TacMed Terms

TacMed Terms

In the movies, if good guys are shot at all, it’s in the shoulder. The bullet misses everything vital. Immediately after the fight their arm is in a sling and they are exchanging witty banter with the other lead character. There is no paperwork, no emergency surgery, no months of physical therapy.

My limited experience with gun battles is, there is a very messy period of cleaning up afterward. Your “tactical” training should prepare you to address injuries before the smoke clears.

Here are some terms specific to the tactical medical world.


BorSTAR–Border Patrol Search, Trauma and Rescue. The USBP equivalent of USAF’s pararescue.


Central Nervous System (CNS)–The brain, brain stem, and spinal chord. Hits to the CNS have the greatest likelihood of resulting in the immediate incapacitation of your assailant. CNS hits may not be necessary with rifles and shotguns but they may be the only thing that does the trick with pistol bullets, which are relatively underpowered.


Confined Space (in rescue)–An area, such as the inside of a tanker truck’s fuel cells, where there is limited room for rescuers and their equipment, the entry is perhaps too narrow for standard gurneys, and / or there is limited ventilation. Confined space has a different meaning when fighting; see Glossary of Gunspeak.


EDC (Every Day Carry)–What you have on you on a more or less daily basis. It might be handgun, and / or a folding knife, and / or a cell phone, and / or spare magazines, and / or house keys, etc. Your EDC should include a tourniquet and compressed gauze. Remember, “If it’s not within arms’ reach when you need it, it might as well be on Mars.”


Field Expedient–An improvised substitute for the real thing. If you don’t have gauze, for example, you can pack a wound with a T-shirt instead.

If you don’t have a full-sized abdominal dressing, a moistened towel is a Field Expedient way of dressing an evisceration. You can keep it moist and clean and hold it in place with Saran wrap–don’t wrap it too tight!


Fine Motor Skill–is something requiring dexterity of our finger tips. Before all the advances in robotics and laparoscopy, brain surgery required fine motor skill (it probably still does). The problem is, the deeper we are into the “fight or flight” reaction, the more our body will shunt blood away from our extremities and into our major muscle groups (like your thighs, so you can run farther faster) and our core organs (primarily your heart and lungs, to power those major muscle groups with the oxygen they need and to circulate around all the adrenal chemicals our body is doping us up with). Accordingly, we should avoid training to perform (and counting on performance of) Fine Motor Skills in or immediately after a fight, although some Fine Motor Skills may not be avoidable. Not to be confused with Complex Motor Skills, although some instructors say “complex” when they really mean “fine.” See also Gross Motor Skill in Glossary of Gunspeak.


ICSAVE (Integrated Community Solutions to Active Violence Events)–A non-profit organization who’s mission is to educate our communities about how to keep the body count low when active killers attack.


Mass Casualty Incident (MCI)–Technically, any time there are more casualties than people with medical training to treat them, necessitating triage. Often used when referring to Active Killer Events.


MCI–see Mass Casualty Incident above.


NAEMT–The National Association of Emergency Medical Technicians


Purpose Built–A tool designed and manufactured for the reasons you use it. Examples would be a fighting knife, as opposed to kitchen cutlery. You might grab a steak knife out of the butcher block on your counter if there is a home invader in your dining room, but it is more likely to break, and won’t make as wide a wound, as a Purpose Built fighting knife.

TECC students applying a Purpose Built CAT tourniquet (he’s lifting it up to get the other side of the loop close to the armpit, but will cinch it down lower, across the arm rather than over the shoulder).

Another example would be a commercial tourniquet like the CAT or SOFT-T. You can improvise a tourniquet out of split pants legs and a tire iron, but by the time you find all the stuff you need and MacGyver it, your casualty may have already bled out. Purpose Built is the opposite of Purpose Built is Field Expedient. Purpose Built medical gear can be expensive, but it is almost invariably faster to apply and more effective.

An improvised, or Field Expedient, tourniquet.


TECC (Tactical Emergency Casualty Care)–Stateside, civilian counterpart to the TCCC protocols.


TCCC (Tactical Combat Casualty Care)–A set of medical protocols for patient care when taking, potentially taking, or having recently taken hostile fire. Designed for the military, various aspects of TCCC have been adopted (as TECC) for use in certain similar civilian combat equivalents, such as mass casualty events (MCIs).


Terminal Ballistics–are what happens to the bullet after it hits a target (the intended target, or otherwise). If you have ever hunted large ungulates (big game) you may have some idea how unpredictable Terminal Ballistics can be, despite all the fancy ballistic gelatin tests and the fantastic claims of ammunition manufacturers.


Triage–Sorting. Especially, sorting in order of priority. In tactical medicine, triage is dividing patients into the following groups:

  1. Those who can be patched up enough to return to the fight ASAP
  2. Those who need evacuation to a higher level of care
  3. Those whose poor likelihood of survival does not warrant the time you will be spending away from the 1)s and 2)s trying to save the 3)s.

When evacuation from the area becomes possible, the 2)s are broken down further into two groups:

  1. Those in need of immediate care (such as surgery), and
  2. Those (with, say, broken arm bones) for whom a hospital visit will eventually be necessary, but are less likely to die if they are not evacuated right this second.


Wyatt Protocols–A laundry list of things you might want to do after any sort of ballistic exchange. The order of precedence is determined by the situation. They are sometimes called “the Ts” because they start with T; for example,

  • Take cover
  • Top off your ammunition
  • Talk to 911, bystanders, suspect, or whomever
  • Take off if the scene becomes unsafe
  • Trade up to a better weapon (or across to a backup)
  • Tighten your abs if you’re starting to feel woozy
  • Transition to police control of the scene without getting shot by the good guys