# TCCC- CEU



## NysEms2117 (Nov 9, 2016)

does anybody have any experience with the TCCC(tactical combat casualty care) CEU? Is there a difference between TCCC and TECC and LEFR-TCC? i'm looking to take a few, but dont really know which ones to take.. Im an EMT-B. also is EPC aimed at ALS providers?

I have already read the NAEMT website.


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## STXmedic (Nov 9, 2016)

They're accredited by CECBEMS. TCCC offers 16hrs CE, TECC offers 8hrs, and I believe LEFR is just 4hrs.

TCCC is overkill for most providers, but I like that it goes into more depth in certain areas. As an EMT, some of it will be above your scope (ABx, pain management, fluid considerations, etc).

TECC is typically sufficient for most field medics. It gives you the down and dirty trauma care considerations, with some scenario based learning (ideally). TECC can vary quite a bit though since it was designed to be flexible to local areas.

LEFR is basically bleeding control and when to do it.


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## EpiEMS (Nov 9, 2016)

Doesn't seem like a ton of value-added above PHTLS, unless I'm mistaken?


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## NysEms2117 (Nov 9, 2016)

EpiEMS said:


> Doesn't seem like a ton of value-added above PHTLS, unless I'm mistaken?


i was also trying to add something to my resume of my main job if i could too, EPC was just something that interested me. 



STXmedic said:


> TCCC is overkill for most providers, but I like that it goes into more depth in certain areas. As an EMT, some of it will be above your scope (ABx, pain management, fluid considerations, etc).


Would i still be allowed to enroll in it? or would it just be moot at that point?


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## EpiEMS (Nov 9, 2016)

NysEms2117 said:


> i was also trying to add something to my resume of my main job if i could too, EPC was just something that interested me.
> 
> 
> Would i still be allowed to enroll in it? or would it just be moot at that point?



Gotcha - I think TECC should do nicely. The best class, it seems, is CONTOMS, which I think is offered by the National Parks Service?


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## NysEms2117 (Nov 9, 2016)

EpiEMS said:


> Gotcha - I think TECC should do nicely. The best class, it seems, is CONTOMS, which I think is offered by the National Parks Service?


looking at that now... Trying to figure out if i meet the reqs for an EMT-T.. never even heard of that before.

Also looked at the locations >.<


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## STXmedic (Nov 9, 2016)

Yes, you're still allowed to take the course as an EMT. 

I think these courses can be very hit or miss. Some are exceedingly good, especially if the hands-on or scenario portion is good. Others are quite poor and mostly death by PowerPoint. Ask around if anybody in your area has taken the course and their thoughts on it.


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## NysEms2117 (Nov 9, 2016)

Has anybody every heard of this: https://www.naemt.org/education/epc/EPCCourses.aspx because it offers a broad range of EMT-Physician, which worries me


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## EpiEMS (Nov 9, 2016)

NysEms2117 said:


> Has anybody every heard of this: https://www.naemt.org/education/epc/EPCCourses.aspx because it offers a broad range of EMT-Physician, which worries me



EPC is a combined course - like GEMS and some of the others - where you have BLS and ALS all there. I took a GEMS class like that, and it was just fine. They even have BLS-specific exams even for a combined class.


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## Qulevrius (Nov 9, 2016)

NysEms2117 said:


> Would i still be allowed to enroll in it? or would it just be moot at that point?



You can enroll and graduate, but most of the stuff they'll teach you will be out of your scope as a civvy EMT.


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## rescue1 (Nov 10, 2016)

Qulevrius said:


> You can enroll and graduate, but most of the stuff they'll teach you will be out of your scope as a civvy EMT.



That's not necessarily a bad thing. It's good to get an appreciation for the care beyond your scope of practice, and it can only make you a stronger provider, assuming you don't start trying to dose patients with antibiotics yourself.


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## Qulevrius (Nov 10, 2016)

rescue1 said:


> That's not necessarily a bad thing. It's good to get an appreciation for the care beyond your scope of practice, and it can only make you a stronger provider, assuming you don't start trying to dose patients with antibiotics yourself.



Tx3C isn't about dosing patients with antibiotics, mate...


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## rescue1 (Nov 10, 2016)

Qulevrius said:


> Tx3C isn't about dosing patients with antibiotics, mate...



TCCC has recommendations about pre-hospital antibiotics for a variety of different traumas, at least the military one does.


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## STXmedic (Nov 10, 2016)

Qulevrius said:


> Tx3C isn't about dosing patients with antibiotics, mate...


