TCCC Tier 3 Certification Examination
ACTUAL EXAM 2026/2027 | Tactical
Combat Casualty Care | Verified Q&A |
Pass Guaranteed - A+ Graded
Time Limit: 3 hours
Passing Score: 80% (80/100 correct)
SECTION 1: TCCC Phases of Care – CUF, TFC, TACEVAC (Questions 1-10)
Q1: A combat medic is part of a dismounted patrol that takes small arms fire. A team member is shot in
the left thigh with active bright red bleeding. The casualty is behind partial cover but still in the direct
line of fire. The medic has immediate access to a CAT tourniquet. According to TCCC guidelines, the
medic should FIRST:
A. Drag the casualty behind full cover before applying tourniquet
B. Apply the tourniquet while still under fire [CORRECT]
C. Assess for other injuries before applying tourniquet
D. Apply direct pressure with gauze while returning fire
Correct Answer: B
Rationale: In Care Under Fire (CUF), the ONLY medical intervention is application of a tourniquet to a
limb with life-threatening hemorrhage. Moving the casualty (A) delays hemorrhage control and exposes
both to fire longer. Full assessment (C) is deferred to Tactical Field Care. Direct pressure (D) is ineffective
for major arterial bleeding and violates CUF principles. Per CoTCCC, tourniquet application takes
precedence over casualty movement when under fire.
Q2: During Tactical Field Care (TFC), a casualty has a patent airway, no massive external hemorrhage,
and is breathing spontaneously. The next step in the MARCH algorithm is:
A. Assess for head injury
B. Check distal pulses
C. Evaluate for tension pneumothorax [CORRECT]
D. Start an IV with Hextend
,Correct Answer: C
Rationale: MARCH sequence: Massive hemorrhage → Airway → Respiratory → Circulation →
Hypothermia/Head injury. After airway is patent, the "R" (Respiratory) requires evaluation for tension
pneumothorax, open pneumothorax, or flail chest. Head injury (A) is the "H" step. Distal pulses (B) and
IV fluids (D) are Circulation ("C") and come after Respiratory assessment.
Q3: A squad is in a firefight. A soldier is shot in the right forearm with minimal bleeding and is able to
self-apply a tourniquet. The casualty is conscious and shouting that he "can't breathe." What is the
medic's CORRECT action in CUF?
A. Immediately perform a needle decompression
B. Drag casualty to cover and begin airway assessment
C. Have casualty self-apply tourniquet; no airway intervention in CUF [CORRECT]
D. Call for immediate CASEVAC for respiratory distress
Correct Answer: C
Rationale: In CUF, the ONLY interventions are: (1) return fire, (2) direct casualty to cover/self-aid, (3)
apply tourniquet for limb hemorrhage. Airway management (A, B) is explicitly deferred to TFC. The
casualty's "can't breathe" complaint could be anxiety, chest wound, or other causes—but CUF protocol
prohibits airway intervention until fire is suppressed or casualty is in cover. CASEVAC (D) is premature
without TFC assessment.
Q4: A medic is conducting TFC on a casualty who had a tourniquet applied to the left leg during CUF. It
has been 90 minutes since application. The casualty is stable, bleeding is controlled, and the tactical
situation permits. What is the NEXT appropriate step?
A. Immediately convert to hemostatic dressing and pressure bandage
B. Leave tourniquet in place; do NOT attempt conversion [CORRECT]
C. Loosen tourniquet to check for bleeding, then retighten if needed
D. Remove tourniquet and apply direct pressure only
Correct Answer: B
Rationale: Per CoTCCC, tourniquet conversion should NOT be attempted until at least 2 hours after
application (ideally in a surgical setting). Attempting conversion at 90 minutes (A) risks re-bleeding.
"Loosening to check" (C) is dangerous and obsolete practice. Removal (D) without surgical capability is
contraindicated. The tourniquet should remain in place until evacuation to higher care or minimum 2
hours with monitoring capability.
,Q5: During TACEVAC preparation, a medic must complete documentation on the DD Form 1380 (TCCC
Card). Which information is NOT required on this form?
