TCCC TIER 3 COMPLETE QUESTIONS WITH
DETAILED VERIFIED ANSWERS
|ALREADY GRADED A+
If a penetrating eye injury is suspected, you should perform a
_______________________.
a. Rapid field test of visual acuity
b. Neurological exam
c. Traumatic brain injury evaluation questionnaire
d. Gait and balance assessment - CORRECT ANSWER ✔✔- a. Rapid field test of
visual acuity
RATIONALE
If a penetrating eye injury is noted or suspected, perform a rapid field test of
visual acuity and document findings. Rapid visual acuity testing includes the ability
to read print, count fingers, identity hand motion, and/or differentiate light from
dark.
What is the most common cause of preventable combat death?
a. Tension pneumothorax
b. Airway problems
c. Shock
d. Hemorrhage - CORRECT ANSWER ✔✔- d. Hemorrhage
1|Page
,RATIONALE
The leading causes of preventable death on the battlefield are due to traumatic
injuries including hemorrhage, both from the extremities and from junctional
areas, tension pneumothorax, and airway trauma or obstruction. By far, the
majority of the preventable deaths are from massive hemorrhage.
Tactical Combat Casualty Care (TCCC) Guidelines recommend that combat trauma
casualties without a pulse or respirations should have ____________________
performed during Tactical Field Care (TFC) due to the potential benefit and clear
absence of additional harm.
a. Active hypothermia measures
b. Tourniquet application
c. Bilateral needle decompression of the chest
d. Cardiopulmonary Resuscitation - CORRECT ANSWER ✔✔- c. Bilateral needle
decompression of the chest
RATIONALE
During TFC, several authors and subject matter experts recommend that for
combat trauma casualties without a pulse, bilateral NDCs should be performed
due to the potential benefit and clear absence of additional harm. As a result, the
TCCC Guidelines now state: ".... casualties with torso trauma or polytrauma who
have no pulse or respirations during TFC should have bilateral needle
decompression performed to ensure they do not have a tension pneumothorax
prior to discontinuation of care."
You are evaluating a casualty using the AVPU method for determining the level of
consciousness. The casualty does not respond when you ask them questions in a
2|Page
,loud voice but reacts to pain when you rub their sternum briskly with your
knuckle. You should classify the casualty's level of consciousness as:
Alertness
Verbal responsive
Pain responsive
Unconscious state - CORRECT ANSWER ✔✔- Pain responsive
RATIONALE
Formally assessing the level of consciousness is a straightforward process. It
involves 3 basic steps:First, ask in a loud but calm voice, "Are you okay?" If the
casualty answers coherently, then they are an A, or Alert on the AVPU
scale.However, if the casualty does not answer or mumbles, you should repeat in
a loud but calm voice, "Are you okay?" to make sure they weren't just distracted.
If the answer is not clear, ask the casualty to squeeze your finger or move an arm
or leg. If they respond to your command, they are a V, or Verbally responsive.If
they do not respond to voice commands, rub the sternum briskly with a knuckle
or squeeze the first or second toe over the toenail, or if the casualty is wearing
individual body armor, pinch their nose or earlobe (do not use injuries). If the
casualty responds in any way to pain stimuli, they are a P, or Pain responsive.If
the casualty does not respond to any of these 3 attempts, they are a U, or
Unresponsive.
On inspection of the back, a trauma casualty has a hematoma and localized lower
back pain that radiates down the legs. You suspect this casualty has a
_________________.
a. Femur fracture
b. Spinal fracture
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, c. Pelvic fracture
d. Compound fracture - CORRECT ANSWER ✔✔- b. Spinal fracture
RATIONALE
Spinal fractures often present with localized spinal pain, or pain radiating down
the extremities from nerve irritation, and may include a deformity at the point of
injury, a hematoma, or crepitus. In some cases, motor function can be affected
leading to partial or complete paralysis, and sensation can be diminished or
absent.
A casualty in hemorrhagic shock received one unit of low-titer group O whole
blood and now has a palpable radial pulse with a blood pressure of 112/70. What
should the Combat Medic/Corpsman do next?
a. Continue to monitor the casualty and transfuse if there is a clinical
deterioration
b. Give a second unit of low-titer group O whole blood
c. Start a crystalloid infusion
d. Transfuse 1 unit of plasma - CORRECT ANSWER ✔✔- a. Continue to monitor the
casualty and transfuse if there is a clinical deterioration
RATIONALE
Casualties being treated for hemorrhagic shock with low-titer group O whole
blood should be reassessed to see if they meet the criteria for discontinuation of
resuscitation - the return of radial pulses or a systolic BP >100 or improved mental
status. If these parameters are not met, then continue resuscitation attempts,
reassessing after every unit.
