Instructor Manual TRAUMA CARE

Texas Commission on Law Enforcement
Officer Standard and Education
Texas Tactical Police Officer’s Association
Self-Aid/Buddy-Aid for Law Enforcement

Instructor Lesson Plan
Version 1.1
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Texas Commission on Law Enforcement

Officer Standard and Education
Texas Tactical Police Officer’s Association

Instructor Lesson Plan
Subject: Self-Aid/Buddy-Aid for Law Enforcement Instructor (train the trainer)
TCLEOSE#: PPD#:
Instructors: Add specific instructor’s names Phone: Add instructor(s)

here contact phone number here
Time Allotted: 16 hours
Instructor Aids: Laptop Computer; Projector with screen; Power Point; Medical Kit
Contents; Skills break-out sessions; outcome based training scenarios
Student Materials: Handouts with note taking space, pen, full duty/tactical rig, NO
WEAPONS
Prerequisite Experience of the Learners: Full-time or reserve local, state or federal law
enforcement, active duty military; No prior medical knowledge/training necessary
GOAL (PURPOSE OF COURSE): For students to be able to provide immediate Life

Saving Skills in the Law Enforcement Environment
Date Prepared: March 2010 Date Revised:
Prepared By: David Flory Revised By:

Brian Lankford
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©2010 Texas Tactical Police Officers Association – Self-Aid/Buddy-Aid Instructor Lesson Plan – All Rights Reserved.
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Instructors’ Profile
Insert bio of specific instructor(s) here…………………………
Course Schedule
16 Hours (dates/times to be determined by host agency/instructor)
Introduction to the course:
As a law enforcement officer you will likely be exposed to high-risk situations throughout
your career that have a potential for creating injuries and illness to you, your fellow
officers, and civilians. Being able to provide medical aid to those in need can reduce the
effects of the injury and increase the chance of the victims’ survival. Remember, the life
you may be saving could be that of your own.
This is an instructor course whereby students will learn how to teach the SABA concept
consisting of the history of Self-Aid/Buddy-Aid, the TCCC concept and history, use of
tourniquets, pressure dressings, etc. Throughout the course, instructor-students will
learn how to motivate students and exercise “teach back” techniques in order to ensure
that end-user students are absorbing the material.
Instructor’s Lesson Plan
Subject: Self-Aid/Buddy-Aid for Law Enforcement Instructor (train the trainer) Program
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MODULE
Self-Aid/Buddy-Aid (SABA) Programs:

1
Need, History and Concepts
TERMINAL OBJECTIVE
Upon completion of this module, the participant (student) will recognize the need for
Self-Aid/Buddy-Aid (SABA) training, the history and development of SABA concepts and
its importance on American law enforcement
ENABLING OBJECTIVES
The participant (student) will be able to:
• Illustrate the need for SABA programs.

• Understand how SABA programs can be a life saving tool for law enforcement
• Explain the history of SABA Programs and cite National events that have helped
create the need for SABA programs
• Explain how the military model of Tactical Combat Casualty Care (TCCC) has
influenced the development of civilian law enforcement SABA concepts and
programs
• Define Self-Aid, Buddy Aid and Medic Aid and be able to differentiate each from
the other
• Compare the strengths and vulnerabilities of these different types of aid
I. PREPARATION (Student Motivation/Opening Statement)
INTRODUCTION
Law enforcement is safer today than it was even as little as a decade ago. With strides
in equipment, body armor, vehicle design and safety tactics to name a few, we’ve
improved our ability to minimize officer’s injuries and deaths. However, as the families
of more than 100 of our colleagues who died in the line of duty during 2009 will attest,
we’ve not eliminated these risks altogether therefore, it is imperative we equip our
officers with the knowledge and tools to mitigate and minimize the consequences of
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injuries when they occur. We can no longer afford to bury our heads and just strive for
zero injuries. Until we get there, we must prepare, and to prepare, we must teach
lifesaving skills to all our officers. What has been limited historically to the tactical team
medic or delegated to the civilian fire/rescue or EMS agency now must be delivered to
the hands of each officer who has the potential for hostile contact. Hence, we present
the “Self-Aid/Buddy-Aid (SABA) program and concept.
In order for this information to be passed on to those officers that need to know it,
qualified instructors must understand the concepts behind the SABA and TCCC and
must be able to impart that knowledge to students.
II. PRESENTATION
1.1 The goal of the Self-Aid/Buddy-Aid for Law Enforcement Class is to provide each
Law Enforcement Officer the knowledge, skills set and tools necessary to survive or
save a fellow officer’s life in time of crisis. All models of this class are based upon
the basic principles of the Tactical Combat Casualty Care (TCCC) adopted by the
military. This class IS NOT a basic First Aid Class. The students attending this class
will learn ways to stop life-threatening hemorrhage through the utilization of
Tourniquet application, hemostatic agents and pressure dressings. Students will
learn that sometimes the best medicine on the battle field is being able to locate,
isolate and eliminate a current threat. Students by the end of class will also learn
the importance of first extracting and officer from the area of wounding takes priority
over performing a medical intervention at the wrong time. Students will also learn
how to recognize and treat severe chest injuries as well as how to place a victim in
the recovery position while waiting on EMS or extraction to a more safe/secure
location.
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Instructor Notes
This is your opening slide to be displayed while class is
gathering and students are filing into the classroom.
Slide 1
Read disclaimer verbatim to students and emphasize that
because this is a medical class, students are encouraged to
check with their agencies medical director for approval of
techniques and adjuncts. Explain that this program was
developed under the direction of Dr. Alex Eastman, MD who
is the Medical Director for TTPOA and any deviation from
the information provided must be approved in writing by Dr.
Eastman.
Emphasize that although our research supports that the

adjuncts that we will be issuing to the students are of a
certain make/model, etc. TTPOA does not endorse one over
Slide 2 the other, except those that are recommended by the US
military Committee on Tactical Combat Casualty Care (Tccc)
nor does TTPOA receive compensation or benefit from any
manufacturer of products discussed in this program.
Instructor Notes
Verbalize and explain all Learning Objectives
Slide 3
Motivating Statement #1……….Stress to the students that
this is why they are here. It is important for them to know
that this is a life-saving technique school; maybe their life,
maybe their fellow officer’s life.
Slide 4
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Motivating Statement #2……...Explain that this is why this
particular training is important. In the event of a severe
injury, there might not be time to wait on EMS to arrive
before treatment is started.
Officers must have a basic understanding and knowledge of

how to provide medical aid/interventions to themselves and
or their fellow officers.
Slide 5
Motivating Statement #3…………Except for those trained in
Tactical Medicine, most EMS personnel are not trained nor
properly equipped (ballistic vests/helmets/weapons) to enter
a scene that is still “active” and are required by policy to wait
(stage) until the scene is safe.
As Paramedics, you understand the “Golden Hour,” your

students may not understand this concept. You may want to
explain how long it takes to bleed out from an arterial bleed
or how long before a person dies from hypoxia.
Slide 6
In the event of severe injury, medical intervention must be initiated
immediately. Being able to start this medical treatment prior to EMS
arrival may help sustain the victim until he/she can reach definitive
care.
A reiteration of the requirement for Fire/EMS personnel to stage

until the “scene is safe” This delay in medical attention could result
in death to an officer.
If not staged, a delay in response can be due to traffic, lack of EMS

units available, etc.
Slide 7
This is a slide that you should reference as to what is killing officers
in the U.S. It is taken from the time period 1997-2007 as provided
by the FBI. It shows the kinds of events that officers died in. It does
not address what the injuries were that caused the death but is a
good visual slide that can serve as an attention grabber for police
officers. This is just the tip of the iceberg; We know that some of
the officers’ lives could have been saved with proper SABA care.
Also, point out the graph on the right that shows over 500,000 that
were injured in assaults.
As an aside note, in calendar year 2009 there was an increase of