A. Casualty's tourniquet application times and locations
B. Vital signs recorded during TFC
C. Detailed mechanism of injury narrative [CORRECT]
D. All medications administered with doses and times
Correct Answer: C
Rationale: The TCCC Card (DD Form 1380) requires: tourniquet data (A), vital signs (B), medications with
doses/routes/times (D), fluids, and treatments rendered. While mechanism of injury (MOI) is clinically
relevant, the TCCC Card prioritizes treatments and times over detailed MOI narrative, which can be
communicated verbally during handoff. The form has limited space; detailed MOI belongs in the medical
record, not the TCCC Card.
Q6: A casualty with a gunshot wound to the chest is being prepared for helicopter evacuation
(TACEVAC). The flight medic requests a "9-line MEDEVAC." Which element of the 9-line is described
INCORRECTLY below?
A. Line 1: Grid coordinates of pickup site
B. Line 4: Number of patients by precedence (urgent/surgical/routine)
C. Line 7: Method of marking pickup site (panels, smoke, signal)
D. Line 9: Detailed patient medical history and allergies [CORRECT]
Correct Answer: D
Rationale: Line 9 of the 9-line MEDEVAC request is NBC contamination (nuclear/biological/chemical),
NOT patient medical history. Medical history is communicated separately during patient handoff. Lines
1, 4, and 7 are correctly described. Common error: confusing Line 9 with medical information rather
than contamination status.
Q7: A medic is treating a casualty in TFC. The casualty has massive bleeding from the left groin
(junctional area) that cannot be controlled with direct pressure. The medic has a Combat Ready Clamp
(CRoC) and hemostatic gauze available. What is the BEST intervention?
A. Apply the CRoC junctional tourniquet [CORRECT]
B. Pack wound with hemostatic gauze and apply pressure
C. Apply an extremity tourniquet proximal to the groin
D. Continue direct pressure while awaiting evacuation
Correct Answer: A
Rationale: Junctional hemorrhage (groin/axilla/neck) cannot be controlled with standard extremity
, tourniquets. The CRoC (or SAM Junctional Tourniquet) is specifically designed for junctional hemorrhage
control. While hemostatic packing (B) is adjunctive, junctional tourniquets are preferred for initial
control when available. Extremity tourniquets (C) are ineffective for junctional wounds. Continuing
pressure (D) delays definitive control.
Q8: During a prolonged field care scenario, a medic must decide when to reassess a casualty's
tourniquet. What is the MINIMUM reassessment interval per TCCC-PCC guidelines?
A. Every 30 minutes
B. Every 1 hour
C. Every 2-4 hours [CORRECT]
D. Every 6 hours
Correct Answer: C
Rationale: Per TCCC Prolonged Casualty Care (PCC) guidelines, tourniquets should be reassessed every
2-4 hours for conversion candidacy, complications, or need for additional interventions. More frequent
reassessment (A, B) is unnecessary and resource-intensive in prolonged care. Six hours (D) is too long
and risks missed compartment syndrome or conversion opportunities.
Q9: In the transition from TFC to TACEVAC, which action demonstrates CORRECT phase-appropriate
care?
A. Performing detailed neuro exam during helicopter loading
B. Initiating blood transfusion during ground ambulance transport [CORRECT]
C. Performing needle decompression while under fire
D. Conducting full body x-ray in field hospital
Correct Answer: B
Rationale: TACEVAC phase includes en-route care with continued resuscitation, including blood
products if available. Detailed neuro exam (A) should be completed in TFC before movement. Needle
decompression (C) is a TFC intervention, not appropriate during CUF. Field hospitals (D) are Role 2/3
facilities, not TACEVAC platforms.
Q10: A medic is in CUF. The tactical commander orders the team to break contact and move to a rally
point 200 meters away. A casualty has severe leg bleeding controlled by a tourniquet and is conscious.
What is the medic's priority?
