Tactical Medicine

Automod Changes

2025-08-06T18:18:46+00:00

Due to recent spam, we have had to implement karma and account age minimums to the subreddit. If you have issues with the automod, please message the moderators.

submitted by /u/skorea2021
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Check out our new sub r/TacMed101!

2024-12-11T00:26:30+00:00

r/TACMED101's mission is to extend r/TacticalMedicine to everyone, provide resources, support, feedback, and a community for those interested in tactical medicine. Civilian, military, law enforcement, all are welcome. Discuss, ask, and answer questions about education, certifications, licensure, jobs, etc.

IFAK questions are only allowed on in the scheduled and pinned post which will reset every Friday. All others will be removed.

submitted by /u/skorea2021
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TMP

2026-06-09T19:31:47+00:00

Just took Tactical Medical Practitioner last week. Was one of the best classes I’ve ever taken and definitely helped bridge the gap of patrol cop/EMS to a Team Medic. I highly recommend it. Just hit me up if you have any questions!

submitted by /u/County_Ambitious
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Looking for some feedback..

2026-06-06T23:20:57+00:00

Got this approved by the mods so hopefully no issues, and thank you in advance for taking a look.

My cofounder (an active law enforcement officer) and I (software developer and cyber security veteran) have been working on this product after he had a cardiac event on duty. The things were trying to solve for are, how do you make sure your information is available? and more importantly, how do you keep it up to date?

This is a device that gets woven into the MOLLE on a vest or clipped onto a belt and is one scan to get information, and then one tap to notify your emergency contacts that an event has taken place.

This is mostly intended for officers and other first responders, but I'm curious if people here have had similar critical events and could help us understand what other kinds of information or context could be helpful.

I am not allowed to post links, so just imagine a holder that gets woven into your MOLLE and then has a card you remove and scan to get the profile.

Its things like:

Medications
Allergies
Medical conditions
Emergency contacts
Blood type

I know this is going to come off salesy but its really not my intent, so I'm sorry about that, hoping to get some product feedback. I'm even very happy to send devices and service for free in order to get real feedback on everything.

Thanks a bunch!!

Nick & Nate

submitted by /u/Infinite_Skin_1503
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How do you guys store your narcotics on person?

2026-06-06T02:32:59+00:00

Currently I store my narcotics in a hard case in my pants pocket. I am looking for better ways to store them on person. Do you use you belt? If so what pouch do you use ?

submitted by /u/Trimiage
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Advice preparing medical equipment

2026-06-04T19:13:19+00:00

I'm going to Ukraine a few months and I'm putting together equipment now in the states. I'm going as a tank crewman and also have training as a civilian medic. I was wondering if anyone has specific advice about what equipment would be most useful inside of a tank so that I can keep a specific medical bag inside with me. There's less fear of gsws, but more fear of shrapnel and burn injuries inside the tank.

If anyone has advice of how I can optimize my equipment for the type of injuries to expect inside of a tank I would appreciate it.

Edit: I think I might have over sold my medical training/ experience. I've done a 2 week basic course, I'm not replacing a real medic just trying to put some of my additional skills to work.

submitted by /u/Jonowe
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CLS bag with personal gear? Request for opinions on a service bag (NATO military)

2026-06-04T10:34:57+00:00

Hey guys,

I know everyone is fed up with kit bags and whatnot but I really want some opinions on this. I am a serving, certified CLS in a NATO army. I currently have a bag that is STUFFED. My unit bought some bags for basic TCCC and first aid and gave me one for my role as CLS because the issued ones are shit. I really appreciate the free kitbag which is infinitely better than the issued one and the fact that my unit allows us to use gear that is readily available off the shelf.

The downside is that I have to carry that extra bag everywhere (I get that this is part of the job, obviously). If we're doing any type of manoeuvre exercise, I am constantly hindered by the fact that I carry my own shit + a bag full of medical kit.

