The experiences of combat medics in World War II, Korea and Vietnam, along with his growing understanding of field support, rapid evacuation, transportation and final treatment of those injured in combat are the basis on which care is based tactical combat casualties. While SWAT teams began to appear in the decade 1960, as a result of incidents like the Sniper Tower of Texas, the shooting in Los Angeles with the Symbionese Liberation Army, and many other acts, it was recognized that some form of medical support units would be needed for missions high risk. The proposed model was based on the military model of combat medic, suggesting it was part of the tactical unit. More specifically, these technicians (basic at first and then the paramedic level) was a medical team of special operations. Some of the policemen and paramedics who were these tactical units were often veterans of Vietnam, for many years United States, there were very few units nationwide. A department SWAT team and began the medical program at that time in the 1970's was the Sheriff of Pima County, Tucson, Arizona. Which has been in continuous operation as a SWAT team with the support of clinicians for more than 30 years. It is important to mention that for best performance of a tactical medical team in a public security force, it is necessary to integrate the staff who are trained in three areas: being a police officer, being a provider of medical services and be official special intervention techniques (SWAT techniques). For this reason, and because the high cost of training staff member of these bodies, most SWAT teams, even today, use the external medical support for their team.
Since the 1960's to the 1980's there was a mosaic isolated from the teams that developed their own versions of tactical medical support. The need to revisit the trauma in the tactical environment has been widely recognized. The Tactical Combat Casualty Care Project (CARE tactical combat casualties) was initiated by the Naval Special Warfare Command (Naval Special Warfare Command) in 1993, and continued later by the Special Operations Command (U.S. Special Operations Command (USSOCOM)). This effort developed a set of protocols for trauma in combat Tactics that were published as a supplement in the journal Military Medicine in 1996. CARE guidelines tactical combat casualties provide physicians combat trauma management strategies in combat. CARE The first course in tactical combat casualties took place in 1996 at the Submarine Medical Office sponsored by the Office of Naval Medicine and Surgery (BUMED). Shortly after this training was mandatory for all paramedics of SEAL (special operations in the United States Navy. His name is an acronym Sea, Air and Land (Sea, Air and Earth)). Since then, it has gradually gained acceptance in the military. He has also found wide acceptance in the medical community civilian security forces. Incorporating CARE guidelines tactical combat casualties in the operating Prehospital Trauma Life Support (PHTLS) was an important step in the process of transition from CARE tactical combat casualties. The fourth edition of this manual, published in 1999 contains for the first time a chapter in military medicine. The recommendations contained in the PHTLS Manual carry the endorsement of the Committee on Trauma of the American College of Surgeons and the Association National Emergency Technicians.
The need for regular updating of the guidelines of CARE tactical combat casualties was recognized. The original document recommended that the guidelines were updated as necessary by a committee of the Department of Defense created for this purpose. This concept was approved by the Special Operations Command United States, and the Committee on Tactical Combat Casualty Care of (CoTCCC), which was subsequently founded in 2002 as part of USSOCOM's biomedical research. In 2007, was increased prominence of CARE tactical combat casualties in the Global War on Terrorism. In March of 2008. the CoTCCC was relocated to function as a Board of Health Undersecretary of the Department of Defense of the United States.
The Committee, updating the guidelines based on:
1) in the ongoing review of the literature of civilian and military prehospital medicine;
2) in continuous interaction with the military research labs care for the wounded in combat;
3) first-hand data from combat health, medical,
4) views of both military and civilian experts.
Historically, many of the lessons learned in assisting wounded in the military field have found application in civilian trauma care. Recently, the civilian emergency medical services have been called to assist in numerous school shootings, mall shootings and other acts of terrorism that have tactical factors similar to those found in combat. The threat of receiving hostile fire, having to attend multiple injuries to shed, and prolonged evacuation times have come into play. The massacres at Columbine and Virginia Tech are examples that illustrate that even in urban settings, starting treatment, and transport of injured may require training and tactics outside the parameters of standard protocols SEM. The adoption of the guidelines of the CARE tactical combat casualties in tactical EMS programs and the application of these principles to the tactical operations of Security Forces and the State can result in better continuity tactics and additional lives saved when the wounded are produced during the course of these operations.