A. Establish IV access before movement
B. Move casualty to rally point using fireman's carry [CORRECT]
ACTUAL EXAM 2026/2027 | Tactical
Combat Casualty Care | Verified Q&A |
Pass Guaranteed - A+ Graded
Time Limit: 3 hours
Passing Score: 80% (80/100 correct)
SECTION 1: TCCC Phases of Care – CUF, TFC, TACEVAC (Questions 1-10)
Q1: A combat medic is part of a dismounted patrol that takes small arms fire. A team member is shot in
the left thigh with active bright red bleeding. The casualty is behind partial cover but still in the direct
line of fire. The medic has immediate access to a CAT tourniquet. According to TCCC guidelines, the
medic should FIRST:
A. Drag the casualty behind full cover before applying tourniquet
B. Apply the tourniquet while still under fire [CORRECT]
C. Assess for other injuries before applying tourniquet
D. Apply direct pressure with gauze while returning fire
Correct Answer: B
Rationale: In Care Under Fire (CUF), the ONLY medical intervention is application of a tourniquet to a
limb with life-threatening hemorrhage. Moving the casualty (A) delays hemorrhage control and exposes
both to fire longer. Full assessment (C) is deferred to Tactical Field Care. Direct pressure (D) is ineffective
for major arterial bleeding and violates CUF principles. Per CoTCCC, tourniquet application takes
precedence over casualty movement when under fire.
Q2: During Tactical Field Care (TFC), a casualty has a patent airway, no massive external hemorrhage,
and is breathing spontaneously. The next step in the MARCH algorithm is:
A. Assess for head injury
B. Check distal pulses
C. Evaluate for tension pneumothorax [CORRECT]
D. Start an IV with Hextend
,Correct Answer: C
Rationale: MARCH sequence: Massive hemorrhage → Airway → Respiratory → Circulation →
Hypothermia/Head injury. After airway is patent, the "R" (Respiratory) requires evaluation for tension
pneumothorax, open pneumothorax, or flail chest. Head injury (A) is the "H" step. Distal pulses (B) and
IV fluids (D) are Circulation ("C") and come after Respiratory assessment.
Q3: A squad is in a firefight. A soldier is shot in the right forearm with minimal bleeding and is able to
self-apply a tourniquet. The casualty is conscious and shouting that he "can't breathe." What is the
medic's CORRECT action in CUF?
A. Immediately perform a needle decompression
B. Drag casualty to cover and begin airway assessment
C. Have casualty self-apply tourniquet; no airway intervention in CUF [CORRECT]
D. Call for immediate CASEVAC for respiratory distress
Correct Answer: C
Rationale: In CUF, the ONLY interventions are: (1) return fire, (2) direct casualty to cover/self-aid, (3)
apply tourniquet for limb hemorrhage. Airway management (A, B) is explicitly deferred to TFC. The
casualty's "can't breathe" complaint could be anxiety, chest wound, or other causes—but CUF protocol
prohibits airway intervention until fire is suppressed or casualty is in cover. CASEVAC (D) is premature
without TFC assessment.
Q4: A medic is conducting TFC on a casualty who had a tourniquet applied to the left leg during CUF. It
has been 90 minutes since application. The casualty is stable, bleeding is controlled, and the tactical
situation permits. What is the NEXT appropriate step?
A. Immediately convert to hemostatic dressing and pressure bandage
B. Leave tourniquet in place; do NOT attempt conversion [CORRECT]
C. Loosen tourniquet to check for bleeding, then retighten if needed
D. Remove tourniquet and apply direct pressure only
Correct Answer: B
Rationale: Per CoTCCC, tourniquet conversion should NOT be attempted until at least 2 hours after
application (ideally in a surgical setting). Attempting conversion at 90 minutes (A) risks re-bleeding.
"Loosening to check" (C) is dangerous and obsolete practice. Removal (D) without surgical capability is
contraindicated. The tourniquet should remain in place until evacuation to higher care or minimum 2
hours with monitoring capability.
,Q5: During TACEVAC preparation, a medic must complete documentation on the DD Form 1380 (TCCC
Card). Which information is NOT required on this form?
