCC replaced Self-Aid and Buddy Care in 2022 as a more advanced form of training that is also more hands-on. TCCC is designed to be a team-based approach to care, using the MARCH algorithm (massive bleeding, airway, respiration, circulation, hypothermia), and teaches service members how to stabilize trauma and provide life-saving care.
140th Wing TCCC program Coordinator U.S. Air Force Tech. Sgt. Charles Guthrie said the TCCC curriculum is standardized across the military but that he adds civilian experience from his time working as a paramedic.
Guthrie also teaches a semester-long emergency medical technician course at Front Range Community College.
“We teach to all skill levels so that a person who isn't medical can say ‘MARCH’ to a medic, and it'll make complete sense to them,” Gutherie said. “It’s better compared to SABC … you didn't really get the context behind how you're helping the patient while we do that. TCCC really bridges that gap better.”
“Tier 3 TCCC training is essential for our Air Force medics,” said U.S. Air Force Lt. Col. Jessica Hegewald, commander, 140th Medical Group. “This training ensures our medical personnel can operate effectively under fire, stabilize casualties in austere conditions, and enhance survivability on the battlefield. Over time, the nuances of the battlefield have shaped the most efficient and effective way that we save lives in a world where seconds matter. TCCC Tier 3 is not just training—it's the difference between life and death.”
During the week of training the group learned Tier 3. Most service members only receive Tier 1 training.
“It’s the same concept, but medics are expected to do a whole lot more,” Guthrie said. “Each day of training is just a different aspect of the MARCH algorithm, focusing on the different pieces of your trauma assessment like control bleeding, make sure someone's airway is good, and that they're breathing.”
Day one involved blood transfusions where the students took turns practicing hands-on by giving one another transfusions of their own blood. “When somebody has lost blood, the best way to get them back to their best state is to give them that lost blood back,” he said. “So doing that in the context of TCCC means if you're in a combat situation, you're probably nowhere near a hospital, you're nowhere near a blood bank, you’re nowhere easy that you can get that good definitive care. So we're teaching our medics to be able to take what's in their kit, get blood from a healthy patient who can donate blood, and give that to the patient who needs their blood replaced.”
Guthrie emphasized the standard of care Tier 3 requires with his class. “For our medics, they are the first responders, and they could be with this patient for hours, potentially, especially in a combat situation, so what we're teaching them is to get more definitive care further forward at that point of injury,” he said. “If someone gets shot in a combat situation and you’re three hours to the next hospital where they might finally see a doctor or surgeon, they could potentially die in those three hours. So, we're training our medics to do a lot of stuff that the hospital would normally do and trying to do that more forward at the point of injury. Blood transfusions are one of those things.”
Having taught all tiers of TCCC, Guthrie stressed the importance of each. “It's been good to see what we're teaching to different skill levels,” he said. “What we teach to the layperson versus what I teach to medics can be translated between skill levels. That person who took the all-service member Tier 1 course may not feel like they can do a lot, but the things that we teach them are the same things we teach medics to do. We just teach medics a little bit beyond that. It allows everybody to kind of feel like they are doing something for the patient that's been hurt.”