Vigilance Elite – Tactical Combat Casualty Care (TCCC) Medical Training


all right hey what’s up guys John Ryan vigilant sleep again here with Dave Rutherford Navy SEAL 18 Delta motivational speaker author CIA whatever combat medic so we’re gonna talk about T Triple C which is tactical combat casualty care so it’s a mouthful that’s brown so go ahead man one of the first off thanks man it’s just always a privilege to be out here with Sean Ryan and vigilance elite man it’s one of the joys that I get to experience man it’s just being and I just man subscribe to his YouTube channel make sure you hit the bell on the bottom because this cat is putting the best content out there hands down so that’s my little plug for you brother thank you yeah so tactical combat casualty care man you know this was a revolutionary thing in the entire combat medicine I mean it changed everything bro and everybody’s like I you know they we’ve been training on it for 17 straight years little over that actually started in 98 was where really get started getting seated in the Special Operations in particular in 18 Delta or so J Psalm see right Joint Special Operations combat medic course in Fort Bragg which I went through in 98 and when I we showed up that all is there right all green berets all arranged there’s all us you know buds graduates man I didn’t even have my tried it going through it was horrible and and all you know PJ’s so all these guys totally focused on medicine and I was like alright I just want to learn how to give it and I he had a tourniquet let me out back to the platoon but what was fascinating was the history of it so everything changed everything prior to the Black Hawk Down incident 93 right prior to Mogadishu the basis of combat medicine had really been taken over post Vietnam by civilian para medicine because ride length times had really shortened emergency medicine had really improved in the hospitals in these major crime cities New York City LA Chicago where was exploding that’s where chips so when there’s no war going on it shifts backed into the hospital so when a Wars going on man we set the stage for all the advancements in that type of trauma medicine so Black Hawk Down happens right we lose a bunch of dudes and as it comes out in the debrief so it was discovered that maybe we weren’t doing the right thing you know two large gate 14-gauge open bore IVs no tourniquets stuff like that it it it raised a lot of questions let’s just say that and I know guys that were there I went through 18 Delta with a guy that was on the ground for an old thing and been briefed by the Delta medic that was there on the ground and what happened was his captain Frank Butler is really intelligent smart doctor team guy looks at all this stuff team guy looks at all this stuff and says all right let’s get into this man let’s look at all the injuries throughout history and what kills dudes on a battlefield man and it’s pretty simple i bleeding out or basically you know trauma penetrating trauma of the chest irreversible surgery based trauma and your gut or you know blast injuries penetrating trauma the head or you know you’re dead on on your DOA right there right so the idea is all right well what can we address and the big ones are penetrating trauma through your extremities right well what’s the easiest way to do it tourniquets which all of a sudden now become at the forefront of what we’re gonna train all right what’s the next one well penetrating trauma through the chest if you figure out how to stop that the air from getting sucked in you know the your thoracic cavity right to cause that you know tension pneumo hemothorax which kills guys if you can stop that and get them you know let them sit for a while guys can live for a while with with a gunshot wound to the chest and one lung even so the cluesive dressings BAM just with those two three man you were raising mortality rates by 80% brother 80% on a battlefield right so there’s some other things that came in quick clot kind of these coagulated you know remember he poured in and originally it would burn your skin it would cauterize your skin but now the advancements chemically they’ve got an injectable thing that goes in for abdominal chest that’s really great stuff out there but those were the two key things that really changed and then the order of remember ABCs it always used to be airway breathing circulation well with this now we changed it up we flipped it around or I shouldn’t say I didn’t I was just a newbie when they were teaching this stuff so they flipped around and they started saying all right under fire what do we need to think about first and right tactical combat casualty care well the first thing we need to do is what when the fire fight when the fire fight right and there are a bunch of incidents in particular Mogadishu well once there was a casualty like the whole crew went to this casualty and forgot that they were know in a high-threat high-risk tactical environment so just that alone in terms of platoon commanders chiefs or master sergeants whoever was in charge OTAs whatever and just that alone was saying hey just because we have a casualty it does not redirect the entirety of the mission focus which was huge so that changed right and the next one obviously is once you gain fire superiority you know you then you deal with movement and it becomes let’s get that guy out of here let’s just not sit on the axe and treat right there let’s get off the X get some cover concealment time and opportunity and now sudden let’s address the casually right and then once you’re in that space boom tourniquets well people are like why can’t if it dudes not dying right away why can’t he just apply his own turn kid Knight thus that’s why everybody should basically have if you’re in a combat environment for tourniquets at a minimum on you right civilian one is enough probably but in combat you definitely have to have one for extremity plus an occlusive dressing then but but in the first parts of a gunfight man that’s really the thing then you get to that cover in concealment then you can go down the line and move into the chest feels good bandaging you know policing the guy up take out litters whatever and really kind of stage it in a more mathematical better tactical mindset and that’s what what this did and man you know I remember going through in 98 we were the second class in the new place out and brag and we spent a month just running through T Triple C and when I got to the teams we picked it up I went through this wonderful course in 98 called Advance battlefield trauma it was so awesome Sean man you would have loved this course I thought every seal should have gone through it they basically took there was I think there’s 16 medics we