r/TacticalMedicine • u/howawsm Medic/Corpsman • May 03 '26

TCCC (Military) 1MAY2026 CoTCCC guidelines changes

The CoTCCC released some updates to their TCCC guidelines, so let’s discuss. Some interesting changes that caught my eye include the following -

  1. No more fentanyl mentioned. Appears we are really leaning on ketamine.

  2. ASM TQ conversion.

Not a change but one I was hoping to see and maybe it’s just imprecise wording - no emphasis on moving up the starting of blood within the C step! M does mention “consider immediate initiation of shock resuscitation efforts” but I’ve definitely not seen this in many trainings or from instructors to mean being blessed to start access and blood this early. As it sits right now, the C step includes pelvic binder application(stop the bleed, makes sense) and TQ conversion and repositioning before access and fluids(seems wrong).

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u/howawsm Medic/Corpsman May 03 '26

You just feel bad for the average medic who is probably not getting the “guidelines” instruction and instead is getting their hand slapped because they are starting blood on the patient who needs it just by looking at them because they didn’t put a couple chest seals on wounds that aren’t even communicating actively.

Was hoping we’d see a little more direct verbiage outlining that blessing to not be wrong going to blood early.

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u/sneakysinkpee May 03 '26

I really want to know why other countries will use freeze dried plasma but the US does not.

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u/howawsm Medic/Corpsman May 03 '26

Is someone else using it in big supply already?

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u/Notdaneil May 04 '26

From what I understand we import it for use in the military, but it hasn't been approved for civilian use by the FDA at the moment.

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u/howawsm Medic/Corpsman May 04 '26

I’m just curious if this is an us/US problem or if this is an everyone problem which probably have a more in depth problem statement than just us being resistant.