63% of officers killed by handguns. That statistic alone should
hammer home to your students the need for understanding the
need for SABA training. Additionally, you might cite the recent
Slide 8 (2009) rash of ambush assaults against U.S. police officers around
the county.
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Although there are a number of events
nationally where officers were treated
by the use of SABA skills, two of these
three occurred in Texas and were highly
publicized.
Details:
On August 30, 2006 Dallas Police Patrol Officer, Jeremy Borchardt
answered a disturbance call at a Dallas hotel. A male suspect, who
was assaulting a female inside the room (the nature of the original
disturbance) shot through the door of the hotel room striking
Slide 9 Borchardt in the upper leg, nicking his femoral artery. Officer
Borchardt’s assist officer had been through Dallas PD’s SABA
training as part of their patrol-rifle program and performed a drag to
evacuate Borchardt from the opposite side of the suspects’ hotel
room door. Dallas FD medics who were also on scene had to leave
their equipment which had also been staged on the opposite side of
the door. Borchardt’s assist and Medics loaded the wounded officer
into the back of the MICU without a stretcher, applied direct-
pressure and a make-shift tourniquet and drove to the hospital. The
tourniquet saved Borchardt’s life.
On July 11, 2008, Wichita, Kansas patrol officer Derek Purcell was
shot twice, once in each leg, by 26 year old Francisco Aguilar.
Purcell had been dispatched to an intersection on a report that
Aguilar was “acting suspiciously”……..a call that occurs in most
American cities, everyday.
Purcell found Aguilar walking down the sidewalk of a neighborhood

street. Purcell got out of his patrol car and approached Aguilar to
question him. As he called for Aguilar to stop, Aguilar spun around
and for no reason fired twice at Purcell striking him twice; once in
each upper leg. Purcell returned fire but missed with four shots.
One of the responding officers had been an Army medic. He

applied direct pressure with his own uniform shirt and a make-shift
tourniquet from Purcell’s inner belt. This is a great example SABA
The Fort Hood shooting was a mass shooting that took place on
November 5, 2009, at Fort Hood, Texas, the most populous US
military base in the world, located just outside Killeen, Texas—
killing 13 people and wounding 30 others. The accused perpetrator
is Nidal Malik Hasan, a U.S. Army major serving as a psychiatrist.
He was shot by civilian police officers, and is now paralyzed from
the waist down.
At approximately 1:34 p.m. local time Hasan entered his

workplace, the Soldier Readiness Center, where personnel receive
routine medical treatment immediately prior to and on return from
deployment. According to eyewitnesses, he took a seat at an empty
table, bowed his head for several seconds and then stood up and
opened fire. Initially, Hasan reportedly jumped onto a desk and
shouted: "Allah!", before firing more than 100 rounds at soldiers
processing through cubicles in the center, and on a crowd gathered
for a college graduation ceremony scheduled for 2 p.m. in a nearby
theater. Witnesses reported that Hasan appeared to focus on
soldiers in uniform. He had two handguns: an FN Five-seven semi-
automatic pistol, which he had purchased at a civilian gun store
and a .357 Magnum revolver which he may not have fired. A medic
who treated Hasan said his combat fatigues pockets were full of
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pistol magazines.
Unarmed army reserve Captain John Gaffaney attempted to stop

Hasan, either by charging the shooter or throwing a chair at him,
but was mortally wounded in the process. Base civilian police
Sergeant Kimberly Munley, who had arrived on the scene in
response to the report of an emergency at the center, encountered
Hasan exiting the building in pursuit of a wounded soldier. Hasan
shot Munley, while witnesses claim Munley also fired at Hasan.
Munley was hit three times: twice through her left leg and once in
her right wrist, knocking her to the ground. Munley was treated by a
fellow soldier who had been trained in the military TCCC buddy aid
concept. This aid included the application of a tourniquet to stop
bleeding from a femoral wound.
The incident, which lasted about 10 minutes, resulted in 30 people

wounded, and 13 killed — 12 soldiers and 1 civilian; 11 died at the
scene, and 2 died later in a hospital.
Instructor Notes
Play video #1 (Derek Purcell) here as a motivator for
SABA training. This video is of an interview with Purcell as
he recounts the events.
Slide 10
SABA-HISTORY
SABA is not a novel concept, it is simply a program designed to
train police officers in simple, lifesaving techniques that have been
proven to be effective. The delivery of training in life-saving
techniques to nonmedical providers and fighters is not new. First
believed to be attributed to Napoleon’s army, it is clear that even
early descriptions of Self-Aid/Buddy Aid (SABA) programs exist.
SABA, as a general concept, involves placing lifesaving skills and
tools in the hands of people most likely to suffer injury. In short, it
essentially involves taking trauma center concepts out of the
hospital and moving them to the point of injury. These programs
are a theoretical offshoot from the fact than when people are
injured, the earlier care begins the better the outcome. While these
Slide 11 concepts are indeed those that were born in trauma centers and
field hospitals, the effectiveness of SABA programs is based on the
simplicity and profound effectiveness of the basic techniques. It
has been clearly proven that these techniques can be easily taught
to police officers, soldiers, or anyone engaged in high-risk
occupations (Butler, 2003).
The origins of EMS date back to the days of Napoleon, when the
French army utilized horse drawn "ambulances" to transport the
injured soldier from the battlefield. Its more recent incarnation can
be traced back to 1869, when Dr. Edward L. Dalton at Bellevue
Hospital, then known as the Free Hospital of New York, in New
York City started a basic transportation service for the sick and
injured. The component of care on scene began in 1928, when
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Julien Stanley Wise started the Roanoke Life Saving Crew, the first
rescue squad in the nation. Over the years EMS continued to
evolve into much more than a "ride to the hospital."
In particular in the US state of California and in King

County, Washington state, projects began to include paramedics in
the EMS responses in the late 1960s. Despite opposition
from firefighters and doctors, the program eventually gained
acceptance as its effectiveness became obvious. Furthermore,
such programs became widely popularized around North America
in the 1970s with the television series, Emergency which in part
followed the adventures of two Los Angeles County Fire
Department paramedics as they responded to various types
of medical emergency. The popularity of this series encouraged
other communities to establish their own equivalent services.
In a return to the military roots of EMS, the United States Army has
developed the combat lifesaver program to instruct soldiers in
advanced first aid and limited paramedic skills including intubation.
The combat lifesaver is intended to bridge the gap between self-aid
/ buddy-aid and the platoon medic on the 21st century
decentralized battlefield.
Instructor Notes
Give accurate definitions of each with any practical
example you wish to use.
Slide 12
Instructor Notes
This is the TEMS concept that is used by a large number
to SWAT Teams across America. As instructors, each of
you have had TEMS training and can speak to this
concept.
Slide 13
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MODULE
Tactical Combat Casualty Care (TCCC):

