Brand-new publication.ATP 4-02.11, Casualty Response, Tactical Combat Casualty Care, and First Aid,
released 23 March 2026 by the Army Medical Center of Excellence, officially supersedes the older
TC 4-02.1, First Aid. If your unit's training materials still reference TC 4-02.1, they're citing a
superseded publication — confirm your unit has transitioned before using old references for instruction.
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OVERVIEW
What changed with the new publication, and the philosophy behind it.
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One Unified Standard
ATP 4-02.11 consolidates casualty response instructions for nonmedical Soldiers into a single, modernized publication, replacing the older separate first aid manual.
Designed to be the primary doctrinal guide for nonmedical Soldiers responding to injuries
Full integration of Tactical Combat Casualty Care (TCCC) protocols throughout the publication
Framed explicitly as supporting mission readiness and unit cohesion, not just individual survival
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What TCCC Is
Tactical Combat Casualty Care — an evidence-based, DoD-standard set of techniques and strategies for delivering the best trauma care in a hostile or tactical environment.
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Who Sets TCCC Standards
TCCC guidelines are developed under the Committee on Tactical Combat Casualty Care (CoTCCC), part of the Defense Health Agency's Joint Trauma System — the same body of guidance every DoD component follows.
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What "Combat Lifesaver" Means
A nonmedical Soldier trained beyond basic self-aid/buddy-aid — the bridge between what every Soldier can do and what a combat medic provides.
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THE THREE PHASES OF TCCC
TCCC breaks casualty care into phases based on the tactical situation — the right action depends on which phase you're in.
Phase
Situation
1. Care Under Fire
You and the casualty are under hostile fire — care is limited to what's essential and safe to perform
2. Tactical Field Care
You and the casualty are relatively safe, no longer under effective hostile fire — free to provide care to the best of your ability
3. Combat Casualty Evacuation Care
Care rendered during casualty evacuation (CASEVAC) to further treatment
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Care Under Fire Priority
If a casualty has a limb hemorrhage or an amputation, life-saving hemorrhage control is applied before moving the casualty, if the situation allows.
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When Not to Render Aid
If providing aid would put your own life in immediate danger, or the casualty shows no signs of life — no pulse, no breathing — the doctrine acknowledges this changes the calculus.
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CORE SKILLS & TECHNIQUES
The hands-on techniques every Soldier should be able to perform without hesitation.
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Bleeding Control
Three primary techniques: tourniquet, hemostatic dressing (such as QuikClot), and pressure dressing (Emergency Trauma Bandage / Israeli Bandage).
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AVPU Responsiveness Scale
A quick way to assess level of consciousness: Alert, responds to Voice, responds to Pain, or Unresponsive.
A pain response can be checked by briskly rubbing the sternum with a knuckle, or squeezing the first or second toe over the toenail
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TCCC Card
Records injuries and treatments performed on a casualty as they move through successive roles of medical care — critical continuity of care information for the next provider down the evacuation chain.
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MARCH Assessment
The standard TCCC assessment order: Massive hemorrhage, Airway, Respiration, Circulation, Head injury/Hypothermia — treat in that priority sequence rather than working head-to-toe.
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TRAINING TIERS
TCCC training isn't one-size-fits-all — DoD Instruction 1322.24 defines distinct tiers by role.
Tier
Who It's For
TCCC for All Service Members
Fundamental, occupation-independent lifesaving trauma skills for the majority of DoD personnel
TCCC Combat Lifesaver
Nonmedical Soldiers designated for enhanced trauma-response training beyond the baseline course
TCCC Combat Medic / Corpsman / Aerospace Medicine Technician
Army combat medics, Navy hospital corpsmen, Air Force aerospace medicine technicians
TCCC Combat Paramedic / Provider
Advanced trauma scope — physicians, PAs, independent duty corpsmen/medics, pararescue, Special Forces medical sergeants, and similar
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TCCC Replaced Older Courses
TCCC training now replaces the trauma skills that used to be taught separately in Service-specific first aid and self-aid/buddy-care courses.
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Certification & Refresher
Soldiers must remain certified on the TCCC skills appropriate to their tier, with refresher training designed to keep proficiency current — commanders can direct additional or advanced training based on unit mission.
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First Aid Skill Level 1 Tasks
Baseline first aid tasks for every Soldier are also captured in the Soldier's Manual of Common Tasks (STP 21-1-SMCT), which cross-references the current first aid doctrine.