4|Page
DETAILED VERIFIED ANSWERS
|ALREADY GRADED A+
If a penetrating eye injury is suspected, you should perform a
_______________________.
a. Rapid field test of visual acuity
b. Neurological exam
c. Traumatic brain injury evaluation questionnaire
d. Gait and balance assessment - CORRECT ANSWER ✔✔- a. Rapid field test of
visual acuity
RATIONALE
If a penetrating eye injury is noted or suspected, perform a rapid field test of
visual acuity and document findings. Rapid visual acuity testing includes the ability
to read print, count fingers, identity hand motion, and/or differentiate light from
dark.
What is the most common cause of preventable combat death?
a. Tension pneumothorax
b. Airway problems
c. Shock
d. Hemorrhage - CORRECT ANSWER ✔✔- d. Hemorrhage
1|Page
,RATIONALE
The leading causes of preventable death on the battlefield are due to traumatic
injuries including hemorrhage, both from the extremities and from junctional
areas, tension pneumothorax, and airway trauma or obstruction. By far, the
majority of the preventable deaths are from massive hemorrhage.
Tactical Combat Casualty Care (TCCC) Guidelines recommend that combat trauma
casualties without a pulse or respirations should have ____________________
performed during Tactical Field Care (TFC) due to the potential benefit and clear
absence of additional harm.
a. Active hypothermia measures
b. Tourniquet application
c. Bilateral needle decompression of the chest
d. Cardiopulmonary Resuscitation - CORRECT ANSWER ✔✔- c. Bilateral needle
decompression of the chest
RATIONALE
During TFC, several authors and subject matter experts recommend that for
combat trauma casualties without a pulse, bilateral NDCs should be performed
due to the potential benefit and clear absence of additional harm. As a result, the
TCCC Guidelines now state: ".... casualties with torso trauma or polytrauma who
have no pulse or respirations during TFC should have bilateral needle
decompression performed to ensure they do not have a tension pneumothorax
prior to discontinuation of care."
You are evaluating a casualty using the AVPU method for determining the level of
consciousness. The casualty does not respond when you ask them questions in a
2|Page
,loud voice but reacts to pain when you rub their sternum briskly with your
knuckle. You should classify the casualty's level of consciousness as:
Alertness
Verbal responsive
Pain responsive
Unconscious state - CORRECT ANSWER ✔✔- Pain responsive
RATIONALE
Formally assessing the level of consciousness is a straightforward process. It
involves 3 basic steps:First, ask in a loud but calm voice, "Are you okay?" If the
casualty answers coherently, then they are an A, or Alert on the AVPU
scale.However, if the casualty does not answer or mumbles, you should repeat in
a loud but calm voice, "Are you okay?" to make sure they weren't just distracted.
If the answer is not clear, ask the casualty to squeeze your finger or move an arm
or leg. If they respond to your command, they are a V, or Verbally responsive.If
they do not respond to voice commands, rub the sternum briskly with a knuckle
or squeeze the first or second toe over the toenail, or if the casualty is wearing
individual body armor, pinch their nose or earlobe (do not use injuries). If the
casualty responds in any way to pain stimuli, they are a P, or Pain responsive.If
the casualty does not respond to any of these 3 attempts, they are a U, or
Unresponsive.
On inspection of the back, a trauma casualty has a hematoma and localized lower
back pain that radiates down the legs. You suspect this casualty has a
_________________.
a. Femur fracture
b. Spinal fracture
3|Page
, c. Pelvic fracture
d. Compound fracture - CORRECT ANSWER ✔✔- b. Spinal fracture
RATIONALE
Spinal fractures often present with localized spinal pain, or pain radiating down
the extremities from nerve irritation, and may include a deformity at the point of
injury, a hematoma, or crepitus. In some cases, motor function can be affected
leading to partial or complete paralysis, and sensation can be diminished or
absent.
A casualty in hemorrhagic shock received one unit of low-titer group O whole
blood and now has a palpable radial pulse with a blood pressure of 112/70. What
should the Combat Medic/Corpsman do next?
a. Continue to monitor the casualty and transfuse if there is a clinical
deterioration
b. Give a second unit of low-titer group O whole blood
c. Start a crystalloid infusion
d. Transfuse 1 unit of plasma - CORRECT ANSWER ✔✔- a. Continue to monitor the
casualty and transfuse if there is a clinical deterioration
RATIONALE
Casualties being treated for hemorrhagic shock with low-titer group O whole
blood should be reassessed to see if they meet the criteria for discontinuation of
resuscitation - the return of radial pulses or a systolic BP >100 or improved mental
status. If these parameters are not met, then continue resuscitation attempts,
reassessing after every unit.
4|Page