2
The science behind the Self-Aid/
Buddy-Aid Concept
TERMINAL OBJECTIVE
Upon completion of this module, the student will be able to understand the history and
development of Tactical Combat Casualty Care (TCCC) and its influence on the Self-
Aid/Buddy-Aid concept.
ENABLING OBJECTIVES
The participant will be able to:
• Explain that the science behind SABA is based upon the military model of TCCC
• Define (TCCC or TC3)
• Explain the history and evolution of TCCC and its impact on America’s Military
Personnel
• Understand and explain the impact of TCCC on American Law Enforcement to include:
o FBI Law Enforcement Officer Killed and Assaulted (LEOKA) Program
 IACP SafeShield Program and new data collection program
o Limitations to
• Recognize and fully define the main goals of TCCC and how those concepts apply to
Law Enforcement SABA Programs
• List, define and explain each of the three phases of TCCC and how they apply to SABA
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Instructor Notes
Begin this block of instruction with an explanation that
SABA Programs get their roots from the American
Military model of Self-Aid/Buddy-Aid known as Tactical
TACTICAL COMBAT
Combat Casualty Care orCASUALTY
TCCC or TC3. CARE (TCCC)-
HISTORY
Give explanation and history of TCCC.
Slide 14 No group has learned more about the care of the injured
over the last decade than our nation’s armed forces. It is
said that one of the few good things that comes from war
are a number of improvements in the care of the injured
warrior. Now more than ever, those improvements learned
overseas and paid for with American blood are being
rushed into the civilian trauma care environment. While a
number of advances have revolutionized the care of the
injured, none has served as a greater “force multiplier”
from a medical standpoint than the delivery of lifesaving
training and tools not just to the military medic, but to the
warriors themselves. In reviewing the Joint Trauma
Theater System that has saved so many lives during
OEF/OIF, Col. Brian Eastridge, JTTS Director, has
identified the delivery of SABA training and tools as the
critical first link in the chain of survival (Eastridge BJ,
Jenkins D, Flaherty S, et al. , 2006).
The SABA Program and its techniques are based on

sound science and the proven techniques known
collectively as Tactical Combat Casualty Care. Originally
designed to address the profound failure of military
medical doctrine in Mogadishu, Somalia in 1993, the US
military started the Tactical Combat Casualty Care
(TCCC) project ultimately developing a set of tactically
appropriate battlefield trauma care guidelines. Much of the
content of these guidelines were geared towards those
interventions that could be taught to the troops, hence
multiplying the available number of “medics”.
Since the first course in 1996, TCCC is now standardized

from the war-fighter/operator to the physician. Many
civilian medical organizations including the American
College of Surgeons Committee on Trauma (ACS-COT)
and the Pre-Hospital Trauma Life Support Program
(PHTLS), as well as law enforcement and EMS agencies,
including the National Tactical Officer’s Association
(NTOA) and the National Association of EMT’s (NAEMT)
have adopted these guidelines for conducting operations
in environments where the risk from penetrating trauma is
a reality. With the DoD implementation of TCCC
guidelines, US forces have achieved the lowest
percentage of Killed in Action and Case Fatality Rate in
recent recordable history (1945-present) (Eastridge, et al.,
Dec 2009). The TCCC recommendations were
“somewhat at odds” with civilian pre-hospital guidelines
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being taught at that time, but the advantages of having
battlefield trauma guidelines customized for the tactical
environment was quickly acknowledged.
It is a common misconception from the civilian sector that

the TCCC guidelines are only applicable in a 360° military
battle space similar to that seen in Blackhawk Down, or in
the middle of the streets of Iraq or Afghanistan. However,
nothing could be farther from the truth. The reality is that
TCCC addresses optimal casualty care within a hostile
environment when there is an unknown or variable
evacuation time or potential delay in casualty transport.
The average transport time to a medical treatment facility
(MTF) in Iraq can be less than one hour, which is not
unlike situations that may be encountered here in the
United States. Weather, traffic, rural response, mass
casualty, and ongoing tactical operations against active
threats can contribute to longer transport times to
definitive care in the civilian environment. Many also
question the relevance of these guidelines due to the
epidemiology of “battlefield” injuries compared to injuries
likely to be encountered during civilian tactical operations.
While military forces face a higher incidence of explosion
and fragmentation injuries, penetrating trauma remains
the predominant cause of injury and death. A gunshot
wound that severs a police officer’s femoral artery is just
as likely to cause death from blood loss as a shrapnel
wound that severs a soldier’s femoral artery, and both are
equally amenable to immediate life-saving treatment.
HISTORY OF THE BATTLE OF BLACK SEA

In 1992, the United States sent Marines to Somalia as
part of a United Nations peacekeeping force (Operation
Restore Hope) providing food to millions of starving
people. Due to a civil war that had cost the lives of more
than 300,000 people, international intervention was more
than warranted.
After the conflict quieted down and U.S. Marines

departed, local warlords battling for control of Somalia
soon raided UN food distribution sites and killed UN
personnel. The warlords controlled the country by starving
their people. No matter that the rest of the world was
supplying vast amounts of aid to relief organizations, the
people were starving to death by the thousands.
Following the slaughter of UN peacekeeping forces, the

United States responded with a show of force. Task Force
Ranger was sent to Somalia with the primary mission of
arresting warlord Mohamed Farah Aidid and his fellow
clansmen for crimes against humanity.
On 3 October 1993 members of the Delta Forces and

Rangers were engaged in a pitched battle against rebel
forces on the streets of Mogadishu, Somalia. The mission
had been to extricate rebel leaders from a known meeting
place and should have been completed within an hour.
Having met heavy rebel opposition, the 18 hour battle
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resulted in the loss of 18 soldiers, with scores of injured.
The command had requested armored vehicles and AC-
130 gunships as support for Task Force operations.
Those requests had been denied by the Clinton
administration, so Task Force Ranger did the best they
could with the equipment they had.
The men who fought this battle did so in a noble and

courageous manner. Two soldiers were awarded the
Medal of Honor (posthumously). Other members of the
group were awarded the Silver Star, Bronze Star, and
Purple Heart, with the "V" device to signify valor under
fire.
Although the Rangers and Delta Forces sustained heavy

casualties, they had accomplished their objective, having
taken important rebel leaders prisoner. Critics of the
military and this mission argue that the daylight raid was a
failure. They had completed their mission, but four Black
Hawk helicopters were shot down during the raid. A
secondary mission became necessary. Protecting the
lives of their fellow soldiers according to the Ranger
Creed gained greater importance.
The Delta Forces and Rangers stood their ground and

rescued as many of their men (including the dead and
wounded) as was possible given the circumstances. One
of the Black Hawk pilots having been shot down in the
area of operation was captured and held prisoner for
eleven days.
This pilot would not have survived had it not been for the
two Delta snipers who gave their lives (subsequently
earning the Medal of Honor) in defense of the pilot and his
downed aircraft.
The United States woke on 4 October 1993 to see images

on the news of dead Rangers and Delta Forces personnel
being mutilated and dragged through the streets of
Mogadishu. The bodies were later recovered and each
was buried with appropriate military honors.
The battle was sensationalized by the movie “Black Hawk