How do you guys handle this? Is a larger bag a good solution or would you guys refrain from mixing personal gear with group gear? This is basically the main issue that I have now that I think about it...

submitted by /u/Jugent
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WPS/PSS Medic narrative advice

2026-06-01T19:04:10+00:00

Hey Y’all,

I’m at the start of hopefully getting onto a WPS slot for Bagdad. I have the appropriate experience but am looking for guidance on how I should be writing out my statement of work. Am I suppose to just flowchart as assessment plan? Should I be using specific injuries as examples to flow chart through? Would love it if I could just have specific questions to answer rather than a general tell us how you do medicine.

Any and all advice is appreciated but really looking for formatting aid.

Also do I bother with a PSS specific narrative if I cannot get a VOE? Current employer would drop me immediately if I requested one and all of my experience is with them.

submitted by /u/Affectionate-Neck505
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How do you build a medical plan? (TEMS/CONUS)

2026-06-01T00:47:32+00:00

Military medic here, soon to be civillian in the near (ish) future. Just trying to get a better understanding of how TEMS/SWAT medics plan out medical contingencies.

What is your process? Google maps, phone calls, something more formal?
Are you ever forced to plan for warrants/ops/training in areas where you are unfamiliar with the medical infrastructure?
How is that plan distributed/communicated to other members of your team?

Thanks in advance to anyone willing to share their experience.

submitted by /u/mbathrowaway012
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TCCC

2026-05-24T23:23:58+00:00

Curious why the Control Cric was removed as the preferred surgical airway device? Im not for or against but was wondering if there have been complications specific to it or if its due to logistics and availability?

submitted by /u/Spiritual_Relative88
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Impact EMS Tactical Medical Provider Online Course

2026-05-19T17:02:40+00:00

I haven’t seen a lot online about it so I figured I’d throw out an honest and humble review of the Impact EMS Tactical Medical Provider course from the perspective of someone who is not a medic and is still learning this side of the profession.

For context, my background is primarily public safety/security with an EMR certification, prior EMT experience, NOLS Wilderness First Responder, firearms instruction, active violence response instruction, and some event medicine experience. I work in a large public venue environment and around LE/fire/EMS operations regularly, but I am not a paramedic, SWAT medic, or high-level tactical medical operator like many of the guys in this sub.

I originally took this course primarily to help fulfill some of my NREMT continuing education requirements while also getting broader exposure to tactical medicine concepts. I actually found the course because the ads kept showing up in my feed.

After taking the class, I ended up finding Mike Carunchio’s podcast, The World’s Okayest Medic Podcast, including an episode on TEMS with Sam from Prep Medic that I found really interesting.

Overall, I thought the course was a solid foundational overview of tactical medicine concepts and decent exposure to TCCC/TEMS doctrine. Topics included:

- MARCH/TCCC
- trauma management
- blast injuries
- airway priorities
- tactical phases of care
- SWAT/TEMS concepts
- CBRNE awareness
- damage control resuscitation

The course clearly states it is not a replacement for hands-on TECC or TCCC training, and I completely agree. Tactical medicine is operational medicine in dynamic threat environments, and that simply cannot fully be taught through passive online lectures alone.

One thing I actually appreciated was the instructor’s real-world analogies and honesty regarding the difference between “what the book/exam wants” versus how things may realistically play out operationally. There were multiple moments where the instruction acknowledged the tension between doctrinal exam answers and practical field realities, and I thought that added authenticity to the course.

My biggest critique is that the course felt heavily geared toward doctrinal exam prep rather than operational application. A lot of the testing emphasized:

- exact terminology
- doctrinal wording
- “most correct” board-style answers

I also think there needs to be clearer separation between Tactical Responder (TR-C) prep and Tactical Paramedic (TP-C) prep. At times, advanced paramedic-level concepts were blended directly into responder-level instruction in a way that could definitely overwhelm EMRs or non-paramedic students.

