Building the Elite Podcast Rima Ziuraitis: Tactical Combat Casualty Care (TCCC) in Ukraine - Ep. 114
Jun 26, 2025
Rima Ziuraitis, a U.S.-born medic in the Armed Forces of Ukraine and tactical medicine instructor, recounts frontline medevac and stabilization work. She discusses tourniquet training, adapting TCCC for drone and extraction threats, counterfeit gear risks, and the harsh realities of long evacuations. Short, vivid scenes highlight resilience, team morale, and practical donation routes.
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Plan For Prolonged Evacuations
- Expect long extraction times and plan for extended casualty care; there's often no 'golden hour' and limited air support.
- Stockpile adaptable substitutes for scarce medications and prepare protocols for delayed evacuation scenarios.
Tourniquet Rules: When And How To Convert
- Teach correct tourniquet use: arms/legs only, high-and-tight in unsafe zones, then perform tourniquet replacement or conversion when safe.
- Train on spotting arterial bleeding signs and on rules for when not to convert (amputation, shock, >2 hours on tourniquet).
Conversion Can Save Limbs If Conditions Allow
- Conversion (packing wound and slowly releasing tourniquet) can save limbs but requires strict conditions and monitoring to avoid crush syndrome.
- Protocols restrict conversion with amputation, shock, poor monitoring, or prolonged tourniquet time (>2 hours).
