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Army Techniques Publication for Casualty Response, Tactical Combat Casualty Care, and First Aid

ATP 4-02.11 is the Army's current first aid and casualty response publication, published in March 2026 by the Medical Center of Excellence. It supersedes TC 4-02.1, First Aid, and brings tactical combat casualty care and first aid into one manual. If your study material still cites TC 4-02.1, it is out of date.

IFAK

Individual First Aid Kit

How do you apply a tourniquet during care under fire?

Apply it high and tight on the injured limb, over the uniform, well above the wound. Tighten until the bleeding stops, secure the windlass, and note the time of application. Refine the placement later during tactical field care.

How do you treat a casualty for shock?

Control the bleeding first. Lay the casualty on their back and elevate the legs if there is no injury that prevents it, loosen tight clothing, keep them warm and off the cold ground to prevent hypothermia, reassure them, and do not give food or drink. Evacuate.

How do you treat a suspected heatstroke casualty?

Treat it as a life-threatening emergency. Move the casualty to shade, strip off gear and outer clothing, and start cooling immediately with water, ice sheets, or immersion while fanning. Do not force fluids into an unconscious casualty. Request MEDEVAC and keep cooling while you wait.

How does tourniquet placement change once you reach tactical field care?

Reassess the wound and, if the situation allows, move the tourniquet to roughly two to three inches above the wound and never directly over a joint. Tighten until the bleeding stops and the distal pulse is gone. Write the time of application on the tourniquet and the casualty card. Do not loosen or remove a tourniquet that has been applied.

Name the common cold weather injuries.

Hypothermia, frostbite, immersion foot or trench foot, chilblain, snow blindness, and dehydration. Cold weather does not stop dehydration, and Soldiers routinely underdrink in the cold.

What are the nine lines of a MEDEVAC request?

Line 1, location of the pickup site. Line 2, radio frequency, call sign, and suffix. Line 3, number of patients by precedence. Line 4, special equipment required. Line 5, number of patients by type, litter or ambulatory. Line 6, security of the pickup site. Line 7, method of marking the pickup site. Line 8, patient nationality and status. Line 9, CBRN contamination.

What are the signs and symptoms of shock?

Pale, cool, clammy skin; a rapid and weak pulse; rapid breathing; restlessness or confusion; nausea and thirst; and, as it worsens, loss of consciousness.

What are the three heat injuries, and which one is a medical emergency?

Heat cramps, heat exhaustion, and heatstroke. Heatstroke is the medical emergency. It is a failure of the body to control its own temperature and it can kill quickly.

What are the three phases of tactical combat casualty care?

Care under fire, tactical field care, and tactical evacuation care.

What are your priorities during care under fire?

Return fire and gain fire superiority, keep yourself from becoming a casualty, and get the casualty to cover if it can be done safely. The only medical treatment expected is stopping life-threatening extremity bleeding with a tourniquet. Airway management and detailed assessment wait until tactical field care.

What does the acronym MARCH stand for, and why is it used in that order?

Massive hemorrhage, airway, respiration, circulation, and hypothermia or head injury. The order puts uncontrolled bleeding first because hemorrhage is the leading cause of preventable death on the battlefield.

What is the difference between MEDEVAC and CASEVAC?

MEDEVAC uses a dedicated, marked medical evacuation platform with medical personnel and en route care. CASEVAC moves casualties on a vehicle or aircraft of opportunity with no dedicated medical crew or en route treatment. Use CASEVAC when MEDEVAC is not available and the delay would cost the casualty.

What signs point to nerve agent exposure?

The mnemonic SLUDGEM covers them: salivation, lacrimation or tearing, urination, defecation, gastrointestinal distress, emesis or vomiting, and miosis, which is pinpointing of the pupils. Add muscle twitching, difficulty breathing, and convulsions as exposure worsens.

Which MEDEVAC lines change between wartime and peacetime, and how?

Lines 6 and 9. In wartime, line 6 is the security of the pickup site and line 9 is CBRN contamination. In peacetime, line 6 is the number and type of wound, injury, or illness, and line 9 is a description of the terrain at the pickup site.