Down.”
Instructor Notes
Show Blackhawk Down video as an example of what
TCCC looks like from the military perspective
Slide 15
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Introductory slide for motivating students about what is
coming next; a closer, more in-depth look at TCCC.
“So lets, take a closer look at TCCC.”
Slide 16
Although TCCC is a concept that is borrowed from the
military the fact that American law Enforcement officers
are subject to similar (i.e., gunshots, blast injuries, etc.)
makes this concept one that makes sense to utilize.
When explaining the TCCC concept to students it might

be helpful to understand that there is very little data to
show that a significant number American police officers
have died as the result of the failure to utilize TCCC
concepts and/or adjuncts because of a lack data drawn
upon from the FBI’s Law Enforcement Officers Killed and
Assaulted (LEOKA) as LEOKA data does not capture
“saves” of officers that had SABA type treatment applied
Slide17
to them. Therefore, it is hard to empirically substantiate
the value of SABA programs for Law Enforcement.
**Read article taken from the 2010 winter

addition of the NTOA’s Tactical Edge written
by Dr. Mathew D. Sztajnkrycer, MD which is
in your resources section in order to
understand the correlation between military
TCCC concepts and America LE self-
aid/buddy-aid concepts.***
Here is the bottom line as taken from a quote from Dr.
Sztajnkrycer’s article: “……Despite strong evidence to
support the use of TCCC in combat, no studies have
examined the appropriateness of TCC for American Law
Enforcement medical care. Unlike the military, the law
enforcement community has not performed studies
examining the types of lethal injuries suffered by officers
during felonious assault, nor possible interventions to
prevent death or disability. “
“Finally, it must be noted that the LEOKA data set is

limited. It does not capture every line-of-duty death in LE .
LEOKA does not capture information on circumstances in
which officers were critically injured yet survived wounds
(“near misses”).
In an effort to better track officer injuries where there

is no fatality, the IACP (International Association of
Chiefs of Police) has begun a pilot study whereby
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agencies across the U.S. will begin a new reporting
system whereby ALL injuries to officers will be
reported and the statistics will be tracked. Three
agencies in Texas have been selected for a one year
study:
Dallas, Bedford and Woodway PD’s each representing

a large, medium and small agency. It is our hope that
this study may be a springboard for more collection
of data that may be valuable in assessing SABA
concepts in the mitigation of injuries.
Additionally, the IACP SafeShield Committee, a

committee that studies safety issues for American
police officers has agreed to endorse the SABA
concept from a national level and has created a sub-
committee to promote the program they are calling:
“Save Our Own.” Dr. Eastman and Chief Flory are
members of the sub-committee and will update the
instructional cadre as information is available.
Here is a slide provided by Col. Ron Bellamy, member of

the Committee on TCCC. It shows the kinds of injuries
that historically been killing U.S. solders in a variety of war
theaters. Stress to students that the key statistics are
those showing KIA- Exsanguation (9%) from extremity
wounds and 1% from Airway Obstruction. If statistics are
similar to L.E., that is potentially 10% off American
Officers whose lives could be saved by SABA techniques.
Slide18
Emphasize these 3 important goals of TCCC
Suggested comments:
“Look guys, we are going to try and make this concept
pretty simple; the three main goals of TCCC are:
• Prevent Further Casualties
- Get off of the X and get your buddy off of
the X
- Take cover/find concealment
- Eliminate the threat (lead down range)
- Mission success
 Finish the original mission if possible
• Treat the Casualty
Slide19
- This means, you have got to give fast,
proper and adequate first aid care to
yourself and/or your fellow officer.
TREAT, means just that……..not wait for
an ambulance!
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Introductory slide as motivator for student(s) having an
understanding of the 3 critical phases of TCCC.
Suggested comments:
“Okay, let’s get into the actual phases of TCCC. They are:
• Care Under Fire
• Tactical Field Care
• Tactical Evacuation
Slide 20
This is the actual definition of what Care Under Fire is…
It is important to stress to your students that this is a

critical point in this entire concept of SABA. It may be
necessary to treat yourself and or a buddy in order to stay
in the fight and live to see the next fight.
We will cover what to carry and how, later

in the program.
Slide 21
Instructor Notes
Maricopa County SWAT shooting video here
The purpose of this video, although a SWAT incident, is

a good example of rendering care while under fire.
Slide 22
Details of incident: Maricopa County, Arizona (Phoenix) Sergeant Glen Powe was part of a SWAT
operation serving a high risk search warrant on October 5, 2006. The suspect was lying in wait with an
automatic AR15 rifle and fired at Glen as soon as he entered the door. The first two rounds hit him on the
lower back, missing his spine. Glen turned to engage the suspect with his rifle and took a round to his
"EO tech" sight. The round sent shrapnel into his left hand (he's left handed), slicing off his thumb and
severely mangling his hand which caused him to drop his rifle. At that point he took 14 additional rounds
to his steel trauma plate which sent shrapnel into his biceps but did not cause any significant damage.
Glen went to the ground and was rescued when the suspect's attention was diverted by a flash
bang deployment to the rear bedroom. Glen took 9 months to recover. The suspect was a 60 year old
Vietnam Vet who is now spending life in prison.
In the video you can hear the operators yell "failed breach" before pulling the door off. The narrator says
they did not return fire because of the family. This is not true. Glen did not return fire because his left
hand was mangled. The other officer who tried to enter the doorway to engage the suspect retreated
when he was shot in the leg. As soon as they were able to rescue Glen, the team treated the incident as
a barricade.
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Glen suffered significant damage to his intestines and his left hand but is otherwise fine. He is still
working for the Sheriff’s Department and giving seminars around the country about his experience.
SUGGESTED BREAK HERE
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19
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MODULE
Basic Management Plans

3
for 3 Phases of TCCC
TERMINALE OBJECTIVE
Upon completion of this module, the participant/student will be able to define, explain
and demonstrate the management plans for each of the three phases of the TCCC
concept.
ENABLING OBJECTIVE:
The participant/student will be able to:
• Define each of the 3 management plans under the umbrella of TCCC

- Care under fire (CUF)
- Tactical Field Care (TFC)
- Tactical Evacuation (TACEVAC)
• Demonstrate knowledge of the components of each management plan to include:
- Reasoning behind each plan
- Implementation of each plan
- Steps of each plan
• Demonstrate (hands-on) the proper use of each adjunct associated with each
management plan
• Explain the when, why, where and how for each adjunct
• Explain how to recognize the success and/or failure of the effects of each adjunct
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20
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This is the nuts and bolts slide that gives detailed
description of what CUF is. This is an important slide and
concept that needs to be hammered home with students.
Spend significant time with this slide and emphasize each
bullet point.
1. Stress to students that they MUST get it in their head
to remember to return fire if possible and if justified.
Accuracy counts…..remind them to keep their head
and be precise.
2. Stress to students that this is not a medical class; this
is a gun-fighter class with extra tools in an officer’s tool
box if they get injured.
Slide 23
3. The right medical intervention at the wrong time will
get you or your fellow officer killed
4. If treating in a Buddy-Aid mode, expect/encourage
partner to continue firing if possible and if justified
5. Give clear and concise instructions to partner to
moved to cover/concealment if possible and treat
himself
6. Reduce the possibility of additionally wounding
7. GET OFF OF THE “X”
8. Treat the wounds (how to treat is coming next)
A good “hammer home” summary for the core concepts of