Production quality also felt fairly low budget. Much of the course consisted of lecture videos with slides and pictures inserted throughout. The information itself was often valuable, but I think the course would benefit from:

- shorter modular lessons
- embedded quizzes
- scenario-based learning
- practical case studies
- operational walkthroughs
- movement/extraction integration

That said, I still found value in it and learned a lot from it. It definitely improved my understanding of tactical medicine terminology, doctrine, trauma priorities, and the way the IBSC/TCCC ecosystem approaches operational medicine.

For EMRs, EMTs, armed security, law enforcement, corrections, church safety teams, event medical personnel, or public safety personnel looking for introductory exposure to tactical medicine concepts, I think it’s a worthwhile foundational/exam-prep resource — just not a substitute for hands-on training.

Personally, I think the ideal path is still:

Hands-on TECC/TCCC
Scenario and operational integration training
Supplemental doctrinal/exam prep courses like this

Just my perspective as someone still learning and trying to grow in this area.

submitted by /u/Fun_Cartoonist_6736
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TP-C prep

2026-05-19T15:04:35+00:00

Hey y’all!

Taking my TP-C next week, and want to ensure I haven’t missed any study material.

Little bit of background:

6 years of military experience, CLS, TCCC, all the things..

7 years of civilian EMS, 4 as a CCP in a high call volume service.

1 1/2 years as swat medic for local Sheriff’s office. Well versed in movement, tactics, and so forth.

Took the whole pocket prep quiz bank of 400 questions, and scored a 93%.

Read Kyle’s book front to back, back to front as it seems to be everyone’s go to.

Read TECC/TCCC guidelines.

Took ImpactEMS’s K9 medic course just to learn more about K9’s as I assume it will be on the test.

Am I cooked chat? Or should I be okay? Any recommendations?

submitted by /u/UpsetPresentation310
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Amputations

2026-05-17T07:56:29+00:00

The only training i have done on stopping bleeding was a 2 hour course so i dont know much but i would of thought that a traumatic amputation is the exact scenario you should use a tourniquet. Do you guys agree with the book or is it wrong

submitted by /u/shrek8642
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GSW by Tokarev TT-33's in Third World

2026-05-17T15:47:45+00:00

https://preview.redd.it/lzlr5smmxp1h1.jpg?width=707&format=pjpg&auto=webp&s=4ed6d4413a197724672d3b7b278777de5f5493f1

https://preview.redd.it/fbwyec0oxp1h1.jpg?width=869&format=pjpg&auto=webp&s=51b9fe1ce6e89c97b33583fc86045200dfac9670

Was unable to add these graphics to an earlier post. Hope this is okay with mods, and useful for fellow redditors. Thanks.

submitted by /u/Creative-Comb5593
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Tokarev 7.62 x 25 mm Wounds

2026-05-16T00:01:20+00:00

Has anyone had experience with wounds believed to be caused by a Tokarev TT-33 or Zastava (Yugo) M57 handgun? The caliber is 7.62mm x 25mm, bottlenecked cartridge. I've only treated one such wound, in Nicaragua where Soviet-bloc weapons were and are abundant. The thigh wound was maybe a little bigger than one from a 9 mm. The victim identified the weapon as a "TT". I ask because the velocity of this cartridge is 1,400 to 1,700 fps. This is a lot but not the usual 2,000 + fps quoted as capable of causing a high velocity wound, with temporary cavity tissue damage. I remember learning to "treat the wound, not the weapon". Nonetheless I wonder if wounds from this caliber are generally worse than those from the much more common 9 mm? Also can there be an overlap zone between low velocity and high velocity wound characteristics? Thanks for any observations.

https://preview.redd.it/po5s6zo0xp1h1.jpg?width=707&format=pjpg&auto=webp&s=cc79b94ef3bbd9c4b76b4da75fa553a7a11a7fb8

(Edit) I added this graphic as soon as my creaky software finally decided to let me upload it.

submitted by /u/Creative-Comb5593
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Just passed Tactical Paramedic

2026-05-13T01:34:33+00:00

Just passed the tactical paramedic IBSC cert test (TP-C)

Ask me questions if you have any. If not, no worries!

submitted by /u/ResponsibleAd4439
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Many of us seriously undertrain for cold and wet weather

2026-05-12T03:02:12+00:00

I imagine the Ukrainians are doing better, but every TCCC training I've ever attended or taught here in the US has been in warm weather or indoors, and based on the unconscious assumption of a tropical or summer environment.

