Page 10 - PJ MED OPS Handbook 8th Ed Preview

1. Introduction

Foreword

This handbook is designed to form the basis of medical practice during both Rescue Operations
and training mishaps for USAF Pararescuemen (PJs). It can be scaled by selecting pertinent sections
to meet mission requirements. Reference cards can be used in place of the handbook to provide
greater flexibility.
You should have a full set of reference cards, available on the GA Sharepoint, which can also be used
in place of the handbook for quick reference for support of direct action and patrols and should be
kept in the diagnostic kit.
This revised handbook includes an updated brief history of Pararescue Medicine (PJ MED). It is fol-
lowed by an outline of the Principles of PJ MED and the patient assessment checklist. This approach
to patients is slightly modified from traditional primary and secondary surveys to reflect both a
more efficient and a comprehensive approach to combat trauma based on PJ experience and data
from Overseas Contingency Operations.
Selected portions pertinent to Pararescue of the new and edited Tactical Combat Casualty Care
(TCCC) guidelines and the ATP Tactical Medical Emergency Protocols (TMEPS) are included and have
been modified to suit the PJ mission. The goal remains to have all PJs work to a single standard. The
section on prolonged care has been modified and expanded based on PJ experiences in Horn of
Africa (HOA) and on civil SAR Guard missions at sea and in Alaska.
The TCCC Guidelines are posted on the GA Sharepoint and the JTS sponsored Deployed Medicine
app/website deployedmedicine.com. The ATP-P Handbook USSOCOM tactical and emergency pro-
tocols are also available in print and digital form from the Journal of Special Operations Medicine
website at www.jsomonline.org.
A portion of the blood protocol is included from SOCOM, which covers general principles. The unit
flight surgeon has the step-by-step power point to practice field transfusions. The use of blood and
blood products at a particular location should conform to local blood bank protocols and be admin-
istered with medical control oversight. Details on the use of Warm Fresh Whole Blood are included
in the ATP-P Handbook on the GA Sharepoint. The step-by-step process is also on a checklist in each
kit. This procedure should be practiced at least three times before deployment to ensure proficiency.
These are followed by the focused PJ medication list with dosages and indications. These drugs are
in the ATP Drug Formulary and are listed in more detail there. PJs carry the fewest medications pos-
sible to be efficient for tactical and weight purposes.
All of the information is derived from a variety of references including expert consultation from
military and civilian medical and surgical specialists, the AF Trauma Service, SOCOM and wilderness
medical subject matter experts, the Committee for TCCC, or from the cadre of board certified emer-
gency medicine and anesthesiology Pararescue Flight Surgeons.
It is your duty to read this handbook cover to cover and be aware of all the protocols to use.
Stay safe, be smart, be prepared, and train like you fight. Practice perfect, play perfect.
Always reflect your professionalism and leadership by adhering to a strong work ethic, positive atti-
tude, open mind, and commitment to excellence.

8 n Pararescue Medical Operations Handbook / 8th Edition