Expert insights on TCCC, combat casualty care, military medical training, and simulation-based learning from Chester 'Chet' Shermer, MD, FACEP.
23 published articles.
The 1 May 2026 TCCC steps for an abdominal evisceration: control bleeding, rinse, cover moist or water-impermeable, no reduction with leakage or active bleeding, at most one brief attempt otherwise, NPO, ceftriaxone, and a surgeon.
Read Abdominal Evisceration in TCCC: When to Reduce, How to Cover
The 2009 60-minute MEDEVAC mandate cut killed-in-action rates. The reanalysis shows how much came from the clock and how much from blood and surgical teams.
Read The Golden Hour Mandate: What Actually Saved Lives in Afghanistan
The 1 May 2026 TCCC steps for a suspected penetrating eye injury: a field vision test, a rigid shield with nothing under it, ceftriaxone or cefadroxil under Change 25-1, and repair within 24 hours when possible.
Read Penetrating Eye Trauma in TCCC: Test, Shield, Treat, Evacuate
Why TCCC and the JTS drop the cervical collar for conscious, neurologically intact penetrating casualties, what the data show, and when blast or blunt force puts it back on.
Read Penetrating Neck Wounds in TCCC: When the Collar Stays in the Bag
The five TCCC pelvic binder triggers, why the binder belongs on the greater trochanters and not the belt line, what military data show about misplacement, and the 2026 JTS rules for skin checks, imaging and removal.
How to size a combat burn, start fluids with the Rule of Ten, and titrate on a long hold, with the data on what over-resuscitation costs evacuated casualties.
Read Burn Fluids in TCCC: The Rule of Ten and the Cost of Overshooting
The Rule of Ten sets the starting fluid rate for burns over 20% TBSA. The errors come from counting the wrong skin, titrating only upward, and letting the casualty get cold. Checked against the 1 May 2026 TCCC Guidelines and the 2025 JTS Burn Care CPG.
Read TCCC Burn Care: The Rule of Ten and the Errors Around It
Army medics gave calcium correctly in 31% of simulated transfusions, mostly from gram-versus-milliliter confusion. The TCCC dose, JTS re-dosing, and what the evidence actually shows.
Read Calcium After the First Unit: Getting the TCCC Dose Right
Four TCCC tiers, four scopes. Which skills belong to All Service Members, Combat Lifesavers, medics and corpsmen, and paramedics and providers, confirmed against the current JTS skill sets and the 1 May 2026 guideline.
Read TCCC Tiers Explained: What ASM, CLS, CMC, and CPP Each Must Do
A 2026 bench study found prolonged high surface temperatures on several self-warming blankets. Here is what combat medics should take from the data while following current TCCC guidance.
Read Self-Warming Blankets in Combat Care: What New Tests Mean
The 2026 TCCC analgesia framework adds suzetrigine and reframes initial treatment around mission capability. Here is what medics should understand and train.
Read The 2026 TCCC Analgesia Update: Treat for Function, Not Just Pain
TXA is a time-sensitive adjunct, not a reflex. Here is how current JTS guidance and recent trauma evidence shape timing, selection, dose, and training for military medics.
Read Tranexamic Acid in Tactical Trauma Care: Timing, Selection, and What the Evidence Supports
A MEDEVAC handoff can fail before the aircraft arrives. Use a structured report, package the casualty for movement, and plan for the longer trip.
Read En Route Care Starts Before the Aircraft: Package the Casualty for MEDEVAC
The 2026 TCCC hierarchy keeps whole blood first. Here is where dried plasma fits when conventional plasma or balanced blood products cannot reach the casualty.
Read Dried Plasma in TCCC: The Bridge When Whole Blood Is Out of Reach
TCCC Change 24-1 shifts field airway training toward positioning, selective adjuncts, and repeated reassessment. Here is how to train the decision before the device.
Read The 2025 TCCC Airway Update: Position First, Reassess Constantly
The latest prehospital whole-blood evidence does not make the decision simpler. Here is what combat medics should train about product choice, compatibility, handoff, and readiness.
The 1 May 2026 TCCC guideline is a focused update, not a new system. Here is what is adopted, what is only proposed, what did not change at all, and what your unit trains before the next event.
Read What Changed in the 2026 TCCC Update, and What Your Unit Trains Next
A field-ready review of moderate-to-severe traumatic brain injury management for combat medics and flight medics, covering initial assessment, secondary injury prevention, and evacuation priorities.
Read Moderate-to-Severe TBI: Immediate Management & Transport
For military medical personnel, maintaining proficiency in NREMT EMT and TCCC-MP is crucial. This guide provides practical strategies for preparing for these certifications and sustaining medical readiness between deployments, ensuring you're always mission-ready.
Read Combat Medic Certifications: NREMT EMT, TCCC-MP & Readiness
Tension pneumothorax is a leading cause of preventable death on the battlefield. This guide provides a step-by-step approach to recognizing and managing this critical injury with needle decompression in tactical environments, adhering to TCCC guidelines.
Read Tension Pneumothorax: Recognition & Needle Decompression
For military medical personnel, mastering Tactical Combat Casualty Care (TCCC) isn't just about knowing facts; it's about performing under pressure. This post explores why hands-on simulation training is superior to traditional classroom lectures for TCCC skill retention and operational readiness.
Prolonged Field Care (PFC) is a critical capability for military medical personnel when evacuation is delayed. This post outlines the fundamental principles and practical considerations for managing casualties effectively beyond the initial golden hour, emphasizing resourcefulness and advanced skill sets.
Read PFC Fundamentals: Managing Casualties Beyond the Golden Hour
Mastering TCCC tourniquet application is vital for combat medics. Learn when, where, and how to apply, avoiding common errors to maximize effectiveness and save lives on the battlefield.