CUF………talk this one up……
I think the important message here is that just because we

are teaching you guys the basic “concepts” of TCCC
doesn’t mean that the tactical situation will necessarily let
you to accomplish CUF in the order that we are showing
you. The situation itself will dictate if you “Get someone off
the X” first, or if “lead and copper downrange” comes first
or maybe even both simultaneously etc. I also think it’s
important for us to stress that we can very easily go from
the CUF phase to the TFC phase and then back to the
Slide 24 CUF phase in a matter of seconds. It’s kind of like the use
of force continuum in the “slice of pie” model vs. the old
triangle example. Officers will understand their use of force
policy and know that you don’t have to utilize officer
presence, verbal, hands on, less lethal, then deadly force
in THAT order during a combat situation where there are
casualties.
A truthful slide that ends with a slight joke……”all bleeding
stops eventually”……….meant to imply that if you do
nothing or don’t adequately treat yourself or your buddy,
you’re going to die!
Slide 25
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21
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An introductory slide announcing that the next topic is TFC
Slide 26
Definition bullet points explaining what TFC is. Emphasize
that this phase is ONLY after the threat has been
eliminated or you are behind cover. Stress to students that
TFC MUST not be done while still under fire. If they are still
under fire they must return fire and get off the X before self
aid.
Slide 27
• This is s skill that will be practiced later in the program
but make sure to stress that downed officers will need
to be disarmed due to a potential altered mental
status.
• When disarming, remember to unload and secure the
weapon but DON’T leave an unarmed officer alone
and unprotected!
• Explain why “head to toe” is done in this
manner/sequence
• Stress EFFECTIVENESS is the key
Slide 28
Instructor Notes
Break here and issue Individual First Aid Kits (IFAK)
Give the students the provided IFAK kit. Keep this

procedure controlled so students don’t’ open something
that is sterile. Talk about each piece of equipment as they
come in the presentation. So, for purpose of this break-out
session, only have them unpack their tourniquet. This may
Slide 29 be a good point to remind them about the fact that this
equipment is what is recommended by CoTccc.
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22
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An introductory slide for the SOF-T Tourniquet. This is what
their tourniquet should look like.
Have students remove the Tourniquet from its packaging

and let them play with it for a minute or two. They tell them
that the next video will give a good explanation on how to
use it.
Slide 30
An introductory slide that shows the Sof T Tourniquet
application. The next slide (video) shows its application in
depth.
This slide’s purpose is only a visual eye-catcher as a lead

in for the next video that goes over the use of the SOF-T
Slide 31
Instructor Notes
Show SOF Tactical Tourniquet video here.
Slide 32
This photo is an example of someone dying as the result of
wound exsanguination.
Although a photo taken of one of U.S. military, it is an injury

that a police officer could encounter in a blast injury, vehicle
crash, etc.
Slide 33
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23
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Conversely, just as bad (or worse) of a wound where this
soldier lived as the result of the application of multiple
tourniquets.
Slide 34
Another example of the use of tourniquets.
Point out to your students that these are “make-shift’

tourniquets (see the paint brush). Stress to students that
anything can work in a pinch.
Slide 35
Again, make-shift, multiple tourniquets
Slide 36
Instructor Notes
Show Wound Sweep video here.
In the previous slide where we introduced Tactical Field

Care (#28), we talked about the need to perform a head-to-
toe assessment of a victim officer. Before showing this
video, explain to the student that this is what a “wound
sweep” head-to-toe exam should look like.
Slide 37
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24
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Instructor Notes
Break out Session on how to perform “Wound sweep
assessment”
Have students pair up and practice “wound sweep

assessment” then have them apply tourniquet to an
extremity as determined by you, the instructor. ***from
this point forward, feel free to call a “tourniquet drill”
whenever you want.
Slide 38
An introductory slide for Quickclot Combat Gauze. A stair-
step approach to revealing all of the contents of the IFAK.
Have students remove their package of Combat Gauze

from IFAK but DON’T open it as it is a sterile dressing. Use
the Combat Gauze trainer packages for demonstration
purposes and hands-on training.
EXPLAIN THAT THE REASON THAT TTPOA HAS

ADOPTED THIS PRODUCT AS THE HEMOSTATIC
AGENT THAT WE SUGGEST IS BECAUSE THE
COMMITTEE ON TCCC (CoTCCC) HAS DONE STUDIES
ON ALL HEMOSTATIC AGENTS AND THIS IS
Slide 39
THE ONLY ONE THAT THEY RECOMMEND. IF THIS
CHANGES, TTPOA WILL UPDATE OUR
RECOMMENDATION.
(NOTE: AS TTPOA INSTRUCTORS, DR EASTMAN MAY BE
CONSULTED IF YOU WISH TO DISCUSS THIS TOPIC
FURTHER AS HE HAS PERSONAL EXPERIENCE WITH
POWDER HEMOSTATIC AGENTS IN THE SURGICAL SUITE)
Tell your students that QuikClot Combat Gauze is a 3-

inch x 4-yard roll of sterile Hemostatic Gauze that is
impregnated with “Kaolin”. Kaolin is an advanced
hemostatic agent that controls blood loss by rapidly
promoting coagulation
• Explain what “Hemostatic” agent means and a brief
explanation of coagulation
A slide that introduces the concept of using direct pressure

along with combat gauze. Introduce to your students the
concept of using pressure “proximal” (tell them what this
means) to the wound along with combat gauze.
Slide 40
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25
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A slide that explains how hemostatic Combat Gauze works
to clot the blood. No need to go into great detail of the
coagulation cascade theory that it simply clots the blood by
its chemical make-up.
It is safe to leave in the wound and won’t burn the skin

unlike some other hemostatic (powder) agents.
Slide 41
A slide that shows the proper use of Combat Gauze. Stress
to students to pack the gauze tightly into the wound and
DIRECTLY onto the source.
Slide 42
Self explanatory…….read verbatim if necessary
Slide 43
Self explanatory….read verbatim if necessary
Slide 44
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26
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Instructor Notes
Now show the Quickclot Combat Gauze video here to
bring home the information in the previous slides.
Slide 45
Instructor Notes
Go to skill break-out session here for Combat
Gauze
Break out session can consist of one of the following:
1. Build and utilize TTPOA designed wound packing

device (equipment list and instructions included in
Slide 46 resource pack)
2. Utilize pork loin/pork shoulder device (equipment
list and instructions included in resource pack)
An introductory slide for the OLAES Modular bandaged.

Another stair step approach to revealing all of the adjuncts
within the IFAK.
• OLAES got its name from United States Army Staff

Sergeant and Special Forces Medic Tony Olaes
who was killed on September 20, 2004 in
Afghanistan. The name of the bandage was given
as an honor to Olaes by Ross Johnson of Tactical
Medical Solutions, the manufacturer of the OLAES.
Slide 47
Special Instructions
Show OLAES Pressure Dressing video here.
After showing video, demonstrate how to use the OLAES

Bandage
Slide 48
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27
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Somewhat self explanatory but use your knowledge to
explain the concepts about how to apply direct pressure.
Slide 49
Instructor Notes
Pressure dressing break-out session.
When performing OLAES break-out session, take the time

to first explain the concept of pressure dressing’s and how
they work. Be sure to include in your discussions the value
of elevation of the injured sight to further mitigate bleeding.
Slide 50
Instructors need to stress to students that this is a
basic class and airway management needs to be
addressed from a basic perspective. There is really
only one airway remedy that we need to look at when
someone determines that a victim is not breathing.
1. Head-tilt/Chin-tilt
Do not teach the jaw thrust maneuver. The procedure is
only needed when we are concerned about maintaining
and protecting the c-spine. In the SABA environment
Slide 51 maintaining c-spine becomes secondary in importance to
getting off of the X.
A slide to use when showing how to perform the Head-

tilt/Chin-lift method. If you have access to an airway head
mannequin, feel free to use it for demonstration purposes
or find a student in the audience that will volunteer to have
this procedure demonstrated on them.
Slide 52
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28
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A slide to use when showing how to perform the recovery
position. If you have access to a mannequin, feel free to
use it for demonstration purposes.
Explain what purpose that the “Recovery Position” serves.
The “Recovery Position” allows the victim/patient to

