Page 4 - 2025 Ranger Medic Handbook

COMMONLY ASKED QUESTIONS
1. TXA may be predrawn into a STERILE 10mL syringe. This should be replaced every 7 days due to bacterial infec-
tion risk.
2. Although the prehospital data is not clear at this time it is likely best practice to administer TXA 2g IV/IO flush as the
initial dose and then do not redose. Ranger Medics are approved to pre-draw 2g TXA and give this as an initial dose.
3. Finger Thoracostomy is a CLEAN procedure. Do not cut into a patient’s chest without cleaning the skin or changing
to clean gloves.
4. Chest Tube is a STERILE procedure. Medics and providers will make every attempt to use sterile gloves, chest
tubes, and peans to decrease our patient’s risk of infection.
5. Backboards are mandated by regulation to carry but have limited proven benefit to spinal patients. Backboards
should be used for patient transfer only. No patient should be on a backboard longer than 10 minutes. A rigid litter
provides the same care without the risks of pressure ulcers.
6. Both Calcium Gluconate and Chloride are approved for use in the Pre-hospital environment. Calcium administration
will be considered after the transfusion of 2 units of blood products and every 4 units after. Calcium should never
be prioritized over Blood and TXA in resuscitation efforts. 1–3g of Calcium will be administered as a slow IV/IO push
over 1–2 minutes or as an infusion in a 100mL or 250mL NaCl bag.
7. Always reassess your patient and treat based on current or trending vital signs.
8. In hemorrhagic shock the priority and focus of the Ranger Medic should be administering blood products; do not
delegate this important task. TXA, calcium, and other adjuncts should not delay blood products.
9. Cold stored blood products will be warmed. In extremis, cold blood is better than no blood, but every attempt must
be made to warm blood. A BLOOD WARMER WILL BE CARRIED.
10. Your medical direction only comes from those within Ranger Regiment. While we appreciate the experts that give
advice and learn from them, they will never dictate your scope of practice. Do not contradict your Ranger medical
leadership by following outside advice.
11. The 75 th Ranger Regiment does not promote commercial products or companies. No Medic will be mandated to
carry a specific product unless a clear, overwhelming, significant advantage can be proven.
12. All fluoroquinolones now have a US Black Box Warning due to serious adverse reactions including tendinitis and
tendon rupture, peripheral neuropathy and CNS effects. In some rare cases benefits may outweigh the risks of
fluoroquinolone use. Fluoroquinolone use requires prior approval from unit physician or physician assistant with the
exception of otic or ophthalmic routes. DO NOT PRESCRIBE OR DISPENSE THESE MEDICATIONS WITHOUT
PRIOR APPROVAL!
13. Medics will carry diagnostics equipment (BP Cuff, Stethoscope, EMMA, Pulse Oximetry) and spare batteries for their
equipment. Medics will be trained on troubleshooting issues with electronics and incorporate patient management
should these items fail.