TCCC: Trauma Medicine for Military and Civilians w/ Archangel Dynamics

I recently spent a weekend taking a TCCC (Tactical Combat Casualty Care) course from Myles Francis at Archangel Dynamics. TCCC is a program originally developed by the Naval Special Warfare School to improve battlefield survivability by specifically modernizing immediate pre-evacuation care doctrine. Retrospective studies showed that a significant number of fatalities had been potentially savable, and three specific condition showed through in the data:

– Massive hemorrhage
– Blocked airway
– Tension pneumothorax

New practices were developed to specifically address these issues, and after their rollout to the whole infantry for circa 2010, combat fatalities dropped significantly. The most important element of the new care guidelines was much greater use of tourniquets to stop bleeding. Prior dogma had it that use of a tourniquet was for only the worst possible situation, because it was said that tourniquet use would result in limb amputation. This was shown to be quite demonstrably not true, and use of tourniquets is now encouraged as an immediate response to massive limb bleeding.

These military care doctrines have come full circle into use by civilian trauma responders. First-world medical care is generally excellent, but that only matters once an ambulance arrives on the scene of an injury. The injuries addressed by TCCC happen in the civilian world, caused by things like car accidents, industrial accidents, power tool accidents, and civilian shootings, either defensive or criminal.

I came away from this class with a great amount of new information and skills. I’m certainly no paramedic, but what I learned gives me the basics needed to potentially safe a life before the professionals can arrive to a scene. I think it’s very worthwhile training to have for anyone, and doubly so for anyone around firearms on a regular basis.

Disclosure: I paid for this class fully out of pocket, and received no remuneration from Myles or Archangel Dynamics.


  1. Fascinating!
    Let’s hear some more about emergency medicine as relates to gun-shot wounds or car crashes.
    Perhaps your next video should be 15 minutes on handling a single wound … perhaps a bullet to the lower leg.

  2. Note how important it is to have rapid transport to higher level medical care: In war this requires air superiority or at least a good chance that a helicopter can get to and from the combat zone. In the civilian world this touches on how close a higher level medical facility is. Here in the USA we have lost around 150 or more rural hospitals in the last 10 years or so (Cf.

    • Canadians snickering about America’s vaunted medical system which is superb for the wealthy and laughable for the poor. But that is a huge political and economic question, way too big for this forum.

    • Mattise,
      the closure of rural hospitals is major, yet often overlooked, healthcare issue in many states. I know it is a serious problem in many counties in Virginia where I live. Thanks for mentioning this.

  3. In Indianapolis, when some asshole ™ was stopped by Elisha Dickens, I have read reports that his girlfriend, a nursing student, rendered aid once the shooting stopped.

    Ian, you are correct: *SOMEBODY* is likely to require aid. BE that somebody who can provide that aid.

  4. The information you present is really true, reflecting events accurately and unbiasedly, and I will have to follow you since it is important for society as a whole to advance.

  5. Very interesting video. This is a topic I am very interested in learning more about; hopefully, I can find a similar class here in central Virginia. Thanks for sharing, Ian.

  6. “gunshots… nowhere near as many as the military…”

    My 300,000 person town has a bullet wound a day. There are probably five hundred to a thousand people shot in the U. S. on any given day. The military has nothing on this armed population.

    • Brady’s stat is 321 a day. I was extrapolating from my rather violent town, the country at large is slightly more peaceful.

      I doubt if the services have had 300 people shot in a day since Nixon was President.

      Knowing this stuff may save the life of someone you know. Get trained.

  7. Range accidents should always be a part of your plan, whenever you go out shooting. Knew a guy who managed to shoot himself in the thigh while fumbling around with a new handgun, and that wasn’t a good day for anyone involved in the mess. When I drove out there to help get his vehicle back, I swear to God that place looked like someone had been slaughtering hogs with a weedwhacker… Blood everywhere. I was really glad I volunteered to drive, and wasn’t the guy who was gonna drive his truck back, because that vehicle was a straight-up mess.

    Guy survived, but he was out of it for a long, long time. If another shooter hadn’t have arrived when he did, the self-inflicted wound victim likely would have bled out from a nicked femoral artery. If you don’t take a first aid kit with a tourniquet out to every range, you’re a clear candidate for evolutionary action taking place.

    • I don’t agree with you. I think that Ian provides a service when he brings these things up, because it illuminates a facet of shooting sports and safety that I think needs doing.

      Hell, I think it’d be interesting to show the behind-the-scenes setup and planning that goes on for some of the ranges he participates in, just to explain to others what the hell all those weird beeping things are. You’d be surprised how few know what a timer sounds like, or how scoring works. The more that is explained, the more interest there is, and the more likely we are to get more people interested in the sports aspect of this stuff… Which makes it a lot less likely that the idjit politicians will ever be able to ban the things we like.

      I think Ian deserves commendation for these little asides; they’re freakin’ educational.

      On the other hand, if you could direct our attention towards some rare firearms that Ian could do pieces on, I’m sure we’d all be appreciative. Including Ian.

  8. Well done. Helpless against mass shootings at least we can better prepare to deal with its consequences while also helping with the myriad other dangers out there.

  9. This video on TCCC (Tactical Combat Casualty Care) with Archangel Dynamics provides valuable insights into trauma medicine that can be useful not only for military personnel but also for civilians in emergency situations. The instructors bring their extensive experience and expertise to the table, sharing practical tips and techniques for managing injuries that can mean the difference between life and death.

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