maintain their own airway. Explain what happens with the
tongue when a victim is on their back.
Slide 53
Instructor Notes
Show/demo Recovery Position and have students place
each other in this position.
Slide 54
Explain to students what causes a sucking chest wound
and that any kind of penetrating trauma (gunshot, knife
wound, etc. can cause this.
Slide 55
This is how most gunshot wounds will present. Minimal
bleeding…from a non-medically trained police officer
perspective, this might not look too bad. Stress to students
that even though this might not look “too bad” it most likely
is a sucking wound or will turn into a tension pnemothorax.
Slide 56
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29
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Show Sucking Chest Wound video here. Remind students
that they may or may not hear the sounds made by a
sucking chest wound.
Slide 57
Emphasize the “navel to neck” (front or back) concept
Slide 58
An introductory slide with a visual example of the different
types of chest seals (Asherman, Bolin, Vaseline, etc.) A
further step-by-step reveal of the adjuncts contained with
the IFAK
TTPOA currently recommends and will issue a Vaseline
gauze chest seal. If we decide to recommend/issue a
different one, we will put that information out to all
instructors. Stress to students that in a pinch, there are a
Slide 59 number of things that can serve as a chest seal such as: a
plastic baggie, a piece of plastic newspaper bag, a small
piece of trash bag, etc.
This slide is just intended for you, the instructor to mention
what a Tension Pneumothorax, how it develops and how it
is treated. We only what you to mention it here as a point of
information and to stress that this is why the concept of
TEMS and having Paramedics attached to SWAT team is
important.
As a side note, some agencies are electing to teach

their SWAT officers in how to perform this intervention.
If non-medically trained police officers are to be taught
this concept and adjunct, it would need to be handled
on a local level under control of a Medical Director.
Slide 60
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30
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Opening slide for the introduction of TACTICAL
EVACUATION (TACEVAC)
Slide 61
An introductory slide that gives a definition of TACEVAC
Slide 62
An explanatory slide for what kinds of remedies there are
for EVAC…..
Stress to students that the main issue is to GET OFF OF
THE “X”
Slide 63
An introductory slide that introduces the casualty
extraction concepts of “Drags, Pulls and Carries.”
Slide 64
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31
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This slide and the next one show examples of the
kinds of drags, pulls and carries mentioned in the
previous slide. There are other extrication techniques
that students may bring to your attention. Feel free, if
time permits, to allow those to be talked about,
describe and/or demonstrated but at least show these
basic skills and make sure everyone is able to perform
them.
Slide 65
Show Tactical Rescue Myths video here. The only
purpose of showing this slide is that it is a good example
of what does/does not work well.
Slide 67
Define Hypothermia for your students as a body
temperature significantly low enough to cause poor
mentation, etc.
Preventing shock is a key reason to understand

hypothermia
Stress the need to keep the victim warm despite the

ambient
Slide 68
Carry options is a topic that should be left to the

individual officer and/or their department. We suggest
that officers have easy access to their IFAK and may
consider incorporating it into an active-shooter style
“go bag” such as those pictured next.
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32
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Slide 69
Slide 70
Slide 71
Slide 72
Break here and go to scenario break-out sessions.
slide 73
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33
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34
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MODULE
INSTRUTOR TRAINING
4
TERMINAL OBJECTIVE
Upon completion of this module, the instructor-participant will be able to evaluate the
student-participant’s understanding of SABA training according to TTPOA standards.
ENABLING OBJECTIVES
Instructor-participants will be able to:
• Value the TTPOA philosophy for the training of law enforcement officers in the SABA
concept and express support for the concepts contained in the SABA training program to
include:
- The purpose behind verbalizing and explaining the TTPOA disclaimer
- The reason for listing, verbalizing and explaining in detail each of the course
learning objectives
- The value of supporting the Medical Director’s role in the SABA training program
- The value of the TCCC concept as the science behind SABA
- The value and purpose behind hands-on training as a reinforcement tool to the
didactic model of training
- The reasoning behind the emphasis of continues training/re-training of the SABA
concepts
1.1 The student will be able to understand and re-teach TTPOA’s concept on certain aspects of
training:
1.1.1 Verbalizing the disclaimer
1.1.2 Verbalizing all learning objectives
1.2 The student will be able understand the structure of the TTPOA’s TEMS Program to include the
SABA Program and the role of the Medical Director
1.3 The student will demonstrate various instructor techniques in a classroom setting to the
satisfaction of the instructor(s)
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35
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The TTPOA is a non-profit organization run by volunteer
police officers and has been in existence for nearly 20 years.
The association is run by a President, Vice-President,
Director of Operations, Secretary, Treasurer, Training
Coordinator, 8 geographical Regional Directors as well as
other personnel. Per bylaws, no one is allowed to take a
salary. The TEMS Cadre/Staff is supervised by a Medical
Director, Dr. Alex Eastman, a Program Manager, David
Flory. It is staffed by several career Paramedics, RN’s and
other physicians. Each member of the TEMS cadre/staff are
all either currently or have operated in the tactical
environment as either a Physician, Medic and/or operator.
Slide 1
It is the goal of the TTPOA Self-Aid/Buddy-Aid Program to
provide each and every police officer within the State of
Texas with the basic knowledge, training and tools
necessary to provide potentially life-saving aid to themselves
and/or fellow police officers. Many of the concepts of this
training are not inherently natural for officers and may
provide challenges for the instructors trying to impart these
ideals. As a Paramedic (or other trained medical provider)
serving as an Adjunct Instructor for the TTPOA SABA
program it is imperative that you are mentally and physically
prepared when teaching this program.
Further, it is the belief of the TEMS Cadre/training staff that

we must train our brothers and sisters in the spirit of the
Warrior. This, we believe, has been lacking for some time
now in our Professional Police Model and must be brought
back. Additionally, as a medical provider you must be willing
to teach the first tenant of medicine: DO NO HARM.
As an instructor for the TTPOA’s SABA Program, you were

WHY ARE YOU HERE? hand-picked based upon several criteria. This does not give
you permission to think of yourself as “special” and show
Each oE you were hand-OHcked to Ae here you ego to students. Your previous medical training, your
AecauRe:
experience and expertise, your ability to teach among other
• Your wHllHngneRR to teach thHR Orogram
• Your CertHEHcatHon leUel, eWOerHence and traHnHng
things, is what brought you here. If you show an ego to your
• FamHlHarHty to TEMS Cadre and each other students you will run the risk of destroying your own
credibility and the credibility of this program. TEACH WITH
HUMILITY AND PATIENCE; REMEMBER, YOU TARGET
AUDIENCE LIKELY HAS NO MEDICAL TRAINING
WHATSOEVER.
Slide 2
WHY THIS, WHY NOW?

• OffHcers Hn AmerHca are dyHng when Shey
cNTld NSherwHse be saved by Shese
SechnHqTes
• There Hs a wave Nf sTOONrS naSHNn-wHde fNr
ShHs SraHnHng and $$ SN sTOONrS HS
• There Hs a SremendNTs cNmmHSmenS by
TTPOA
• CNmmHSmenS by ShHs Cadre
Slide 3
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36
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WHAT DO WE EXPECT OF YOU?

