TCCC Hemorrhage Control & Wound Management 1 — Questions and Answers
Question 1: What is the preferred first-line method for controlling life-threatening extremity hemorrhage in TCCC?
- Wound elevation and direct pressure
- Pressure dressing with hemostatic gauze over the wound
- Tourniquet application (Correct answer)
- Manual compression of the proximal artery
Correct answer: Tourniquet application
In TCCC, a tourniquet is the preferred first-line treatment for life-threatening extremity hemorrhage because it rapidly stops arterial bleeding.
Question 2: Where should a tourniquet be placed on a bleeding extremity per TCCC guidelines?
- Directly over the wound site
- 1 inch below the wound
- At the nearest joint proximal to the wound
- 2-3 inches above the wound (Correct answer)
Correct answer: 2-3 inches above the wound
TCCC guidelines recommend placing the tourniquet 2-3 inches proximal (above) the wound to effectively occlude blood flow without being placed over the injury.
Question 3: Which hemostatic agent is the TCCC standard of care for compressible wounds not amenable to tourniquet application?
- Vaseline-impregnated gauze
- Combat Gauze (kaolin-impregnated) (Correct answer)
- Saline-moistened gauze
- Chitosan-based gauze only
Correct answer: Combat Gauze (kaolin-impregnated)
Combat Gauze impregnated with kaolin is the TCCC Committee-recommended hemostatic dressing for compressible wounds where a tourniquet cannot be applied.
Question 4: How long should sustained direct pressure be applied after packing a wound with hemostatic gauze per TCCC protocol?
- 30 seconds
- 1 minute
- 3 minutes (Correct answer)
- 10 minutes
Correct answer: 3 minutes
TCCC guidelines recommend applying firm direct pressure for 3 minutes after packing with hemostatic gauze to allow the agent to activate and form a stable clot.
Question 5: What critical information must be documented immediately upon tourniquet application in TCCC?
- Patient's blood type and allergy status
- Type of tourniquet and lot number
- Time of tourniquet application (Correct answer)
- Name of the medic who applied it
Correct answer: Time of tourniquet application
The time of tourniquet application must be marked on the tourniquet or the patient's forehead so receiving medical personnel can track total ischemia time.
Question 6: Which wound location is NOT appropriate for tourniquet application in TCCC?
- Above-knee traumatic amputation
- Gunshot wound to the mid-thigh with arterial bleeding
- Deep laceration of the forearm with pulsatile bleeding
- Penetrating abdominal wound with external hemorrhage (Correct answer)
Correct answer: Penetrating abdominal wound with external hemorrhage
Abdominal wounds cannot be controlled with a tourniquet due to anatomical constraints; wound packing or junctional hemorrhage control techniques are required instead.
Question 7: After approximately how many hours does tourniquet application become a significant risk factor for limb viability?
- 30 minutes
- 1 hour
- 2 hours (Correct answer)
- 6 hours
Correct answer: 2 hours
While tourniquets may remain in place longer when necessary, ischemia-related muscle and nerve injury risk increases significantly after 2 hours, making reassessment and documentation critical.
TCCC Hemorrhage Control & Wound Management 1
What is the preferred first-line method for controlling life-threatening extremity hemorrhage in TCCC?