231020-N-KC192-1151 PORTSMOUTH, Va. (Oct. 20, 2023) Lt. Adrian Proumen, a dental officer assigned to the U.S. Navy Military Sealift Command hospital ship USNS Comfort (T-AH 20), inserts an intraosseous vascular access on a simulated patient during a Tactical Combat Casualty Care (TCCC) course on board Naval Support Activity (NSA) Hampton Roads – Portsmouth Annex, Oct. 20, 2023. TCCC, an evidence based course provides life saving techniques and strategies for Department of Defense first responders, is required for U.S. Navy medical forces in order to maintain deployment readiness. (U.S. Navy photo by Mass Communication Specialist 2nd Class Levi Decker)