Casualty Collection Point
A pre-designated location, behind cover and away from active threat, where casualties are gathered for systematic medical assessment, treatment, and preparation for evacuation.
In the Field
A Casualty Collection Point is the difference between organized care and chaos. In a multi-casualty event, you cannot treat patients in the same hallway where they got shot, and you cannot run an evacuation pipeline if your casualties are scattered across a building. The CCP is where the tactical environment lets you actually do medicine. Choosing it well, before the call comes in or in the first minutes of the response, is what separates a coordinated response from a disorganized one. If you do not have a CCP designated by the time you have more than two casualties, you are about to find out the hard way why you needed one.
Common Mistake
Trying to treat casualties at the point of injury during an active or recent threat instead of moving them to a designated CCP where systematic care is possible.
Technical Detail
A Casualty Collection Point (CCP) is a location selected by responding personnel for the gathering, triage, treatment, and evacuation staging of multiple casualties during a tactical or mass casualty event. The CCP concept is a core element of both Tactical Combat Casualty Care (TCCC) and Tactical Emergency Casualty Care (TECC) frameworks, and it is a common reference point in Active Shooter/Hostile Event Response (ASHER) doctrine.
Site selection criteria. CCP location is one of the more consequential tactical decisions in a multi-casualty response. Effective CCPs typically meet several criteria:
Behind cover. The site must be protected from direct fire, blast, and observation from any remaining threat.
Accessible to evacuation transport. The CCP must allow ambulances, transport vehicles, or aeromedical assets to reach it, ideally via a route that does not cross the threat area.
Sufficient space. Multiple casualties, working medical providers, equipment, and movement of personnel in and out require space that a hallway or single room typically does not provide.
Reasonable proximity to casualties. Carrying or dragging casualties to a CCP that is too far away wastes time and energy. The CCP must be close enough to make casualty movement feasible.
Defensible. The site can be controlled and secured by responding law enforcement during the operation.
Communication-supported. Radio, cellular, or other communication is required to coordinate evacuation, request additional resources, and maintain situational awareness.
Identifiable. Responding personnel and arriving evacuation assets must be able to find the CCP. In some operations the CCP is marked with chemlights, signage, or designated personnel.
Functions performed at a CCP. Once casualties arrive at the CCP, the operational tempo shifts from emergency stabilization to systematic care:
Triage. Casualties are sorted by treatment priority using an established system (START, SALT, or local protocol). Triage assigns immediate, delayed, minimal, or expectant categories.
Reassessment of prior interventions. Tourniquets applied during Direct Threat Care or Care Under Fire are evaluated for effectiveness. Conversion to wound packing or pressure dressings occurs where appropriate.
Systematic MARCH-based assessment. Each casualty receives a structured assessment for massive hemorrhage, airway, respiration, circulation, and hypothermia.
Treatment to provider scope. Hemostatic gauze, chest seals, airway adjuncts, and other interventions appropriate to the provider scope are performed.
Hypothermia prevention. CCPs are commonly cold or exposed environments, and hypothermia management is an active priority.
Documentation. Patient identification, interventions performed, time of application, and vital signs are documented for handoff to evacuation teams.
Evacuation staging. Casualties are prepared for transport, including patient packaging, communication with arriving transport, and prioritization of evacuation order based on triage.
Operational variations. Different operational contexts produce different CCP configurations:
Law enforcement tactical operations. CCP is typically established by SWAT medics or the team medical lead in a secured area within or adjacent to the operational target.
Active shooter / ASHER incidents. CCP is established by responding fire and EMS personnel under law enforcement protection, often in a building lobby, parking structure, or other secure location near the threat zone.
Mass casualty events. CCP may be a formally established Casualty Collection Area within a larger Incident Command structure, with separate triage, treatment, and transport zones.
Field force operations. CCPs are pre-planned as part of crowd control or public order operation medical planning, with locations selected based on the deployment area.
Pre-incident planning. Effective CCP designation begins before the incident. ASHER programs (NFPA 3000) and tactical operational planning increasingly include pre-identified CCP locations for known target sites: schools, government buildings, public venues, transit hubs. These pre-identified locations can be activated during a real event with no time lost to site selection.
For procurement officers and program planners, CCP capability is reflected in equipment procurement (mass casualty caches positioned at likely CCP sites, additional litter and movement equipment, weather and shelter capability), training expenditure (multi-agency CCP exercises, medical lead training), and pre-incident planning documents (site-specific CCP designations).
Site selection criteria. CCP location is one of the more consequential tactical decisions in a multi-casualty response. Effective CCPs typically meet several criteria:
Behind cover. The site must be protected from direct fire, blast, and observation from any remaining threat.
Accessible to evacuation transport. The CCP must allow ambulances, transport vehicles, or aeromedical assets to reach it, ideally via a route that does not cross the threat area.
Sufficient space. Multiple casualties, working medical providers, equipment, and movement of personnel in and out require space that a hallway or single room typically does not provide.
Reasonable proximity to casualties. Carrying or dragging casualties to a CCP that is too far away wastes time and energy. The CCP must be close enough to make casualty movement feasible.
Defensible. The site can be controlled and secured by responding law enforcement during the operation.
Communication-supported. Radio, cellular, or other communication is required to coordinate evacuation, request additional resources, and maintain situational awareness.
Identifiable. Responding personnel and arriving evacuation assets must be able to find the CCP. In some operations the CCP is marked with chemlights, signage, or designated personnel.
Functions performed at a CCP. Once casualties arrive at the CCP, the operational tempo shifts from emergency stabilization to systematic care:
Triage. Casualties are sorted by treatment priority using an established system (START, SALT, or local protocol). Triage assigns immediate, delayed, minimal, or expectant categories.
Reassessment of prior interventions. Tourniquets applied during Direct Threat Care or Care Under Fire are evaluated for effectiveness. Conversion to wound packing or pressure dressings occurs where appropriate.
Systematic MARCH-based assessment. Each casualty receives a structured assessment for massive hemorrhage, airway, respiration, circulation, and hypothermia.
Treatment to provider scope. Hemostatic gauze, chest seals, airway adjuncts, and other interventions appropriate to the provider scope are performed.
Hypothermia prevention. CCPs are commonly cold or exposed environments, and hypothermia management is an active priority.
Documentation. Patient identification, interventions performed, time of application, and vital signs are documented for handoff to evacuation teams.
Evacuation staging. Casualties are prepared for transport, including patient packaging, communication with arriving transport, and prioritization of evacuation order based on triage.
Operational variations. Different operational contexts produce different CCP configurations:
Law enforcement tactical operations. CCP is typically established by SWAT medics or the team medical lead in a secured area within or adjacent to the operational target.
Active shooter / ASHER incidents. CCP is established by responding fire and EMS personnel under law enforcement protection, often in a building lobby, parking structure, or other secure location near the threat zone.
Mass casualty events. CCP may be a formally established Casualty Collection Area within a larger Incident Command structure, with separate triage, treatment, and transport zones.
Field force operations. CCPs are pre-planned as part of crowd control or public order operation medical planning, with locations selected based on the deployment area.
Pre-incident planning. Effective CCP designation begins before the incident. ASHER programs (NFPA 3000) and tactical operational planning increasingly include pre-identified CCP locations for known target sites: schools, government buildings, public venues, transit hubs. These pre-identified locations can be activated during a real event with no time lost to site selection.
For procurement officers and program planners, CCP capability is reflected in equipment procurement (mass casualty caches positioned at likely CCP sites, additional litter and movement equipment, weather and shelter capability), training expenditure (multi-agency CCP exercises, medical lead training), and pre-incident planning documents (site-specific CCP designations).