Tactical Combat Casualty Care — Combat Paramedic / Provider
Advanced provider certification for the TCCC ladder.
Tier 4 TCCC course for advanced providers — paramedics, PAs, RNs, and physicians in a tactical role — equipping them with the most sophisticated prehospital trauma care available in the CoTCCC curriculum.
Course Overview
TCCC-CPP is the Tier 4 capstone of the TCCC ladder, designed for advanced providers who are expected to deliver the most sophisticated prehospital care to keep wounded service members alive en route to definitive care. The course extends the CMC curriculum with provider-level skills: endotracheal intubation, finger and tube thoracostomy, advanced ventilation (automated and BVM with oxygen), procedural and analgesic sedation, foley catheterization and urinary output monitoring, hypertonic saline (3%/5%/23%) for traumatic brain injury, advanced field blood banking, and non-compressible torso hemorrhage strategies. Across roughly 80 hours, students rotate through 24 core modules. Students must pass an 80% minimum multiple-choice exam plus a scenario-based Tactical Trauma Assessment.
Who It's For
Military combat paramedics, advanced providers (PA, MD, DO, RN), and federal medical personnel in tactical or combat-support roles. Active duty, reserve, and federal personnel only.
Prerequisites
- Paramedic-equivalent or higher prehospital provider credential (NRP, PA, RN, MD/DO) with an operational / tactical role
- Strongly recommended: prior TCCC-CMC (or equivalent) experience
- Pass criteria: 80% minimum on the multiple-choice exam plus successful performance of critical TCCC skills during the scenario-based Tactical Trauma Assessment
Quick Facts
Duration
80 hours+
Format
In-Person
Certification
NAEMT-issued certification AND direct CoTCCC pathway (pending). TCCC-CPP (Combat Paramedic / Provider) qualification per CoTCCC Guidelines.
Starting From
Contact for pricing
Upcoming Offerings
Reserve your seat — class sizes are limited
No open enrollment dates scheduled yet.
Request a CourseCurriculum Breakdown
Day-by-day schedule and topics covered
- Principles and Application of TCCC (CoTCCC origins, JTS mission, evidence-based practice)
- Medical Equipment (JFAK, CLS kit, medic/corpsman bag, CPP provider kit (CPP-only))
- Care Under Fire (CUF tourniquet skills, drags and carries)
- Principles and Application of Tactical Field Care (security, casualty extraction, triage, casualty collection point planning and management)
What You'll Learn
Describe the practice of TCCC in accordance with CoTCCC Guidelines, including the origins, methodology, and current best evidence.
Describe the use of individual medical equipment components, including the Combat Paramedic / Provider kit.
Perform Care Under Fire interventions per CoTCCC Guidelines.
Perform Tactical Field Care including triage and casualty collection point planning, principles, roles, and management.
Perform a Tactical Trauma Assessment using the MARCH PAWS sequence.
Perform massive hemorrhage control including junctional tourniquets, injectable hemostatic agents, and wound closure devices, applying evidence-based best practices for aggressive hemorrhage control.
Perform airway management in TFC including extraglottic airway insertion, surgical cricothyroidotomy, endotracheal intubation, BVM ventilation, automated ventilation, and pulse oximetry.
Perform assessment and management of respiration and chest trauma, including bilateral needle decompression, finger thoracostomy, and tube thoracostomy.
Perform hemorrhage control in TFC including pelvic compression device application, tourniquet replacement and conversion, and advanced procedures for non-compressible torso hemorrhage.
Describe shock assessment in TFC and identify the lethal triad of hemorrhagic shock.
Perform IV or IO access on a trauma casualty during TFC.
Perform tranexamic acid administration on a bleeding trauma casualty.
Perform fluid resuscitation including administration of cold-stored LTOWB, fresh LTOWB, and blood component products, applying principles of field blood banking.
Perform hypothermia prevention and treatment measures during TFC and TACEVAC.
Identify a head injury per DoDI 6490.11 and administer hypertonic saline (3%, 5%, or 23%) to a TBI casualty per CoTCCC Guidelines.
Perform assessment and initial treatment of penetrating eye trauma including a rapid field test of visual acuity.
Perform analgesia administration via all CoTCCC-recommended routes and demonstrate the preparation, administration, and management of procedural or analgesic sedation in TFC.
Perform antibiotic administration during TFC (moxifloxacin, ertapenem).
Perform assessment and initial management of wounds (open abdominal, impalement, amputation), burns (with fluid resuscitation calculations), and fractures.
Perform monitoring of a trauma casualty including end-tidal CO2 (colorimetric and digital), foley catheterization, and urinary output monitoring.
Perform communication during TFC including 9-Line MEDEVAC, modified MIST, and casualty reporting for command and medical management.
Describe cardiopulmonary resuscitation in TFC and demonstrate bilateral needle decompression.
Perform documentation of care including DD Form 1380 and the Casualty After Action Report.
Prepare casualties for evacuation during TFC and TACEVAC.
Your Instructors
Our instructors come from diverse operational backgrounds — military and SOF medics, tactical medics supporting state and local specialty teams, federal agent medics, rescue specialists, and emergency medicine physicians. They don't just teach the material — they live it.
Frequently Asked Questions
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