• ThD samD commHtmDnt that wD haUD to thD
OroFram
• A OroEDssHonal rDOrDsDntatHon oE thD EMS
anC TactHcal EMS OroEDssHon
• A rDsODct Eor thD OrocDss anC OroFram
CDUDloOmDnt
• A rDsODct Eor XoTr law DnEorcDmDnt
ArothDrs/sHstDrs/stTCDnts
Slide 4
WHAT SHOULD YOU EXPECT
OF US?
• SHLHlar rDsODcS on all sHLHlar OoHnSs
• ProFraL, cTrrHcTlTL anC loFHsSHcs sTOOorS
• A wHllHnFnDss Eor nDw HCDas anC chanFD So ShD
OroFraL
• STOOorS EroL ShD TTPOA RDFHonal DHrDcSors ShaS
wHll coorCHnaSD ShD class XoT wHll SDach
• RDsDarch HnEorLaSHon anC sTOOorSHnF CocTLDnSs
• STOOorS EroL Dr’s EasSLan anC MDSYFDr Eor HssTDs
rDlaSDC So LDCHcal CDAaSD concDrnHnF cDrSaHn
aCjTncSs, DSc.
Slide 5
GOAL AND PURPOSE OF THE
TTPOA
• PrNUHdD PTalHSy, cNRS-DEEDcSHUD SN ONlHcD NEEHcDrR and LDdHcal
OrNUHdDrR Hn SGD SSaSD NE TDxaR and ADyNnd
• SaUD SGD lHUDR NE PNlHcD OEEHcDrR, CHUHlHanR and STRODcSR
• BD rDcNFnHzDd aR a lDadDr Hn SGD arDna Hn law DnENrcDLDnS
SraHnHnF Nn a naSHNnal lDUDl
• FNllNw all SraHnHnF rTlDR and rDFTlaSHNnR aR DRSaAlHRGDd Ay
TCLEOSE
• FNllNw SGD OrNFraL OrNSNcNlR aR DRSaAlHRGDd Ay SGD TPPOA
MDdHcal DHrDcSNr, Dr. AlDx EaRSLan and SGD TEMS CadrD
• TDacG SGD SABA PrNFraL AaRDd TONn SGD TCCC FTHdDlHnDR
• URD DHdacSHc and GandR-Nn SDacGHnF LDSGNdR
• ELOGaRHzD SGD HLONrSancD NE SraHnHnF /rD-SraHnHnF NE
NEEHcDR SGaS rDcDHUD SABA SraHnHnF.
• SSrDRR and OracSHcD SAFETY, SAFETY, SAFETY
Slide 6
ATTRIBUTES OF THE TTPOA
SABA INSTRUCTOR
• NN eFNR are allNweC!
– We are a Seam NE SraHnerR anC are exOeBSeC SN
aBS aR a Seam, nNS HnCHUHCTalR
– TeaBh wHSh a OaRRHNn ENr She RTAIeBS
– TeaBh wHSh OaSHenBe anC reROeBS ENr RSTCenSR
– ExOreRR yNTr CeRHre SN helO ONlHBe NEEHBerR
RaUe SheHr Nwn lHUeR anC She lHUeR NE NSherR
wHSh SraHnHnF Hn SABA SeBhnHPTeR
Slide 7
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37
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TTPOA’S PHILOSOPHY AND
METHODOLOGY
• TGD TTPOA’s OGHlNsNOGy Hs SN SDacG SGD
cNMcDOS:
– TraHM lHkD yNT EHgGS, EHgGS lHkD yNT SraHM”
• SSrDss HMNcTlaSHNM LTsS AD HMclTdDd HM
LNsS L.E. SraHMHMg HM NrdDr SN ETlEHll SGHs
EHgGSHMg OGHlNsNOGy
• SaEDSy, SaEDSy, SaEDSy
Slide 8
Teaching is about imparting knowledge that you have to
TEACHING STYLES…
those that need the same knowledge. Students learn in
COACHING vs. CRITICIZING different ways but few learn by intimidation or being “talked
• Be a SeacGer, cNacG, LenSNr… nNS a down to.”
CHcSaSNr
• ParenS-CGHlC vR. ParenS-ParenS SeacGHng The “Parent-Child relationship gives a visual of someone
RSyle standing over someone else and intimidating them….not
– NN Nne lHkeR SN Ae crHSHcHYeC
allowing feedback…….and a concept of domination.
 ReLeLAer yNTr aTCHence (cNOR)
The Parent-Parent relationship gives the visual of a calm,

professional relationship and conversation allowing for
feedback and mutual respect. This is the visual we want of
Slide 9 our instructors when they are teaching this program. Talk to
your students in a “parent-parent” style relationship or, “adult
to adult.” Don’t criticize when a student is not grasping a
concept or a technique
Remember your audience in this program; Non medically

trained police officers. As a Paramedic, each of you has a
tremendous amount of medical knowledge compared to the
target audience. Don’t use “paramedic” terms; use everyday
terms. In other words: “Dumb it down for the Cops.”
This curriculum was specifically developed under the

TEACHING THE CURRICULUM supervision of Dr. Alex Eastman, TTPOA Medical Director,
David Flory, TTPOA TEMS Program Manager, and the
• DNM’t CeUHate ErNL tGe cTrrHcTlTL
TEMS cadre of instructors and with the approval of the
• PerHNCHc reUHew wHll Ae cNMCTcteC tN TTPOA Executive Board to include the TTPOA President,
eMRTre cTrreMt HMENrLatHNM
Paul Hershey.
– UpCateR wHll Ae ReMt wHtG clear HMENrLatHNM aR
tN cGaMgeR LaCe
– ALple NppNrtTMHty wHll Ae gHUeM tN HMRtrTctNrR
DO NOT deviate from the curriculum without the express
tN prNUHCe HMpTt NM pNRRHAle cGaMgeR, etc. written approval from Dr. Eastman. We realize that there is
– MTRt cNrrelate tN TCCC multiple way of delivering the same message but it is our
• CTrrHcTlTL wHll Ae TpCateC wGeM TCCC TpCateR desire that because of the sensitive nature of teaching a
“medical” course that we all teach from the same page. In an
effort to keep current, we encourage ALL instructors to
Slide 10
forward in writing any questions, concerns or suggestions for
curriculum changes or, for suggestions on the type and/or
style of Power Point slides, etc. The Cadre, along with Dr.
Eastman will review TCCC guidelines periodically and will
update this presentation as needed.
The Committee on TCCC updates often based on current

research and trends. The CADRE will monitor the
committee’s publications and will update our curriculum
based on their updates.
________________________________________________________________________________
38
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f any instructor has suggestions about the curriculum send
to the list serve for feedback. The Cadre will review and
make changes as appropriate.
CLASS LOGISTICS
• Classes will Ae scGeCTleC Ay geograOGic regional
CirecSors on an as-neeCeC Aasis
– ReqTesSs froL agencies, eSc.
• RD’s will work wiSG eacG insSrTcSor in SGeir region
So coorCinaSe scGeCTling, nTLAer of sSTCenSs,
sSTCenS/insSrTcSor raSios, aCeqTaSe classrooL
sOace, CaSes, Cay of week, SiLes, eSc.
• RD’s are resOonsiAle for all OosSing of classes on
weAsiSe, TCLEOSE reOorSing reqTireLenSs,
cerSificaSes, collecSion of $$, eSc.
• InsSrTcSors are resOonsiAle for
– Being OreOareC
– ProOer coorCinaSion wiSG RD for aAove
– MeCia neeCs, eSc.
Slide 11
CLASS LOGISTICS cont…

• Classes LTsS Ae 8 GoTrs in lengSG wiSG a Leal
Areak*
• Can Ae any Cay of week, any SiLe of Cay as long
as coorCinaSeC wiSG RD anC fiSs SGe Cesires of
sSTCenSs
• DiCacSic vs. GanCs-on is inSenCeC for 4-4
• YoTr OayLenS is $500.00 Oer class SaTgGS OlTs
Sravel exOenses (Lileage is ?? Oer Lile) So inclTCe
GoSel if necessary*
• PayLenS will Ae sTALiSSeC Ay RD So TreasTrer anC
cGeck will Ae senS So insSrTcSor
• YoT Lay Ae reqTireC So fill oTS an exOense reOorS
Slide 12
HANDLING STUDENT ISSUES

