During TCCC, what should be closely observed to assess circulation effectively?

Monitoring pulse and capillary refill time is crucial for assessing circulation in a casualty during Tactical Combat Casualty Care (TCCC). The pulse provides information about heart rate and rhythm, which are indicators of cardiovascular status. A weak or absent pulse can suggest decreased blood volume or cardiac output, which are critical signs of shock.

Capillary refill time is another vital assessment tool; it reflects peripheral perfusion and can indicate the adequacy of blood circulation. In a well-perfused individual, capillary refill should occur within two seconds. Prolonged capillary refill can indicate poor circulation and potential shock.

Together, these two assessments offer a more comprehensive understanding of the patient's circulation status compared to blood pressure alone, which can sometimes be misleading, especially in cases of severe trauma or shock. While skin pallor and respiratory effort provide important information about overall condition, they do not specifically assess circulation as effectively as pulse and capillary refill time do.