There is a large section about dosing a patient with antibiotics, mate.


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## Qulevrius (Nov 10, 2016)

STXmedic said:


> There is a large section about dosing a patient with antibiotics, mate.



Same as it has large sections about exsanguination and blast trauma. Your point ?


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## STXmedic (Nov 10, 2016)

Qulevrius said:


> Same as it has large sections about exsanguination and blast trauma. Your point ?


Oh? Are we not assuming that a single reference to something should be extrapolated to mean far more than it actually did? I thought that's what we were doing... I'll stop following your lead then


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## Qulevrius (Nov 10, 2016)

Or maybe you can lose some of that smug, go back and re-read my first. Then you can extrapolate all you want.


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## rescue1 (Nov 10, 2016)

Qulevrius said:


> Same as it has large sections about exsanguination and blast trauma. Your point ?



My point was just that antibiotics for trauma is outside the scope for civilian EMS in the US, so it was an example of taking a course that had stuff outside your scope and then deciding to inappropriately use it in the field. I could just have easily used "put in a chest tube" as an example too. So I guess I don't really understand what the confusion is.


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## STXmedic (Nov 10, 2016)

You make comment about being out of scope

Rescue makes a reference to one of the out of scope things

You say the course is not about that thing

He never said the course was about that thing

I extrapolate that your reading comprehension is poor



Oh, and I'm sorry if I came across as smug. That was not my intent. Smartass was my intent.


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## Qulevrius (Nov 10, 2016)

rescue1 said:


> My point was just that antibiotics for trauma is outside the scope for civilian EMS in the US, so it was an example of taking a course that had stuff outside your scope and then deciding to inappropriately use it in the field. I could just have easily used "put in a chest tube" as an example too. So I guess I don't really understand what the confusion is.



There's no confusion. Extracurricular stuff is always useful, especially when it's applicable in your current field. Getting familiar with the pharm section of Tx3C is good and nice, but it's purely academic. In the end of the day, it will only benefit you if you decide to further your education beyond your current scope.


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## Qulevrius (Nov 10, 2016)

STXmedic said:


> You make comment about being out of scope
> 
> Rescue makes a reference to one of the out of scope things
> 
> ...



Then I'm sorry to tell you, but you missed the mark. The entire point is that you don't have to take the entire course to familiarize yourself with a single concept of tactical casualty care (which, incidentally, is utterly useless to a civvy EMS provider). Unless, of course, the said course is offered to you free of charge; in which case...


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## STXmedic (Nov 10, 2016)

Qulevrius said:


> Then I'm sorry to tell you, but you missed the mark. The entire point is that you don't have to take the entire course to familiarize yourself with a single concept of tactical casualty care (which, incidentally, is utterly useless to a civvy EMS provider). Unless, of course, the said course is offered to you free of charge; in which case...


Then it's not your reading compression, it's your expression (considering two of us immediately read it the same way).

While I wouldn't say TCCC is useless, it certainly covers more and goes into some concepts that most civilian providers won't need. It does give a different perspective on trauma care, and a good course will have you functioning under stress, which can be useful even as a civilian.

And if it's free, definitely jump on it  Especially since a lot of services see value in the training (regardless of if there is any or not) and are often willing to send their personnel.


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## NysEms2117 (Nov 10, 2016)

I'm not sure I even meet the requirements for civvie ems either if I'm honest >.< but I do appreciate everybody's opinions and further knowledge on the subject then I had !!


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## Qulevrius (Nov 10, 2016)

STXmedic said:


> Then it's not your reading compression, it's your expression (considering two of us immediately read it the same way).
> 
> While I wouldn't say TCCC is useless, it certainly covers more and goes into some concepts that most civilian providers won't need. It does give a different perspective on trauma care, and a good course will have you functioning under stress, which can be useful even as a civilian.
> 
> And if it's free, definitely jump on it  Especially since a lot of services see value in the training (regardless of if there is any or not) and are often willing to send their personnel.



Gawd. Now you're making me type a wall of text, lest I'll be misunderstood again.

Honestly, I usually would be the 1st one to say that anything extra is beneficial (take it from someone who paid for various AHA certs out of the pocket, both to be more competitive and more knowledgeable). But in this particular case, as someone who's intimately familiar with Tx3C/CLS, I'm fairly convinced that in a civilian setting it will be more confusing rather than helpful. The main rationale is that it gives a provider considerably greater and more intimate knowledge with a rather narrow aspect of field care, but zero follow-up training. Which is, potentially, more dangerous than beneficial.

