FORT KNOX, Ky. -- When Soldiers sustain injuries on the battlefield, the difference between life and death is often measured in seconds not minutes, according to Lt. Col. Matthew Hoefer, division surgeon, 1st Theater Sustainment Command (TSC). Being surrounded by fellow Soldiers who are trained and know how to react to injuries can be the difference between injured Soldiers returning home to their loved ones or not returning home at all. "With a small group of injuries, if they can be addressed within the first 60 seconds of being incurred, it will save a life," Hoefer said. "If they're ignored for more than a few minutes, that person has a high probability of dying." Because of this, U.S. Army Forces Command (FORSCOM) requires all deploying Soldiers to take Tactical Combat Casualty Care (TCCC) -- a course that teaches evidence-based, life-saving techniques and strategies for providing immediate trauma care on the battlefield to address these injuries. As essential as TCCC is, the 1st TSC Surgeon Cell developed a course that goes beyond it and also incorporates elements of the Combat Life Saver Course (CLS), which it calls the Blackjack Life Saver Course. All deploying members of the 1st TSC complete it. "We added in the combat life saver skills into our course to allow people who wouldn't normally get this level of training -- senior NCOs (noncommissioned officers) and senior officers -- to get some familiarization with the training that the more junior Soldiers who carry combat life saver bags are getting," Hoffer said. "It also helps with our readiness at the 1st TSC MCP (main command post) to get more people CLS-qualified." The course focuses on three phases of tactical care, which are care under fire, tactical field care, and tactical evacuation. During it, students learn how to respond to four categories of preventable deaths: a) extremity hemorrhage, loss of blood from injury to a limb or appendage; b) junctional hemorrhage, loss of blood from an injury occurring at the junction of an extremity with the torso such as the base of the neck; c) tension pneumothorax, commonly called "collapsed lung" which occurs after an injury to the lung that causes air or gas to build up in the chest cavity; and d) airway trauma, when a casualty has an obstruction or impending airway obstruction. Hoefer said the most critical skill the course focuses on is how to control and stop blood loss. "The human body has five or six pints of blood. When you donate blood to a blood center, that bag is about 20 percent of your total body's blood," he explained. "With an injury from a major artery, someone can bleed out in three or four minutes." To stop blood loss, students learn the proper use of tourniquets and hemostatic bandages to stop or control blood loss until the casualty can be evacuated to a medical facility. "If you can keep the heart going which requires oxygen, which is carried in the blood, if you can keep the blood in the body, that will keep the heart going and you can maintain all kinds of other injuries," Hoefer said. 1st TSC Soldiers will continue to learn critical life-saving skills before deployment. The 1st TSC Surgeon Cell most recently taught the Blackjack Life Saver Course to Soldiers from the 14th Human Resources Command, 18th Financial Management Support Center, and the Strategic Operations and Plans team, all of whom are scheduled to deploy to southwest Asia in the coming months. The Blackjack Life Saver Course is just one of the many unique ways the 1st TSC, which has had Soldiers, sections, and rotational subordinate units perpetually deployed since 2006, maintains readiness.