TACTICAL COMBAT CASUALTY CARE (TCCC) CARD
BATTLE ROSTER #:
EVAC:
Urgent
Priority
Routine
NAME
LAST 4:
:
(Last, First)
DATE
TIME:
GENDER:
M
F
:
(DD-MMM-YY)
SERVICE:
UNIT:
ALLERGIES:
M
echanism of Injury:
(X all that apply)
Artillery
Blunt
Burn
Fall
Grenade
GSW
IED
Landmine
MVC
RPG
Other:
I
njury:
(Mark injuries with an X)
TQ: L Arm
TQ: R Arm
T
YPE:
T
IME:
T
IME:
TQ: L Leg
TQ: R Leg
T
YPE:
T
IME:
S
igns & Symptoms:
(Fill in the blank)
Time
Pulse
(Rate & Location)
Blood Pressure
/
/
/
/
Respiratory Rate
Pulse Ox % O2 Sat
AVPU
Pain Scale
(0-10)
DD Form 1380, JUN 2014
TCCC CARD
TACTICAL COMBAT CASUALTY CARE (TCCC) CARD
BATTLE ROSTER #:
EVAC:
Urgent
Priority
Routine
NAME
LAST 4:
:
(Last, First)
DATE
TIME:
GENDER:
M
F
:
(DD-MMM-YY)
SERVICE:
UNIT:
ALLERGIES:
M
echanism of Injury:
(X all that apply)
Artillery
Blunt
Burn
Fall
Grenade
GSW
IED
Landmine
MVC
RPG
Other:
I
njury:
(Mark injuries with an X)
TQ: L Arm
TQ: R Arm
T
YPE:
T
IME:
T
IME:
TQ: L Leg
TQ: R Leg
T
YPE:
T
IME:
S
igns & Symptoms:
(Fill in the blank)
Time
Pulse
(Rate & Location)
Blood Pressure
/
/
/
/
Respiratory Rate
Pulse Ox % O2 Sat
AVPU
Pain Scale
(0-10)
DD Form 1380, JUN 2014
TCCC CARD
BATTLE ROSTER #:
EVAC:
Urgent
Priority
Routine
T
Type
reatments:
(X all that apply, and fill in the blank)
C:
TQ-
Extremity
Junctional
Truncal
Dressing-
Hemostatic
Pressure
Other
A:
Intact
NPA
CRIC
ET-Tube
SGA
B:
O2
Needle-D
Chest-Tube
Chest-Seal
C:
Name
Volume
Route
Time
Fluid
Blood
Product
MEDS:
Name
Dose
Route
Time
Analgesic
(e.g., Ketamine,
Fentanyl,
Morphine)
Antibiotic
(e.g., Moxifloxacin,
Ertapenem)
Other
(e.g., TXA)
OTHER:
Combat-Pill-Pack
Eye-Shield
R
L)
Splint
(
Hypothermia-Prevention
Type:
N
OTES:
F
R
IRST
ESPONDER
N
L
4
AME
:
AST
:
(Last, First)
DD Form 1380, JUN 2014 (Back)
TCCC CARD
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