went out to the island we spent four days going through the entirety triple c curriculum and and we had four doctors and we said as this work is this work and we hashed everything out and they proved everything then we went out and we did man down drills morning noon and night oh man I never did more man carries in my whole life we put tourniquets in a boat I gave IVs on a zodiac I gave IVs in a briar patch I gave IVs in a in a helo at night on nods man I I did everything everywhere and so did everybody else and each guy would move around to take the role as the platoon commander the medic and then just the nugs right you know so it really created this comprehensive overview and understanding of what it meant for that comprehensive T triple T and that was where my skill sets just jump fast forward I become a sqt and truckers steel coffin instructor that’s where we met and I was in charge of doing all the scenarios that we went through now one of the interesting things you know I punched out after a combat deployment to Afghanistan Oh to use T Triple C myself there and coming back and then teaching it to you guys what I always thought was fascinating is once you guys got into Iraq and that that popped off man we really saw it come into play if I’m not correct huh yeah you know so just breaking it down real cool teacher we’ll see is it’s it’s like a process that you go through so if you can’t win the fire fight then you’re gonna take more casualties so the most important thing you want to do is when the fire fight all right absolutely then pulling them off the X the X is where the initial contact happened or where the bullets are flying – all right so you got to get off the X – some type of safety before you can safely treat somebody ok so that’s kind of like its tactics and medicine all die lumped into one huge very in-depth very kinetic dynamic course so you know when you were in Iraq where they when you guys were hearing about casualties T Triple C just all the lessons learned just started compiling if I’m not mistaken right it kept evolving evolving evolving and I mean I don’t even I don’t even know how many teacher will see courses I’ve done and you know live tissue labs and goulash labs and I mean you know from one we met you know was tourniquets IVs occlusive dressing x’ I mean it’s always been that IVs have kind of gone to the wayside yeah it seems like but you know minor things have changed they come up with new tourniquets they came up with you know the Ashman chest still kind of went away and now they have that new one I can’t remember what yeah the hell they call it but you know it’s always it’s always little things that change like how long can you keep the tourniquet on I remember I think initially it was what like above the elbow and then guys kept dying because they were getting they were missing entry wounds so then it became don’t just go above the wound that you see just go up on you know all the way up on the external on the extremity that way you don’t miss any and then readjust on triage yeah when you yeah when you reassess when you you know take the clothing off look and and you know if you can lower it great if you can’t then you know but initially you know that’s what they they started coming out with was just put it up as high as you can and tell until you take over when you got when you switched over and start contracting for the agency where they trained in the same level as you were getting in the platoons I would say I don’t know if I would say it’s the same level I think the training was just as good it was just very different because you’re running two guys versus sixteen dudes or you know whatever many guys are in your team and tasking it whatever but yeah so I mean it same concept but completely different because your operation Wow yeah where it’s you and you know one other guy or a couple other people or so I mean the med stuff was had evolved you know a little bit same type concepts but the tactical portion was completely completely differently different I remember when I when I first went to work for the agency I was actually training case officers for two years before I went on being started doing what we did and we helped set that program that whole program no I keep it started about three years prior to me getting there what I did when I came in is I help revamp the medical portion the T Triple C portion of it and then we actually helped them make the transition to bring it in-house through a particularly in within the agency and and we wrote the curriculum me and another guy who is still a reservist and an army who’s one of the greatest curriculum development guys I ever worked with and the world man guy was genius and then another guy out there who’s really smart SF meta qui he we all work together to create this curriculum and really take it to the next level so I remember you know teaching this stuff you know to case officers who would be working with us or they would actually be working with our guys you know going out with the Tier one units or even with regular the regular teams or OTAs and and and man it was really cool to see the aptitude that this stuff because of the structure and the technical methodical way T Triple C is implemented in a in a in a firefight even case officers you know we’re able to pick it up rapidly and be able to do it under high stress which was a really cool thing and then obviously going operational where we then we came together again it was always nice to see you know that regardless if it was a two seals working together if it was two Green Berets working together a green beret seal Rangers seal MARSOC guy seal whoever it was an agency guide no matter what when we work together T Triple C didn’t matter the fundamentals were universally applied across unit tactics yeah so I mean that’s kind of the history and how its evolved and kind of like what T Triple C actually means which I think a lot of people have kind of gotten away from the meat and potatoes of it and there’s there’s a truckload of information online you can go read there’s a lot of history behind it that you can rip up there’s a ton of actual good maddox out there that are teaching this stuff you can find a lot of baseline videos online highly recommend that I know we’re going to be putting out some more T Triple C videos we’re going to do actually a two Triple C vigilance elite course here coming up so please you know contact Shawn and you’ll see my ugly up mug out there and I’ll be putting a tourniquet around your neck boy all right don’t forget to subscribe to our YouTube channels team frog logic vigilance elite Instagram Shawn Ryan 762 vigilance lead team frog logic team never quit and hit that Bell at the bottom and we’ll see you next week