Standard training practice of stripping casualties trauma naked and then wrapping them only in a plastic blizzard blanket/HPMK would mean rapid death from hypothermia even in temperate 30-40 degree F conditions, let alone true arctic conditions.

I don't entirely know the answer, I think extreme cold weather care has to look something like care under fire in the sense that cold is the greater threat and many treatments wait until a heated environment, but that could be hours or days and we could do a lot better job getting people to think about this as a mainstream part of TCCC training.

How and whether we can get casualties warmed and treated at Role 1 and 2 echelons also needs to be addressed. Tents are death in LSCO unless they're very well hidden or able to tear down and move on a dime. Interior of vehicles/ambulances is a solution but quickly space limited with multiple casulaties.

submitted by /u/Any-Hovercraft-1749
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TCCC Changes

2026-05-11T18:24:09+00:00

I saw the new changes to TCCC, but when are the changes to R and C coming out? Last year I saw a bunch of buzz around CPT John Maitha and possibly switching to Resusitation then Chest compared to current MARCH algorithm. That didn’t happen in this update, is this still being worked or is it dead?

submitted by /u/mattattack224
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Pouches for NAR Trauma Pack CCRK

2026-05-11T18:16:00+00:00

Anyone have any idea where to find the inserts that go into this? I found one second hand and it’s great but was missing 7 of the 9 pouches internally. Would love to be able to find the same ones or if you have recommendations on alternatives how many and of what size should I be getting? Saw some by Krydex or TT (expensive though) and unsure how many would be appropriate.

https://www.narescue.com/medic-trauma-pack-ccrk.html?utm\_id=21454109728&creativeId=&gclid=Cj0KCQjw\_IXQBhCkARIsADqELbIEysDZcQ1P-loeNjy5\_PdvgZk5m-iqcim6EIKKYXBIGHb1uQN2-l0aApBLEALw\_wcB&utm\_term=&utm\_campaign=Branded+Performace+Max+Campaign&utm\_source=google&utm\_medium=&utm\_content=&hsa\_acc=4622308128&hsa\_cam=21454109728&hsa\_grp=&hsa\_ad=&hsa\_src=x&hsa\_tgt=&hsa\_kw=&hsa\_mt=&hsa\_net=adwords&hsa\_ver=3&gad\_source=1&gad\_campaignid=22091311158&gbraid=0AAAAAD\_HyzHU15kXBPwCD0B7XHM4B42uV

submitted by /u/mattattack224
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What triage algorithm are y’all using?

2026-05-08T05:51:08+00:00

We are coming up to a rather politically charged multi day public event in town and due to usually fuck all happening in this country (not USA obv) only now public health officials remembered that it might be prudent to update their decades old disaster plans for EMS, police, and hospitals.

I have surveyed the existing plans (our hospitals disaster coordinator only answered “a what now algorithm?”) and it seems at this point we would have to marry our START with EMS xABCDE documentation, and polices MARCH. Personally i’m partial to the berlin algrorithm but i’m not going to introduce that to the polycule.

What are y’all using? I’m bot looking to change policy here, that’s fighting windmills. I’m more on a personal gotta catch ‘em all quest.

submitted by /u/D15c0untMD
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LEO MARCH Belt/Bag

2026-05-03T12:47:32+00:00

This is my setup for a mass casualty/aid belt. It’s setup to be worn over my duty belt and can be easily rotated to the front for use while being worn. From how I’ve mainly used it I take it off once I get to where I need to be or I’ll hang it on something and work from there.

