Page 32 - JSOM Winter 2022

of instruction, ensuring instructors are qualified to conduct train nonmedics in advanced lifesaving procedures and to as-
training, and tracking and reporting individual and unit train- sist medics with more complex medical procedures. The ARFR
ing status in conjunction with unit medical readiness. must maintain proficiency in their medical skill set. The ARFR
provides advanced care at or near the point of injury either
The RFR course includes nine training objectives: (1) demon- under direction of a medic or medical provider, or as a sole re-
strate appropriate casualty assessments and treatments using sponder. Ideally, units should certify and maintain a minimum
principles of TCCC and MARCH-E algorithm, (2) demonstrate of one ARFR per squad in a rifle platoon. However, the focus
knowledge of all TCCC phases of treatment, (3) demonstrate should not be on the quantity but the quality of ARFRs.
and communicate knowledge of roles and responsibilities
during a mass casualty (MASCAL) event, (4) demonstrate abil- The regimental medical section is the proponent office for
ity to communicate effectively with key leaders and medical ARFR training and will provide approval and oversight of
personnel, (5) demonstrate and communicate ability to pre- training scheduled to ensure course integrity across the Reg-
vent, identify and treat environmental injuries, (6) demonstrate iment. Battalion medical sections are responsible for the plan-
understanding of roles and responsibilities of Ranger leaders ning and execution of the ARFR course. Battalion medical
and medical personnel, (7) successful completion of hands-on sections will facilitate this training with resources, personnel,
patient assessments and written exam, (8) successful comple- and expertise to ensure quality and standardization of training.
tion of a casualty collection point (CCP) exercise in support of
a MASCAL event, and (9) successful identification and treat- Company senior medics are the primary instructors for the
ment of environmental injuries. ARFR course. The instructor and medical provider (physician,
physician assistant) requirements for ARFR are the same as
Training follows the RFR course curriculum validated by the those listed above for the RFR course. The planning and sup-
Regimental medical section (Table 1). The total academic RFR port for ARFR require continual communication and coordi-
training time requirement is 27.5 hours (9 hours didactic time, nation between the Regimental medical section and battalion
18.5 hours practical time) over 15 blocks of instruction. Train- medical sections to include development and adherence to
ing must also meet RFR CTL objectives, hands-on training training preparation milestones. ARFR student selections are
requirements, and testing of skills proficiency (Table 2). The based on aptitude, exceeding RFR standards, general technical
student to instructor ratio should be no greater than 9:1, and score on the US Armed Services Vocational Aptitude Battery
training should occur annually. test, and a minimum of one year of retainability in the organi-
zation with intent to reenlist.
RFR instructors are required to be current and certified as
Advanced Tactical Paramedics (ATPs) in accordance with The ARFR is a course designed to occur over 10 consecutive
medical training requirements outlined in US Special Opera- working days. The course schedule will follow the MARCH-E
tions Command Directive 350-29, Special Operations Forces algorithm and the RFR format with education content ex-
(SOF) Baseline Interoperable Medical Training Standards, and tending into ARFR subjects. Hands-on training will utilize a
US Army Special Operations Command Regulation 350-1, crawl-walk-run methodology using simulators including task
Appendix G, Medical Sustainment Training. Medical provid- trainers, moulage, and human patient simulators. All platoon
ers (physicians, physician assistants) are not required to meet medics will participate in ARFR training as a student alongside
ATP certification requirements. However, they must know the their platoon ARFRs in order to establish confidence in one
material and complete an RFR course before they are able to another and to better integrate as a casualty response team.
validate instructors. Instructors are required to review course
materials and have their program of instruction validated by a Training follows ARFR course curriculum validated by the
company senior medic prior to conducting RFR course train- Regimental medical section (Table 3). The total academic
ing. A medical provider will validate all classes given by any ARFR training time requirement is 70 hours (22 hours didac-
first-time instructors. Instructors must have successfully com- tic time, 48 hours practical time) over 14 blocks of instruction.
pleted RMAV as well as completed an in-person brief to the Training must also meet RFR CTL objectives, hands-on train-
battalion physician, physician assistant, or senior medic prior ing requirements, and testing of skills proficiency (Table 4).
to class instruction. The only authorized classes for the course The student to instructor ratio should be no greater than 6:1,
are those provided by the Regimental medical section. Addi- and training should occur annually.
tional training is authorized; however, the mandated classes
must be completed in their entirety. ARFR is conducted using the current regiment-approved pro-
gram of instruction. Each student must successfully complete
The battalion medical section will issue a certificate of com- all hands-on graded skills and achieve 80% on a final cognitive
pletion to those who successfully complete the course. A copy examination. One-time retraining and retesting may be admin-
of these certificates will be maintained by the battalion medi- istered to a student who fails the cognitive exam. Once certi-
cal operations officer who centrally manages RFR training re- fied, an ARFR receives written counseling defining their skill
cords. As RFR training is an integral part of medical readiness, set both with and without medical supervision. ARFR person-
the completion rates will be briefed in conjunction with all nel maintain a standardized medical kit for all missions in ad-
medical readiness statistics. dition to their normal Ranger equipment (Table 5). A training
record for each ARFR at battalion level includes their training
completions, skills sustainment, and counseling records.
Advanced Ranger First Responder
The ARFR course is another vital component of the Ranger Ranger Medic Assessment and Validation
casualty response system. ARFR bridges the gap between RFRs Ranger medics are expected to remain tactically and tech-
and Ranger medics. The purpose of the ARFR course is to nically proficient. The RMAV is a dynamic and challenging

30 | JSOM Volume 22, Edition 4 / Winter 2022