Page 7 - 2021 Advanced Ranger First Responder Handbook

SCOPE OF PRACTICE
CASUALTY RESPONSE SYSTEM – The Regiment’s solution for managing combat casualties is to recognize that the
problem is solved by the entire unit, not just medics, and that a casualty can occur during any phase of an operation. The
principles of the casualty response system are that the first responder to a casualty can be any Ranger in the unit, that
medical personnel manage casualty care, and that leaders run the mission. When a casualty is incurred, it immediately
becomes a component of the unit’s mission to extract, treat, and evacuate the casualty while still completing the assigned
combat mission as an integrated team. Thus, every member of the unit must maintain first responder medical skills, med-
ics must be highly proficient, and leaders must know how to properly integrate casualty management into any phase of
an operation.
RANGER FIRST RESPONDER (RFR) – A Ranger First Responder is the baseline for all Rangers. This level of training
equips all Rangers with treatment skills as a secondary mission to their primary mission role. The RFR medical capability
provides a TCCC skillset with specific trauma skills. An RFR is always trained and employed in conjunction with a platoon
medic or higher but has the skillset to provide basic medical interventions independent of any trained medical personnel.
This skillset will be trained and verified annually.
ADVANCED RANGER FIRST RESPONDER (ARFR) – The Advanced Ranger First Responder medical capability is a non-
medical Ranger trained on specific first responder medical skills beyond the RFR level, to provide a higher level of trauma
response during Ranger operations. This is the highest level of capability for nonmedical Rangers. The ARFR is expected
to provide limited scope trauma and emergency care in a tactical or austere setting; they may work independently or in
support of a medical provider. They are proficient at advanced medical procedures and basic medication administration.
PLATOON MEDIC – The Ranger Platoon Medic is the minimum standard for an individual serving as sole medical support
for a Ranger mission. The Ranger Platoon Medic is a Special Operations-Advanced Tactical Paramedic (SO-ATP). The
Ranger Platoon Medic provides advanced emergency medical care for critical and emergent casualties in a tactical setting,
with a specific focus on trauma management within < 4 hours of injury. These personnel are employed in disaggregated
operations to ensure tactical elements have adequate advanced trauma medical capabilities. The Ranger Platoon Medic
also provides medical support to the platoon outside of tactical operations, is able to treat basic medical conditions inde-
pendently, and is able to treat difficult medical conditions with oversight or medical direction. Ranger Platoon Medics are
responsible for training and validating RFRs.
STANDING ORDERS – Advanced life support interventions, which may be undertaken before contacting online medical
control.
PROTOCOLS – Guidelines for out-of-hospital patient care. Only the portions of the guidelines designated as “standing
orders” may be undertaken before contacting an online medical director.
MEDICAL CONTROL/MEDICAL DIRECTOR/MEDICAL OFFICER – A licensed and credentialed medical provider, phy-
sician, or physician assistant who verbally or in writing states assumption of responsibility and liability and is available
on-site or can be contacted through established communications. Medical care, procedures, and advanced life saving
activities will be routed through medical control in order to provide optimal care to all sick or injured Rangers. Medical
Control will always be established, regardless of whether the scenario is a combat mission, a training exercise, or routine
medical care. Note that, ultimately, all medical care is conducted under the licensure of an assigned, attached,
augmenting, or collocated PHYSICIAN.