I've seen Whiskeys who freeze and I've seen Whiskeys who are cool and collected. In some of them, the continuous drills kick in and they autopilot it; and some just cannot get over a certain point. It's all individual, but the military, as a whole, makes sure they get continuous drills to keep them up to speed. As opposed to a civilian EMS provider who'll take the class, get his cert and hang it on the wall. It won't make him a better or a worse EMT/medic, because he won't ever use these skills. And to be completely clear on this, I'd rather take an extensive pathophys class, because it'll benefit me a magnitude times better.

P.S. Especially if it's free


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## STXmedic (Nov 10, 2016)

I'm quite intimately familiar with TCCC myself, as well as TECC and LEFR (never seen it referred to Tx3C before...).

I don't see how it would be confusing. The end goal of treating a traumatic injury doesn't change based on your location/situation. Bleeding needs to stop. Airways need to be patent. Breathing needs to be present. Circulation needs to be maintained. TCCC gives you some some insight on when to or not to provide certain interventions, but the interventions themselves are largely the same. A tourniquet is a tourniquet. QuikClot is QuikClot. The only thing I can think of off the top of my head that is significantly different is airway management, simply due to the limited options yet aggressiveness that TCCC employs. Otherwise, TCCC simply expands your toolbox and gives you a different perspective.

Oh yes, and I've seen the same. Both with military medics and civilians. But you can't tell me you think the stress training is useless? You said it yourself that some of them fall into autopilot and fall back to their training. And without knowing your limits, how do you know where you stand or how to improve? A single class with stress innoculation isn't going to turn you into a badass with ice in your veins, but it can help, and it will show you weaknesses that need work. At that point it's up to the individual to continue improving- some will and some won't.

I'm with you, I love going into in depth medical topics. I've got a copy of Katzung's open on my desk right now. But even there, there's only so much you can put into use. Tell me the last patient you actually thought about inflammatory cytokines with. Or did you recognize sepsis, load them with fluids, and manage them until you gotto the ED. As field providers, there's only so much extensive medical education that can be beneficial. And again, I love reading that crap too. You just very often can't use the advanced stuff. Same with the combat medicine courses. You can't use it all, but you can certainly benefit from some of it.

I honestly don't know why I'm arguing this though.... Just to be argumentative I'm sure  Damn bourbon...


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## Qulevrius (Nov 11, 2016)

Yeah, it seems that we're pretty much on the same page. Good talk. I just want to address the issue of stress inoculation; as an example, let's take the live fire drills (unrelated to medicine) - everyone goes through it, but the infantry guys get it the hardest, with actual stress training. As in, being slapped up your head, sand and gravel kicked in your face, blanks fired over your head etc. 2-3 weeks of that crap every day, and eventually the grunts start ignoring the distractions. But it doesn't stop there, they go through that ordeal every training phase. As opposed to the usual 2nd-3rd echelon troops who have the mandatory training but nothing extensive, and not too many refreshers. Long story short, the more you sweat in training...


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## STXmedic (Nov 11, 2016)

Absolutely. Our team trains quite regularly with inoculation, and for some of our guys it's still not enough. I wouldn't expect anybody to be hardened after a TCCC course, mainly just more aware.


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## Handsome Robb (Nov 12, 2016)

One of these days I'll make it down to take one of your classes @STXmedic. Been a couple years since I took my last TOMS/TCCC class. 

If you slap me in the head in a scenario I will slap you right back. 


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## STXmedic (Nov 12, 2016)

Handsome Robb said:


> One of these days I'll make it down to take one of your classes @STXmedic. Been a couple years since I took my TOMS/TCCC class.
> 
> If you slap me in the head in a scenario I will slap you right back.
> 
> ...


We still have two spots in the next one 

We've got the 56hr course coming up in a couple months though. That's the one you want to come to 

Well don't need an attention-getter and you won't get slapped...


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## Handsome Robb (Nov 12, 2016)

Did I give you my new number? Send me the deets on the 56 hour course. 


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## Bullets (Nov 14, 2016)

NysEms2117 said:


> does anybody have any experience with the TCCC(tactical combat casualty care) CEU? Is there a difference between TCCC and TECC and LEFR-TCC? i'm looking to take a few, but dont really know which ones to take.. Im an EMT-B. also is EPC aimed at ALS providers?
> 
> I have already read the NAEMT website.


Take TCCC, if down the road you decide to get an instructor cert and you have TCCC you can also teach down to TECC and LEFR. If you only have TECC you can teach TECC and LEFR but not TCCC.


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