# TCCC, TECC, ITLS, PHTLS, TP-C, Acronyms everywhere



## ExpatMedic0 (Sep 5, 2016)

Hey guys,
I am hoping someone can provide some clarity for me regarding "Tactical EMS" and Prehospital Tactical themed Trauma courses. I am having a hard time differentiating them

First off, Let me start with what I think I may (or may not) know.

1. The BCCTPC (aka IBSC) offers the *Tactical Paramedic Certification* (TP-C) This is a written test (like the FP-C for example) but there is no mandatory course or practical portion required before taking the written test?
https://www.ibscertifications.org/certifications

2. The NAEMT offers *Tactical Combat Casualty Care* (TCCC) certification which according to the NAEMT website is based on PHTLS for combatants and combat support for military environments? http://www.naemt.org/education/TCCC.aspx

3.  The NAEMT also offers *Tactical Emergency Casualty Care (*TECC) Which according to the NAEMT website is based on TCCC, but for civilian EMS providers who are involved in some form of tactical EMS operations? http://www.naemt.org/education/tecc

4. The NAEMT also offers a military provider version of *Pre-Hospital Trauma Life Support *(PHTLS) which is really confusing since they also offer TCCC and TECC (and also a lower level *LEFR-TCC* for cops)? So really confused as to how military provider PHTLS differs from TCCC for example
http://www.naemt.org/education/PHTLS/PHTLScourses.aspx

5. ITLS offers a military provider version of I*nternational Trauma Life Support* (ITLS) just when it could not get anymore confusing. This appears to be a direct competitor to the PHTLS military cert?
https://www.itrauma.org/education/itls-military/

6. The National Park Service and other agencies offers *Counter Narcotics and Terrorism Operational Medical Support* (CONTOMS), which appears to result in a EMT-T and EMT-T Advanced certification and is also one of the older programs I herd back about back in the early 2000's. Appears to be a SWAT medic themed course, but I could be wrong?
https://www.nps.gov/subjects/uspp/contoms.htm

7. Am I missing any? Does any of this information sound wrong? I am especially confused about the military themed ITLS and PHTLS courses and how they differ.


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## dutemplar (Sep 5, 2016)

Nutshell version:

TPC is a test the wizards came up with to see if you understand the concepts of tactical medicine.  You're paying for letters and tested on "current materials knowledge.

PHTLS and ITLS are basically the same materials.  But released by a different group of doctors.  PHTLS is the American College of Surgeons.  ITLS is the American College of Emergency Physicians.

TECC is actually more like "combat medicine for cops."  They're now pushing that for tacticool EMS and "first responders."  Pretty much TQ, needle decompression/"cric" airway (if you consider a one hour lesson in how to do a cricothyroidotomy a lesson), drags and carries and an introduction to the concept of "Get off the X" "life saving intervention.".  Course quality varies GREATLY even given the same packaged content and you get what you pay for...

TCCC Is more a 24 hour couse of "combat medicine for medics"  It has a lot more in it than cops need (or want) but it certainly isn't a 16 hour 18D program.  Combat dressings, TQs, junctional TQs, crics, IOs, TXA, Ketamine...  Overkill for cops.  This was designed as either"ITLS" or "PHTLS" for combat medics"  Course quality varies GREATLY.

There is a difference in the military and civilian trauma courses.  Military tends to get big massive wounds, civilians tend to get a lot more normal fractures and injuries.  Civilians tend to get all age brackets.. military, not as much.  The military "trauma" modules are geared very much towards bullets, bombs and such.  NOT for car crashes, normal impalements,...

I thought CONTOMS vanished back in the day.  A few agencies do offer Tacticool Medic programs, Cyprus Creek Tx comes to mind, CDP Anniston was talking about it but I don't know if they pulled the trigger.

I don't know CCs quality, I've merely seen it advertised for several years.  Caveat emptor.
Cyprus Creek:  http://www.ccems.com/special-operations/basic-tactical-operational-medical-support-course-btomsc/


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## EpiEMS (Sep 6, 2016)

dutemplar said:


> Nutshell version:
> 
> TPC is a test the wizards came up with to see if you understand the concepts of tactical medicine.  You're paying for letters and tested on "current materials knowledge.


Apparently they're also developing a BLS version...for what it's worth...


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## Summit (Sep 6, 2016)

Oh good even more good acronyms! 

Uncle Sam is literally taking lessons!


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## WolfmanHarris (Sep 6, 2016)

Are any of these courses actually required for a medic to get on their tac team in most areas? Up here our tactical medics go through selection (written exam, scenario exam, the PD tactical team physical test, then an interview) but all the training is done after they're selected. I'd have to double check but I think they spend about 6 weeks FT training plus their ongoing training with PD's team and usual CME requirements.


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## dutemplar (Sep 6, 2016)

It's a split between agencies and policies may differ.  

However, the courses provide a basic foundation for tactical operations, care under fire, and casualty extrication and management.  Some places prefer their in-house training.  Level and quality differs.  

It _should_ be moving towards a standard of training with local flavor.  I would expect TP-C to become "normal."


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## MackTheKnife (Feb 12, 2017)

You ought to take a look at some of the nursing forums. Nurses that list every qual/cert they ever had. It's hilarious. And some will post something like "RN, BSN, NREMT, EMT, NREMT-P, EMT-P. Kind of redundant and overkill.