A. Casualty's tourniquet application times and locations
B. Vital signs recorded during TFC
C. Detailed mechanism of injury narrative [CORRECT]
D. All medications administered with doses and times
Correct Answer: C
Rationale: The TCCC Card (DD Form 1380) requires: tourniquet data (A), vital signs (B), medications with
doses/routes/times (D), fluids, and treatments rendered. While mechanism of injury (MOI) is clinically
relevant, the TCCC Card prioritizes treatments and times over detailed MOI narrative, which can be
communicated verbally during handoff. The form has limited space; detailed MOI belongs in the medical
record, not the TCCC Card.
Q6: A casualty with a gunshot wound to the chest is being prepared for helicopter evacuation
(TACEVAC). The flight medic requests a "9-line MEDEVAC." Which element of the 9-line is described
INCORRECTLY below?
A. Line 1: Grid coordinates of pickup site
B. Line 4: Number of patients by precedence (urgent/surgical/routine)
C. Line 7: Method of marking pickup site (panels, smoke, signal)
D. Line 9: Detailed patient medical history and allergies [CORRECT]
Correct Answer: D
Rationale: Line 9 of the 9-line MEDEVAC request is NBC contamination (nuclear/biological/chemical),
NOT patient medical history. Medical history is communicated separately during patient handoff. Lines
1, 4, and 7 are correctly described. Common error: confusing Line 9 with medical information rather
than contamination status.
Q7: A medic is treating a casualty in TFC. The casualty has massive bleeding from the left groin
(junctional area) that cannot be controlled with direct pressure. The medic has a Combat Ready Clamp
(CRoC) and hemostatic gauze available. What is the BEST intervention?
A. Apply the CRoC junctional tourniquet [CORRECT]
B. Pack wound with hemostatic gauze and apply pressure
C. Apply an extremity tourniquet proximal to the groin
D. Continue direct pressure while awaiting evacuation
Correct Answer: A
Rationale: Junctional hemorrhage (groin/axilla/neck) cannot be controlled with standard extremity
, tourniquets. The CRoC (or SAM Junctional Tourniquet) is specifically designed for junctional hemorrhage
control. While hemostatic packing (B) is adjunctive, junctional tourniquets are preferred for initial
control when available. Extremity tourniquets (C) are ineffective for junctional wounds. Continuing
pressure (D) delays definitive control.
Q8: During a prolonged field care scenario, a medic must decide when to reassess a casualty's
tourniquet. What is the MINIMUM reassessment interval per TCCC-PCC guidelines?
A. Every 30 minutes
B. Every 1 hour
C. Every 2-4 hours [CORRECT]
D. Every 6 hours
Correct Answer: C
Rationale: Per TCCC Prolonged Casualty Care (PCC) guidelines, tourniquets should be reassessed every
2-4 hours for conversion candidacy, complications, or need for additional interventions. More frequent
reassessment (A, B) is unnecessary and resource-intensive in prolonged care. Six hours (D) is too long
and risks missed compartment syndrome or conversion opportunities.
Q9: In the transition from TFC to TACEVAC, which action demonstrates CORRECT phase-appropriate
care?
A. Performing detailed neuro exam during helicopter loading
B. Initiating blood transfusion during ground ambulance transport [CORRECT]
C. Performing needle decompression while under fire
D. Conducting full body x-ray in field hospital
Correct Answer: B
Rationale: TACEVAC phase includes en-route care with continued resuscitation, including blood
products if available. Detailed neuro exam (A) should be completed in TFC before movement. Needle
decompression (C) is a TFC intervention, not appropriate during CUF. Field hospitals (D) are Role 2/3
facilities, not TACEVAC platforms.
Q10: A medic is in CUF. The tactical commander orders the team to break contact and move to a rally
point 200 meters away. A casualty has severe leg bleeding controlled by a tourniquet and is conscious.
What is the medic's priority?
A. Establish IV access before movement
B. Move casualty to rally point using fireman's carry [CORRECT]