From what I’ve seen with my use of it the bag itself I feel is set up perfectly for how I use it. I’ve only used combat medical systems stuff and man personally I like it better than NAR, that being said I still keep CAT TQs on my gear.

The TMT TQs I’ve found can be kinda used for a combination of things if you’re crafty enough, I’ve used a SAM Splint and 2 TMTs to make an improvised Pelvic binder for a GSW to the pelvis. The swift clips are a lot easier to use than trying to thread two CATs together.

The battle bandages and battle wraps I’ve seen have really good pressure but if wrapped too tightly can be a little too good. So you just have to account for swelling.

I kinda like the sentinel chest seals for their size, I kinda played around with them and a hyfin and honestly they’re pretty similar when it comes to the adhesive. Just like any chest seal you just gonna slightly clean the area if able.

I’ve yet to use the blood pressure cuff other than taking manuals on officers, but when using the BVM I like to use the O2 monitor to see how effective respirations are and if an airway needs to be used.

Also I’ve only used the stretcher a few times to actually move a patient. Most of the time I use it as a more cleaner place to work instead of the patient just being on the ground.

Things I wanna add is definitely some saline flushes for irrigation and washing out the eyes, aswell as maybe some petroleum gauze. Also a few basic 4x4s for wiping off the area of injury.

What do you guys think of this? I used to work fire service prior to law enforcement so I have a decent amount of knowledge with the equipment I’m using. I’m also not trying to replace a med unit so most of my stuff is just focused on stabilizing so med unit can transport. I decided to go with this style of kit because I wanted something I could hang on my passenger seat and not get in the way of my duty bag. And the way it’s setup I can still access my gun and it’s out of the way. What do you guys think I should add or take away? Thinking about moving the thermometer to a separate sickcall bag since it’s pretty much useless.

submitted by /u/Frequent_Mulberry261
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1MAY2026 CoTCCC guidelines changes

2026-05-03T03:32:48+00:00

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

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

submitted by /u/howawsm
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Thoughts on TT Medic Combat Pack 38

2026-05-02T12:20:53+00:00

I work with LE as their medic. I have a Rescue Essentials Paratus bag, but I'm not sure I like everything about it. I recently saw the TT Medic Combat Pack 38 and kinda dig it. What are your thoughts?

My use case for this bag would be as a car bag. On my body, I use a dangler (this handles M), a CRO tearaway hybrid (this handles ARC), and have a few TQs on my kit and keep some "junction kits" I made in my cargo pockets. On my back I have a 7L bag. I can handle 1 x patient with what I have on my body and a few more from the backpack plus a few things extra.

The car bag has all the other not-right-away needed stuff, such as diagnostics, IV/IO, some meds, maybe an AED, etc. The Rescue Essentials Paratus is filling that role now, but I'm thinking I might like something else for that role more maybe. The reviews/thoughts/whatever on the TT Combat Med 38 are not very prevalent so I figured I'd ask specifically. I currently have my car bag, an AED, a litter, a this, a that, etc that I want to consolidate down as much as possible.

I think I could also use it (and not the 7L) for any kind of long foot movement (think rural manhunts and the like). This might require some reconfiguring, but not a big deal.

submitted by /u/Lazy_Buffalo_4142
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Med bag

2026-04-28T20:08:56+00:00

Heard y'all don't like seeing med bags so I made one anyway. This is not a review of the bag, but short answer is, I hate it. Too small. It is also important to note that I carry other supplies on my person. So if you think I'm missing something, it's probably somewhere else. Or I truly am missing it. Who knows.

These are some of the contents I carry in my bag. Not pictured is a pelvic binder from the inside right, and a Readyheat that is sandwiched in the middle of the bag when closed. I also didn't show the outside with a few extras, and the TQs. Also underneath is the soft litter attached by bungee.