100 thoughts on “Vigilance Elite – Tactical Combat Casualty Care (TCCC) Medical Training

  1. Ruts high energy and Shawn's No bullshit makes these videos truly awesome . Great chemistry if I might add… Thank you Shawn and Rut for your service and knowledge. Aways looking forward to next week Shawn . . Cheers !!

  2. Ruts mic levels need to be adjusted like for example around 13:00 u can hear how much it pops n gets distorted . Has that sound like when u have a mic to close to your mouth.

  3. Dang, man… Does Shawn Ryan have a sense of humor, or is he just stone cold business? I do not want to piss that guy off.

  4. Paul Howes a friend…go check out his documentary on blackhawk down if you havent. Great, great vid as usual Shawn, favorite channel on the tube man, cheers…

  5. I really love your videos bro!! Informative in the best way that's not a mind numbing sleep aid. Every guest you have I automatically subscribe and follow because if they're in your video that's all I need to know! Thanks again brother! Keep it up!

  6. My wife thinks Iโ€™m paranoid because I always have a crazy med kit with me. From band aids all the way to chest seals.

  7. Always take your gloves off when your checking someone for entry and exit wounds because itโ€™s easier to feel holes and blood with bare hands. This is especially so if itโ€™s dark.

  8. Got my SCW's pin at my first command and learned a little bit about causality care then i went to a eod mobile unit got my EXW pin and learned a lot about TCCC. Now im training the support guys going for their EXW what to do. I love the channel and videos!!!! Keep it up!!!

  9. Med retired 11 bang bang. 13yrs. Thank you very much for your awesome vids. True to the end. Cordon the area, providing 360 deg security suppressing fire towards enemy. Lace report. 9 line if necessary. Mission dictates. The ๐Ÿ˜€๐Ÿ‘ thank you for your service

  10. I worked with a DARPA program manager a long while ago and they were working on an estrogen based shot that would help the wounded survive greater blood loss. Not sure if it has filtered down to the military yet.

