What is the first step in the Tactical Combat Casualty Care sequence?

• A. Tactical field care
• B. Combat casualty evacuation
• C. Care under fire
• D. Casualty Collection Point

Answer: (C)

Care under fire is the first step in the Tactical Combat Casualty Care sequence. In a live-fire situation, the immediate threat to a casualty’s life is usually massive hemorrhage, so the priority is to stop life-threatening bleeding right away while staying under cover and minimizing exposure. Quick, decisive measures like applying a tourniquet or hemostatic dressing can save a life even as you remain engaged with the threat. Once the threat is reduced or you have a moment of safety, you move on to tactical field care for a more thorough assessment and treatment, and then to evacuation care as the plan progresses to move the casualty to higher care. The other options reflect later stages of care: tactical field care comes after initial under-fire actions, casualty evacuation is about moving the patient to higher care, and a casualty collection point is a staging area rather than a medical action step.