TCCC Updates
Hey everyone, Doc Miles at North American Rescue. We're going to go over today some of the Committee on Tactical Combat Casualty Care updates that occurred in May of 2026.
So there was several changes in there that a lot of you may have noticed. Remember, go look these up yourself. So, on Deployed Medicine is a free open access resource that has all the current CoTCCC guidelines, and then it'll highlight there what the changes are as well. Also, on the Joint Trauma System, they've got the updates as well.
Another resource that I've found really useful is our friends at SOAR Rescue. They do a really good job breaking down what the updates were and what that means to you in the field.
TCCC vs. TECC
Remember that the Committee on TCCC is focused on military medicine in the pre-hospital space. While you'll see a lot of guidelines in the civilian pre-hospital space that looks similar to it, just keep in mind that's a different environment and a different set of circumstances.
In general, in the pre-hospital civilian side, they're going to follow the Committee on Tactical Emergency Casualty Care, which is a different but similar set of guidelines.
Analgesia Updates
So one of the first things that you'll notice is the analgesia section, and what the Committee on TCCC did is they updated it to include suzetrigine, and that dose is 100 milligrams once, which is going to be two 50 milligram tablets, and that's PO, and you take that every 12 hours.
So the advantage of that is it keeps the dosing at every 12 hours. It's a readily available medication, although it's still brand name, so a little more expensive than some of the other ones on the list, like acetaminophen and meloxicam.
What The Hell Is Suzetrigine?
This is one that I'm not familiar with. It only recently came on the market. It's not something that I've prescribed.
Basically, what this medication is, it was approved by the FDA in 2025. It's a non-opiate for pain management, and really, it's indicated for moderate to severe pain. The way it works is a little bit complicated, but basically just think of it as it blocks peripheral nerve pathways.
So it's not working centrally like an opiate does in the brain, which is why you get that respiratory depression. It's working peripherally to block nerve signals, so that's a big advantage with it. It's been shown to be very safe, very few side effects, really doesn't affect respirations like we talked about, which is our concern on the battlefield, hasn't been shown to have any dependence or abuse potential, so it's safe medication.
So what's the data show on suzetrigine? Well, the data isn't necessarily overwhelming that it's a magic be-all end-all to replace all pain control medications. But most of the studies show it does help to decrease moderate pain. Most of those studies are in post-op patients. So again, it's a different patient set in a different setting.
But the nice thing is it's a non-opiate, it's PO, it's every 12 hours, and it'll likely help reduce some of that pain for your casualty depending on the injury.