• MakD cNnSacS wHSG agDncy GNsS/cNnSacS
• AddrDss any “prNAlDL” sSTdDnSs wHSG cNnSacS Nr RD
• SSTdDnSs LTsS cNLplDSD all 8 GNTrs NE class SN gDS
crDdHS
• SSTdDnSs LTsS AD pGysHcally aAlD SN cNLplDSD all drHlls,
Gands-Nn pNrSHNns SN HnclTdD drags, carrHDs and
scDnarHNs
• SSTdDnSs LTsS pass all skHlls
– CNLplDSD skHlls cGDck-NEE sGDDSs and ENrward SN RD
• GHUD aLplD SHLD dTrHng ArDaks ENr sSTdDnSs SN ask
qTDsSHNns/addrDss HssTDs SGaS SGDy dNn’S TndDrsSand
Slide 13
HANDLING STUDENT ISSUES cont.
• AllNw HnpTS ENr cGangD SN SGD prNgraL/

cTrrHcTlTL
– DNcTLDnS rDasNnaAlD sTggDsSHNns and ENrward
SN D. FlNry and B. LankENrd ENr dHsSrHATSHNn SN
SGD CadrD ENr cNnsHdDraSHNn
– EncNTragD HnsSrTcSNr DUalTaSHNns
– UsD prNUHdDd ENrLs and ENrward SN RD wHSG
NSGDr papDrwNrk and rTn cNpHDs and sDnd SN D.
FlNry ENr dHsSrHATSHNn SN SGD CadrD
Slide 14
________________________________________________________________________________
39
____________________________________________________________________________________
DRILLS/BREAK-OUT SESSIONS
• OnKy BNndTBS driKKR/ArDak-NTS RDRRiNnR

whDn RkiKKR haR ADDn diRBTRRDd/SaTghS
and BNrrDRONnding adITnBS haR ADDn
BNUDrDd
– OnBD BNUDrDd, TRD driKKR aR NESDn aR SiLD wiKK
ODrLiS
– SkiKKR
Slide 15
BREAK-OUT SESSIONS
• TNTrniqTeS RSaSiNn
• CNmAaS GaTze RSaSiNn
Slide 16
TOURNIQUET STATION
Slide 17
COMBAT GAUZE STATION
Slide 18
________________________________________________________________________________
40
____________________________________________________________________________________
Slide 19
SCENARIOS/SKILLS TESTING
• URe OreOareC RcenariNR
– May aCC any NSGerR SGaS are reaRNnaAKe
• IE NSGerR are TReC, RenC cNOy ENr EiKe anC
cNnRiCeraSiNn NE CiRSriATSiNn SN NSGer inRSrTcSNrR
• SkiKKR SeRSing
• URe SeRSing RGeeSR SN RcNre OaRR/EaiK anC ENrwarC
SN RD wiSG aKK NSGer OaOerwNrk
Slide 20
SKILLS TESTING
Slide 21
Slide 22
________________________________________________________________________________
41
____________________________________________________________________________________
Slide 23
Slide 24
Slide 25
Slide 26
________________________________________________________________________________
42
____________________________________________________________________________________
Slide 27
Slide 28
Slide 29
Slide 30
________________________________________________________________________________
43
____________________________________________________________________________________
Slide 31
Slide 32
IFAK CARRY OPTIONS

• IFAK’R cNme aR NrCereC
• TTPOA iR nNS makinF NfficiaK
recNmmenCaSiNnR Nf any OarSicTKar AranC,
manTfacSTrer, CeRiFn, eSc.
• OnKy recNmmenCaSiNn iR SN have
ePTiOmenS aR aRReRRaAKe SN Nfficer aR
ONRRiAKe
Slide 33
CARRY OPTIONS
Slide 34
________________________________________________________________________________
44
____________________________________________________________________________________
CARRY OPTIONS
Slide 35
________________________________________________________________________________
45
____________________________________________________________________________________
Operational Emergency Medical Skills Course Manual, LTC (Ret) J. Hagmann, M.D.,
2004
Tactical Combat Casualty Care, Committee on Tactical Combat Casualty Care,

Government Printing Agency, Feb 2003
Tactical Combat Casualty Care in Special Operations, CPT Frank Butler, Jr., MC, USN;
LTC John Hagmann, MC, USA; ENS George Butler, MC, USN, Military Medicine, Vol.
161, Supp 1, 1996
Texas Tactical Police Officer’s Association Basic Tactical Medic Training Program
Curriculum
________________________________________________________________________________
46

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Texas Commission on Law Enforcement

Officer Standard and Education

Texas Tactical Police Officer’s Association

Self-Aid/Buddy-Aid for Law Enforcement

Texas Commission on Law Enforcement

Texas Tactical Police Officer’s Association

Subject: Self-Aid/Buddy-Aid for Law Enforcement Instructor (train the trainer)

Instructors: Add specific instructor’s names Phone: Add instructor(s)

Time Allotted: 16 hours

GOAL (PURPOSE OF COURSE): For students to be able to provide immediate Life

Date Prepared: March 2010 Date Revised:

Prepared By: David Flory Revised By:

Insert bio of specific instructor(s) here…………………………

Introduction to the course:

Instructor’s Lesson Plan

Self-Aid/Buddy-Aid (SABA) Programs:

• Illustrate the need for SABA programs.

I. PREPARATION (Student Motivation/Opening Statement)

Emphasize that although our research supports that the

Officers must have a basic understanding and knowledge of

As Paramedics, you understand the “Golden Hour,” your

A reiteration of the requirement for Fire/EMS personnel to stage

If not staged, a delay in response can be due to traffic, lack of EMS

As an aside note, in calendar year 2009 there was an increase of

Purcell found Aguilar walking down the sidewalk of a neighborhood

One of the responding officers had been an Army medic. He

At approximately 1:34 p.m. local time Hasan entered his

Unarmed army reserve Captain John Gaffaney attempted to stop

The incident, which lasted about 10 minutes, resulted in 30 people

In particular in the US state of California and in King

Tactical Combat Casualty Care (TCCC):

The SABA Program and its techniques are based on

Since the first course in 1996, TCCC is now standardized

It is a common misconception from the civilian sector that

HISTORY OF THE BATTLE OF BLACK SEA

After the conflict quieted down and U.S. Marines

Following the slaughter of UN peacekeeping forces, the

On 3 October 1993 members of the Delta Forces and

The men who fought this battle did so in a noble and

Although the Rangers and Delta Forces sustained heavy

The Delta Forces and Rangers stood their ground and

The United States woke on 4 October 1993 to see images

The battle was sensationalized by the movie “Black Hawk

“So lets, take a closer look at TCCC.”

When explaining the TCCC concept to students it might

**Read article taken from the 2010 winter

“Finally, it must be noted that the LEOKA data set is

In an effort to better track officer injuries where there

Dallas, Bedford and Woodway PD’s each representing

Additionally, the IACP SafeShield Committee, a

Here is a slide provided by Col. Ron Bellamy, member of

It is important to stress to your students that this is a

We will cover what to carry and how, later

The purpose of this video, although a SWAT incident, is

SUGGESTED BREAK HERE

Basic Management Plans

• Define each of the 3 management plans under the umbrella of TCCC

A good “hammer home” summary for the core concepts of

I think the important message here is that just because we

Give the students the provided IFAK kit. Keep this