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## EpiEMS (Feb 13, 2017)

MackTheKnife said:


> Nurses that list every qual/cert they ever had.



I laugh even more when I see stacking levels, like this: "BSN, LPN, LVN, RN, EMT-I"  - Dude, if you're an RN, why do I care that you are an LPN and an LVN (aren't those the same?)

Or "ADN BSN MSN RN"...how about just "MSN, RN"? I've rarely seen folks in any of the other fields I've worked in have "M.S., Ph.D" on their business card when the degrees are in the same field or sequential - people just list their highest degree in the field (like if I had earned an ADN, got licensed as an RN, then earned my BSN, then earned my MSN and got licensed as an APRN, and then earned my DNP, I would just list DNP for my degree, and APRN for my level of licensure, not RN, APRN).


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## Summit (Feb 13, 2017)

MackTheKnife said:


> You ought to take a look at some of the nursing forums. Nurses that list every qual/cert they ever had. It's hilarious. And some will post something like "RN, BSN, NREMT, EMT, NREMT-P, EMT-P. Kind of redundant and overkill.


I believe I covered this here:



Summit said:


> Not quite... it should be (for the US):
> 
> 1. Highest degree in the discipline presenting
> 2. Highest degree in other disciplines
> ...


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## EpiEMS (Feb 13, 2017)

@Summit, I think that's generally right. (As you show, it goes highest degree in a field, then professional licenses/designations, then any relevant "stuff".) Basically, people only care about the highest degree(s) in a discipline and highest license(s) in a discipline, followed by any meaningful, relevant professional certification (i.e. not that a person took ACLS).


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## MackTheKnife (Feb 14, 2017)

My business card has "RN, EMT" after my name. I am NREMT certified. Not on my card. I am completing my BSN. I'm trying to take the Florida PM exam (FLDOH is screwed up!). Once I pass and get my BSN, my card will say "RN, EMT-P". That's it!

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## EpiEMS (Feb 14, 2017)

MackTheKnife said:


> My business card has "RN, EMT" after my name. I am NREMT certified. Not on my card. I am completing my BSN. I'm trying to take the Florida PM exam (FLDOH is screwed up!). Once I pass and get my BSN, my card will say "RN, EMT-P". That's it!



Why not BSN, RN, EMT-P, out of curiosity? (Presuming that the BSN is your highest degree, and the RN and EMT-P are your licensures)

That said, only in EMS do I use AB, NREMT. In my work outside of EMS, a bachelors degree is pretty much de rigueur (a masters-level degree is pretty much held by a third of folks).


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## SandpitMedic (Feb 14, 2017)

I found some confusion with NRP & the other NRP. National Registry vs. Neonatal Resuscitation?

So is it NRP and NR-P? Granted you shouldn't be writing specific certs in a sig line.

For instance, I'd sign:

AS, FP-C, NRP

How do you keep people from getting confused? Because NRP was a thing before the Registry changed from NREMT-P to NRP.
Or does it really matter at all... because no one cares I'm a paramedic. Haha!


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## MackTheKnife (Feb 14, 2017)

EpiEMS said:


> Why not BSN, RN, EMT-P, out of curiosity? (Presuming that the BSN is your highest degree, and the RN and EMT-P are your licensures)
> 
> That said, only in EMS do I use AB, NREMT. In my work outside of EMS, a bachelors degree is pretty much de rigueur (a masters-level degree is pretty much held by a third of folks).


I'm retired military. I feel I don't need to toot my own horn. I get so sick and tired of the "Nursing Alphabet Sickness Syndrome." And my first love will always be EMS. Us medics know we're special!

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## NomadicMedic (Feb 14, 2017)

I should stop signing stuff NREMT-P. I just think nobody knows what NRP is.


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## SandpitMedic (Feb 14, 2017)

NomadicMedic said:


> I should stop signing stuff NREMT-P. I just think nobody knows what NRP is.


Right, that's my point.


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## EpiEMS (Feb 14, 2017)

NomadicMedic said:


> I should stop signing stuff NREMT-P. I just think nobody knows what NRP is.



Neonatal Resuscitation Program, duh!


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## TransportJockey (Feb 14, 2017)

Eh I'm nrp and nr-p so they both work lol
My work email signature has FP-C, C-NPT, EMT-P on it. I throw the C-NPT because it's so uncommon and it was a pain to earn

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## MackTheKnife (Feb 14, 2017)

TransportJockey said:


> Eh I'm nrp and nr-p so they both work lol
> My work email signature has FP-C, C-NPT, EMT-P on it. I throw the C-NPT because it's so uncommon and it was a pain to earn
> 
> Sent from my SM-N920P using Tapatalk


What is that one?

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## VentMonkey (Feb 14, 2017)

MackTheKnife said:


> What is that one?


http://www.nccwebsite.org/Certification/Exam-detail.aspx?eid=26
Thought about, I just can't justify its existence and effective utilization with the general patient demographic at our program.


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## EpiEMS (Feb 15, 2017)

VentMonkey said:


> http://www.nccwebsite.org/Certification/Exam-detail.aspx?eid=26
> Thought about, I just can't justify its existence and effective utilization with the general patient demographic at our program.



It's probably tax deductible, which might be justification enough.


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