Page 12 - PJ MED OPS Handbook 8th Ed Preview

1991: First edition of PJ Handbook created by Docs Neace, Bagian, and Allen.

1994, September: USAF Pararescue School began requiring all students to be nationally certified as
EMT-Paramedic to graduate. This allowed PJs to do ambulance ride-alongs.

1996: TCCC introduced to Navy SEALs, Army Rangers, Army Special Missions Unit, and USAF Parares-
cue. Created by CAPT Frank Butler (Naval Special Warfare) and others.

1999: TCCC-based First Responder Course mandated for all in the 75th Ranger Regiment and in-
cluded documentation through TCCC Cards and AARs to validate, refine, and improve performance.
This would prove to be the foundation for modern casualty care.

2001: The Committee on TCCC is established to review and update guidelines. Pararescue has had a
continuous presence since its founding.

2002: PJs began in-house training on delivery of blood products to patients/survivors in combat and
establish alert protocols with deployed blood banks should blood be needed on a mission.

2007: HH-60s/GA begin flying CASEVAC in lieu of DUSTOFF when weather conditions prohibit the
latter from Bagram. TCCC mandated for all deploying SOF Personnel by Commander, USSOCOM.

2009: Fragmentation Order formalizing USAF HH-60s/GA role to fly CASEVAC in OEF in addition to
PR role. C-130 “FEVER” missions fly to transport patients including post-op critical patients on ven-
tilators and drips. Humeral head IOs increasingly used over sternal IOs. Ketamine increasingly used
by PJs based on the British MERT (Medical Emergency Response Teams) use of this drug.

2010, December: PJs become the first non-physician DoD asset to routinely fly with and administer
blood products as far forward as the POI.

2011: Tranexamic acid (TXA) is adopted for use in hemorrhagic shock.

2011: TCCC is validated when COL Russ Kotwal (US Army) shows a significant reduction in potentially
preventable deaths amongst the Rangers versus conventional forces after analyzing mortality met-
rics from TCCC cards and TCCC AARs collected from 2001 to 2010.
2011: Rapid Sequence Induction used more often; video laryngoscopy introduced.

2012: Ketamine approved for traumatic pain relief by the Defense Health Board for all military ser-
vices based on PJ experience.

2012: Formal Canine casualty care training increasingly provided.

2012: Development of PJ-driven operationally focused Paramedic recertification courses begins.

2013. PJs perform the first field whole blood transfusion during a transload of a security team mem-
ber in hemorrhagic shock from a GSW in a remote theater of operations.

10 n Pararescue Medical Operations Handbook / 8th Edition