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Thank you! If you do not wish to have your item(s) delivered on data disc(s), I can provide them on a flash drive and other means as well. Just let me know if a disc does not work for you and we can discuss delivery by other methods. COMBINING SHIPPING COSTS Are you purchasing multiple items? I will: a) combine all invoices before payment and charge shipping equivalent to one item, or b) refund all shipping costs in excess of one item after payment. ForewordTactical Combat Casualty Care (TCCC) has saved hundreds of lives during our nation’s conflicts in Iraq and Afghanistan. Nearly 90 percent of combat fatalities occur before a casualty reaches a medical treatment facility. Therefore, the prehospital phase of care is needed to focus on reducing the number of combat deaths. However, few military physicians have had training in this area and, at the onset of hostilities, most combat medics, corpsmen, and pararescue personnel in the U.S. military have been trained to perform battlefield trauma care through civilian-based trauma courses. These courses are not designed for the prehospital combat environment and do not reflect current practices in the area of prehospital care. TCCC was created to train Soldiers and medical personnel on current best practices for medical treatment from the point of injury to evacuation to Role 3 facilities. The challenge of meeting training needs was met by the voting members ofthe Committee on Tactical Combat Casualty Care (CoTCCC) and its many liaison members who collectively make up the TCCC Working Group. This group includes trauma surgeons; emergency medicine physicians; internists; family medicine physicians; operational physicians and physician assistants; combat medical educators; trauma researchers; pathologists; combat medical doctrine developers; medical equipment specialists; and combat medics, corpsmen, and pararescue personnel. All the U.S. Armed Services are well-represented in the TCCC Working Group’s committee membership, and 100 percent of the CoTCCC voting members have been to war. The CoTCCC and the TCCC Working Group represent different Services, disciplines, and military experiences, all of which contribute to the single goal of reducing preventable deaths on the battlefield. This type of working group did not exist when the Twin Towers fell. The U.S. Special Operations Command funded the initial group as a research effort. Ownership of the group was then successively assumed by the Naval Operational Medicine Institute, Defense Health Board, and, now, the Joint Trauma System, which is part of the U.S. Army Institute of Surgical Research. This group took the TCCC guidelines established in 2001 and continually updated them. These updates were based on input from the Joint Trauma System performance improvement trauma teleconferences, published case reports and case series from war zones, breakthroughs in military medical research, and new publications from civilian medical literature on combat trauma. The group processed a continual stream of input from the battlefield throughout the war years and ensured that battlefield trauma care lessons were not only noted, but acted upon. So, they became lessons learned. Through the efforts of this dedicated group of individuals, U.S. forces have had prehospital trauma care guidelines customized for the battlefield and updated continuously based on real-time evaluation of outcomes from ongoing combat operations. This is the first time in the nation’s history this has occurred. The success of the TCCC effort has been well-documented and is a great tribute to all members of the CoTCCC and the TCCC Working Group. The TCCC efforts transcend Service and medical specialty differences; expertly process new information; and develop evidence-based, best-practice guidelines that have completely transformed battlefield trauma care. This TCCC Handbook is dedicated to the CoTCCC and all the valued colleagues in the TCCC Working Group. Our country and its casualties owe you all a profound measure of thanks.

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