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“We seldom rise to the occasion, we often fall to the level of our training”

-LTC Dave Grossman (Ret.)

About the Competition

Direct Threat Care

In this phase of the competition, competitors are expected to provide care to a victim while a simulated direct threat is still present. Competitors are expected to then extract a patient to cover or a Casualty Collection Point, where they will then continue Care. 


All care to be provided in line with the Tactical Emergency Casualty Care Guidelines. 


1. Accomplish the mission with minimal casualties
2. Prevent any casualty from sustaining additional injuries
3. Keep response team maximally engaged in neutralizing the existing threat (e.g. active shooter, unstable building, confined space HAZMAT, etc.)
4. Minimize public harm


Indirect Threat Care

In the Indirect Threat Care Phase, competitors will perform all the treatments comprised within the ITC phase of care. Competitors will be expected to complete a proper assessment, and treat all life threats found in the assessment, in accordance with the TECC Guidelines. 






1. Goals 1-4 as above with DTC care
2. Stabilize the casualty as required to permit safe extraction to dedicated treatment sector or medical evacuation assets
1. Maintain tactical supremacy and complete the overall mission.
2. As applicable, ensure safety of both first responders and casualties by rendering weapons safe and/or rendering any adjunct tactical gear safe for handling (flash bangs, gas canisters, etc).
3. Conduct dedicated patient assessment and initiate appropriate life-saving interventions as outlined in the ITC guidelines. DO NOT DELAY casualty extraction/evacuation for non life-saving interventions.
4. Consider establishing a casualty collection point if multiple casualties are encountered
5. Unless in a fixed casualty collection point, triage in this phase of care should be limited to the following categories:
    a. Uninjured and/or capable of self-extraction
    b. Deceased / expectant
    c. All others
6. Establish communication with the tactical and/or command element and request or verify initiation of casualty extraction/evacuation.
7. Prepare casualties for extraction and document care rendered for continuity of care purposes.

Evacuation Care

In this portion of the Competition, competitors will be expected to move a patient to an evacuation platform. Competitors will then continue to perform care in the vehicle until their time is completed. 







1. Maintain any lifesaving interventions conducted during DTC and ITC phases
2. Provide rapid and secure extraction to an appropriate level of care
3. Avoid additional preventable causes of death

High Angle Extraction


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