  11. Saw a video yesterday by Wil Willis(Army Ranger and USAF PJ) on how to do the Ranger Roll when needing to carry casualties. Talk about badass!

    Watched 160lb guy roll up and carry a 220lb guy on his shoulders like it was nothing! Best part was he explained that you can do this with all gear on, including your weapon. All except probably a rucksack. Able to be done standing, running, or even on your knees. At one point, he even did it from his back, while laying across the other guy back to chest. It was awesome to watch.

  12. great video; misspeak @4:45: ",,,raising mortality rates…." No, with those interventions in the field (occlusive dressings- preventing expanding pneumothorax, and use of tourniquets- decreasing blood loss), you were decreasing mortality rates.

  13. Guys are you getting any training by the tactical strategic medical training at all, ie: the company based in the US which uses real people who have lost limb etc and then put the medical training aspect to treat these people in real world situations gun fire going off,explosions going of right next to your medical care with the real amputee and also with fake upper torso rubber or plastic upper torso injuries etc. ๐Ÿ™‚

  14. Really like watching these guys and hearing there stories which are very informative and canโ€™t wait to watch some new content.

  15. Hey Rut I'm going to school to be and emt and I'm looking for some advice thanks. And I would like to email you but can't find it. Thanks

  16. Iโ€™ve always carried tourneys in my range bag. Buddy asked me once, โ€œyou expecting something bad?โ€. Nope, but better to have and not need but if you need and donโ€™t have, your dead.

  17. The moth to flame or children's soccer game happens in the fire service too sometimes when a MAYDAY is transmitted. The OIC must ensure everyone continues to control the fire while a team locates and removes the injured person. If everyone abandons their orders and focus's on the injured person the fire or fire fight will grow.

  18. Hey Shawn. I'd just like to say, for a guy like myself, getting to peer into your world is absolutely invaluable. Due to medical circumstances I was never able to serve in the military. As a young kid, this was…. heartbreaking. To be able to see you discuss these crucial factors is just amazing.

    Keep going strong, man. I appreciate you.

  19. First of all, u guys are fucking legit, 2nd i cant stop watching this channel, 3rd and most important i learn so much. Thank you shawn and rut! And you other guys who come on too! And ladies! Corrine is a bad ass…wouldn't wanna fuck with her ….

  20. I'm an 11 year EMT. Awesome clip here. I did a shooting a week ago. Hearing this is just incredible

  21. I have heard people from back east refer to the places I like to go out west as only accessible by way of "DEATH HIGHWAYS", and I am way out 4 hours from any trauma centers shooting (always with someone who can at least call 911 and knows where we are), so this is super great content for anyone who lives out away from "the big shitty," I mean big city. Parts of my state are technically sovereign TRIBAL LANDS, and not actually the USA, so I am sitting on my butt staring through a piece of moving glass for hours on end, so a shoulder holster works for me, but I do usually (always) have a little Glock tucked somewhere, it's just really hard to access quickly through a seatbelt or a harness.

  22. Just found this channel and really have enjoyed watching several this evening. This is what our greatest Americans are all about. Notice the sentence around 2:08 and the cities mentioned are not just the largest, they also have the most restrictive gun control measures in place that cause the most trauma to civilians. Keep that in mind in the upcoming elections.

    God bless you men and thank you so much for what you do and have done with your lives. America's Finest role models.

  23. Ok, when they talked about readjusting the TQs after the initial application, Iโ€™m convinced these guys really know what they are talking about. These videos are worth watching. Subscribed.

  24. I do not have the experience in the military to say for sure, but dealing with wounded people seems more stressful than the actual firefight.

  25. bout time I discovered something entertaining on u tube..And fellow sailors to boot…Im all in!