It is setup on the outside as MAR. I have a different bag for circulation as the Delta bag is too small to incorporate that. HWS along with Dx is on the inside of the bag.

Inside panels were designed by me and created by A&A tactical. I also have a prototype "binder" style for the bag. It helps if you have flat items, but the Delta bag is just not deep enough for my needs.

Not sure what else to say. Feel free to ask any questions.

submitted by /u/guerillamedicine
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Should you wound pack the abdomen?

2026-04-29T01:25:23+00:00

TL;DR No, you should not wound pack the abdomen even though Techline Trauma sells a $3k packable abdominal evisceration simulation aid

I recently watched the documentary Thoughts & Prayers which explores active shooter training and the industry surrounding it. One of the vendors featured is Techline Trauma who sell a Packable Abdominal Evisceration for $2,794.84 (https://techlinetrauma.com/collections/simulation-aids/products/ww3-902). I had stumbled upon the site a while back because they seem to make a decent product, but I emailed the company asking for more information on this specific simulation aid.

My original message:

Hello! I have a question about your Packable Abdominal Evisceration Simulation Aid. Is the packing portion designed for the simulated organs only or is the cavity also intended for wound packing gauze? Thank you for your time.

Their response:

Thanks for your inquiry. You should never attempt to replace the eviscerated organs into the body. The cavity is for gauze packing when significant bleeding is present.

Now this objectively goes against the CoTCCC Combat Medic & Paramedic guidelines plus the Army Techniques Publication for Casualty Response, Tactical Combat Casualty Care, and First Aid March 2026 which says things like “CAUTION Do not pack hemostatic dressings into the abdomen or chest.”, “While hemostatic dressings should be packed into limb wounds, they should not be used in the abdomen or chest.”, “WARNING Avoid packing wounds in the chest or abdomen.”, and “While hemostatic dressings should be packed into wounds of the limbs, when the source of bleeding is too high on the limb for TQ application (such as the neck, armpit, and groin) they should NOT be packed into the abdomen or chest.”

When I provided those citations I was met with the following:

Civilian medicine vs military medicine. The documents you reference are all military and assumed in austere environments and yes, the suggestion is to control bleeding and return the organ into its rightful cavity. Civilian medicine is to leave it exposed and covered to prevent further contamination. My response did not specifically state use hemostatic dressing in the cavity, my response was simply pack to control bleeding, if present.

So here’s where I’m just really hung up on the company selling a “packable” abdominal evisceration simulation aid and how that does anything but train using gauze to pack the cavity. I sent another message with quotes from and links to more “civilian” and less “austere” sources of information that can be viewed below.

https://handbook.bcehs.ca/clinical-practice-guidelines/pr-clinical-procedure-guide/pr04-wound-packing/

https://www.youtube.com/watch?v=XieRLnynqhA&t=255s

https://www.jems.com/patient-care/emergency-trauma-care/wound-packing-essentials-for-emts-and-paramedics/

https://www.nethealth.com/blog/wound-packing-basics/

https://scholars.uthscsa.edu/en/publications/the-management-of-abdominal-evisceration-in-tactical-combat-casua/

https://wms.org/magazine/magazine/1359/abdominal-trauma-update-evisceration-management/default.aspx

https://www.redcross.org/take-a-class/resources/learn-first-aid/abdominal-injury?srsltid=AfmBOoqXXvAZOl_blDYPXCSGo62YAUHSjiC3tAu-v6AFN15Fu2mciJN7

https://deltaemergency.com/thedeltadispatch/2025/4/15/how-to-handle-eviscerations-in-trauma-a-guide-for-emrs-and-afa-responders

https://www.instagram.com/p/DT0lfTID0oe/

I’ve reached out to my WEMT, 68W, and PA friends who agree that this is a pretty wack product. A quick pile on the supine patient with wet cloth and a protective layer is what I would do before transporting to a higher level of care. Their trademarked design just feels like an answer looking for a question. Am I taking crazy pills here??

submitted by /u/NomadMedix
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