I’ve recently returned from Peru with the non-profit foundation, Team 5. Team 5 Foundation is comprised of Special Operations medical practitioners, survival experts and civilian ultra-athletes. The five person team ventures to the most extreme, overlooked and remote locations in the world to provide medical assistance. While the primary mission of Team 5 is humanitarian in nature, this trip also included a specific teaching element. For this mission, I was tasked with teaching Tactical Combat Casualty Care (TCCC) to over two dozen Peruvian Special Operations medics from the nation’s Army, Navy, Air Force, and Marine forces. The opportunity provided a unique perspective to both instruct and work alongside the Peruvian military in a single week.

The following is my personal experience and take away from working with Team 5 and Peru’s elite commando medics.


It’s evident from the first five minutes of instruction that the class was highly motivated, yet under equipped. Of the twenty-seven men in attendance, all were highly attentive with notebooks open, two had an Individual First Aid Kit (IFAK) and none had what’s considered an equipped aid-bag, by US medic standards. The first question asked to the class is, “Who has treated a trauma patient in combat?” Half of the class raised a hand in response.

Fully stocked IFAKs provided by North American Rescue were distributed to the students, and a baseline for extremity hemorrhage control is established. The average time to effectively apply a tourniquet to a limb designated as having an arterial bleed is over two and a half minutes. This is a potentially fatal time standard for a femoral bleed.


Knowing more than half of the preventable deaths on the battlefield are a result of extremity hemorrhage, and the lack of equipment for advanced trauma interventions in the field, this task became the primary focus of the course. Secondary focus was the second most common killer on the battlefield, tension pneumothorax (collapsed lung). These two injuries account for roughly eighty percent of preventable deaths on the battlefield.

By the end of the third day of training, the average time to tourniquet placement was just under thirty seconds and the average student time on assessment and treatment of a multi-system trauma was just over four minutes total. This includes tourniquet application, wound dressing, identifying a tension pneumothorax and performing a needle decompression.