CAMP HANSEN, Okinawa, Japan -- A group of Marines with 9th Engineer Support Battalion, 3d Marine Logistics Group, listen intently to their instructors as they begin a Tactical Combat Casualty Care (TCCC) course, on Sept. 8, 2021,.
TCCC is the first step in a trauma life support situation to reduce preventable deaths while operating and maintaining mission success in a forward deployed environment. Upon finishing the course, Marines will become Combat Life-Saving certified with a completion of TCCC.

In the early 90s TCCC was introduced as a Naval Special Warfare biomedical project and was used by the Navy SEALs, Army Rangers, and Airforce Paratroopers. The project focused on improving the ability of special operators to provide timely care when higher echelon medical support is not immediately available. Studies showed that 90% of combat deaths happened before reaching any treatment facility. The majority of these deaths were from extremity hemorrhages, in other terms, bleeding out. This in turn proved that tourniquets are one of the most effective death-preventing tactical medicines available.

“Why is this course important to our mission, and the Marine Corps Expeditionary Advanced Base Operation concept?” asks Lt. Col. Marcus Gillett, the battalion commander of 9th ESB, to the group of Marines. “If doc’ becomes the casualty who is going to continue to provide aid to him and to the potential Marines to the left and right of you? The more Marines who can provide life-saving aid enables us to be ready for combat.”

Gillett plans for every Marine in the battalion to participate in the TCCC courses and to become CLS certified. HM3 Justin Harvey, and HM3 Anthony Nail, both corpsmen with 9th ESB, are tasked with the job to provide the training to each of the Marines.

“Realistically the ratio between Marines to corpsmen is about 100-1. The more Marines that are educated, the more lives could be saved on the battlefield. I also know I am not going to have my entire medical team with me, so if I go down I want to feel confident that my Marines will know what to do,” says Nail.

Harvey and Nail are conducting the first iteration of the TCCC courses during this mass training. Both the corpsmen work together to make the curriculum appropriate for each style of learning and to make sure each Marine is given the tools to properly conduct life-saving tasks.

“I am very passionate about anything medicine, teaching these Marines gets me so excited and pumped!” Nail exclaims. “Not only does it make me happy to teach something I am so passionate about, it makes me really happy to know that I am bettering Marines to my left and right and teaching them potentially life-saving skills.”

Harvey and Nail share the responsibility and the passion of medicine and are eager to get Marines trained to the best of their abilities.

“The biggest thing to me is to get people certified in the highest level of care that is possible for them. These trained Marines and this program is the future of combat medicine,” adds Harvey.

The course they have conducted involves 2 days of formal learning in a classroom setting, with practical applications during the lessons.

Harvey and Nail spend plenty of time going over the useful mnemonic device “MARCH PAWS”, a checklist to follow during the tactical field care and evacuation portion of TCCC. MARCH PAWS stands for Massive hemorrhaging, Airway, Respiratory, Circulation, Head, Pain, Antibiotic, Wounds, Splint.

“TCCC is the most important role in traumatic medical care – without effective TCCC our wounded have no chance to make it to the next echelon of care. TCCC is the first responders, and they are the first to spot the injuries and to treat them accordingly,” Harvey expresses. “I want to trust and know that from what I teach, that they are going to be able to be a first responder effectively and save lives.”

On top of in-class instructing, Marines are led to a training facility where they practice on lifelike and anatomically correct simulation dummies. The dummies can have injuries ranging from gunshot and burn wounds, to loss of entire limbs. They also bleed and even have the ability to talk to the trainees and express pain.

“I think the TCCC mannequins are a wonderful resource because of how realistic they are and the capabilities they have to offer,” Nail explains. “Using them gives the trainees the most authentic training without actually being in those situations. You never know what it is actually like to apply the medicine you’ve learned until you actually get to use it in the real world. These dummies are the closest we can get them to that experience.”

While the TCCC course is focused on timely medical care on the battlefield, it also holds strong value as a useful skill in everyday life, a fact one of Harvey and Nail’s students can personal attest to.

Sgt. Alexander Koeneke, an explosive ordnance disposal technician with Explosive Ordnance Disposal Company, 9th ESB, is a returning TCCC student. He participated in a CLS course in 2016, and is taking this TCCC course as a refresher. Koeneke describes this course as “leaps and bounds” better than the previous PowerPoint and lecture-based methods used to teach TCCC in the past.

“There is a lot more than just the added confidence on the battlefield to take away from TCCC. In life you’re going to run into situations outside of the Marine Corps, where people are going to get hurt,” says Koeneke. “For example, I once ran into a motorcycle accident, and the guy had a pretty bad traumatic amputation to his leg. I had to apply the skills I learned in TCCC in 2016, and put on a tourniquet! You just never know when you’re going to find yourself being the first responder for someone in need.”

TCCC is a quintessential skill for any person to have whether or not on a battlefield or in your hometown. Harvey and Nail help 9th ESB’s mission of all the Marines to be 100% TCCC qualified and ready. This enables the Marines to provide effective tactical medical care and to be confident in knowing what to do in situations where a corpsman cannot be provided.