  26. My c.a.t.s. came with a TCCC card i.c.e. do you suggest filling that out off X. I carry my tourniquet every time I carry concealed just makes sense to me I figure if I have to pull I'm not the only one who is packing. The medical side of combat is really intriguing to me because can't win if I'm dead. Love to see more in-depth videos on this subject and maybe what as a civvy I can do gear, practice to prepare myself for or my family.

  27. Whoever dislikes this stuff is an emotionally un-squared away endividual that needs to see the HM'S๐Ÿคฆโ€โ™‚๏ธ๐Ÿ˜‚๐Ÿคฃ

  28. Did some live tissue training back in 07' for pre deployment at Lejeune. Bunch of former SF guys running the course. A lot of Marines could have benefited, but PETA found out about it and it got shut down. Damn idiots mess everything up.

  29. I really enjoyed Ruts knowledge on this subject, one can really appreciate his experience and dope that he carries in that dome.

  30. Man would love for you to come talk to these young basketball hoopers to put things in perspective โ€ผ๏ธ

  31. Thats one thing about the old war movies i always thought was dumb, whenever one of the soldiers would get hit thered always be that guy who would run out in the open to save his buddy and end up getting shot himself. Glad to hear the military frowns on that behavior these days

  32. Military trauma Nurse here, part of a forward deployed Surgical team.

    Off to do my TCCC course in a few weeks haha.

  33. For anyone looking to see TCCC procedures in action, I would recommend "Inside combat rescue". You'll be able to see in action (Blood sweeps, IV/IM/Bone injections, tension pneumothorax/hemothorax, tourniquet installations, cricothyrotomy and many more things. Super interesting. Won't be as intense as what these guys go through since the PJ's don't go through initial contact.

  34. Man y'all are good men. I've never served in the military but have major respect for every man and woman serving in any branch. I respect what you are doing. Keep it up

  35. Battlefield advanced trauma, thats a tough one but worth it, saved many lives has that course. we were also taught not to be the next casualty.

  36. Wow, I cannot believe this guy sat through that. I could not….lets rid religions, that kill. And lets, end bankers wars. We are, not this species, anymore. You guys are amazing.

  37. I was one of the first instructors at Camp Lejeune. (I think we called it basic originally. 95 maybe, the Army created the first train the soldier programs.) I wish i could see your kit. Mine is much bigger but it is not tactical it is for if a riot occurs. Of course you have a gas mask which was not shown. I also keep some Harley motorcycle glasses for eye protection but they will only last doe a few minutes because the plastic foam will absorb the tear gas. I also keep plenty of ophthalmic saline. But it is hard to get now because they require a prescription. I keep two tourniquets but have 5 bandannas I can use for covering the eyes and can be turned into tourniquets. So I require more bulk. I also keep a lot of ace wraps for my bulky dressing. I am just mentioning this because i focus on riot control. I could only assist one person with a gunshot wound. I am more worried about glass and gas. I like the ace bandages for blunt damage too. I am sure your kit is good, better than mine for combat. I watched Antifa so made my kit accordingly. I protect myself with a gas mask so i can get other out of the tear gas and give them some shielding for a few minutes. I protect the eyes and keep plenty of those bulky eye dressings for penetrating would to the eye. I am sure you carry hemostats. Good job! Blunt trauma and eye injuries are the main threat by Antifa so far. I went the C4 route so have different training. Thanks for the video. The only experience i have with SEALs is one who one of their wives, an LT, got drunk and forgot her good sense, I got out of there fast. I did not need a SEAL on my ass. I used to hang some at Dam Neck, i think SEALs went there sometimes. I ran into a Master Chief Diver in GTMO. But I was Nurse Corps so had no need to be around ya'll. God Bles you.

  38. Who The FUCK are the Blowjobs Leaving THUMBs Down ? You should be the one shot in the chest with no1 able to help ….

  39. Why only a thousand thumbs up IF ANYTHING SUPPORT THIS BROTHER BY A SIMPLE THUMBS UP. AND TO THIRTY THUMBS DOWN SCREW YOU Al-Qaeda

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