Page 39 - JSOM Winter 2022

assessments in both low and high-visibility settings using stan- board (e.g., other Ranger battalions or Special Operation
dardized grading rubrics. The primary reference for all proce- Forces units).
dural skills is the most current edition of the Ranger Medic
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Handbook. The Ranger medic is expected to complete the Each board member completes an RMAV oral board work-
procedure without prompting. The grader may provide patient sheet on each Ranger medic boarded. Board member questions
status indicators and dialogue based on patient responses to can cover any portion of the RMAV material listed above,
the procedure. Ranger medical operations, the Ranger medic’s previous con-
duct, and individual counseling packet. Focused questions
For synthesis and analysis, knowledge and skills are evaluated should also cover previously identified shortfalls or perfor-
through a pre-scripted scenario in a controlled tactical setting. mance demonstrated in the preceding readiness cycle, written
The complexity of trauma lanes and number of patients to exam, procedural skills, or scenario lanes.
be managed simultaneously is gradually scaled, culminating
in a MASCAL scenario. Performance is evaluated by observer Each Ranger medic will be ranked against their peers based on
controllers using a standardized grading rubric for each sce- performance before and during their board, which is annotated
nario that evaluates the individual’s critical thinking capacity in their formal counseling. Upon completion of each board,
in a chaotic environment. Every medical intervention during the board members deliberate and designate the medic as ful-
trauma lanes is evaluated to ensure performance steps are ly-mission qualified (FMQ), basic-mission qualified (BMQ), or
done correctly and improves patient outcomes (Table 7). non-mission qualified (NMQ) based on performance through-
out the preceding didactic and hands-on training.
TABLE 7 Measure of Effectiveness – Medical Intervention
Every medical intervention during trauma lanes will be evaluated Fully Mission Qualified (FMQ): Nationally Registered Emer-
for effectiveness to ensure performance steps are done correctly and gency Medicine Technician (NREMT)-Basic (minimum),
to improve patient outcomes. current ATP certification, Prehospital Trauma Life Support
Category Measures (PHTLS) Certified, Basic Life Support (BLS) certified, achieved
Placement Correct anatomical placement of intervention. all FMQ Critical Tasks, scored above 90% average RMAV to-
Patency Patency of lines and tubes after intervention. tal task score with no score below 80% on any task, and has
completed at least one complete joint operational readiness
Flow Adequate flow of intervention (e.g. cc/min). training cycle. Ranger medics found to be FMQ are autho-
Vitals Any improvement in vitals of patient (i.e. O sat, rized to perform the full spectrum of Ranger operations which
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blood pressure, pulse). includes deployments with minimal medical supervision.
Timeliness Total elapsed time from assessment to required All Company Senior Medics are required to maintain FMQ
intervention.
Longevity Qualitative measure of duration of intervention status.
(e.g., did the IV come out or did the ET tube
become loose?) Basic Mission Qualified (BMQ): NREMT-Basic (minimum),
current ATP certification, BLS certified, achieved all BMQ
The trauma lane assessment is designed to provide an objec- Critical Tasks, above 80% Average RMAV Total Task Score,
tive assessment of the medic’s ability to execute TCCC, ad- no score below 70% on any task.
vanced medical skills, patient management, and evacuation
preparation under challenging (mentally and physically) and Non-Mission Qualified (NMQ): NREMT not current and
realistic combat conditions. The conditions must be within ATP lapsed greater than 12 months, RMAV exam score less
the constraints of normal Ranger operations to include low- than 70%, or less than 70% on any critical task, also included
light, full-kit, simulated combat surrounding (weapons, fire/ are any violations of medical practice. Ranger medics found to
smoke), supplies limited to what is carried, and use of radio be NMQ will be pulled from their unit in coordination with
communications. Use of pneumatic weapons, smoke, artillery the company commander and first sergeant and will subse-
simulators, and ultimate training munitions is highly encour- quently fall under headquarters company in which they will
aged. As various mobility platforms are used during Ranger receive remedial training until re-validated during either an-
operations, RMAV requires training that addresses mobility other RMAV or an individual validation session. Recommen-
tactics, casualty transportation, and vehicular treatment con- dation of deployment status, medical supervision, removal
siderations. Use of air, ground, and water vehicles for assault of the “W1” additional skill identifier for Special Operations
force simulation are not required but are highly encouraged. combat medic, and/or release for standards from the organiza-
During MASCAL scenarios, battalions are also encouraged to tion will be at the discretion of the battalion physician, physi-
integrate platoon sergeants, first sergeants, and communica- cian assistant, or senior medic.
tion personnel.
The battalion senior medic will formally counsel the Ranger
After completion of hands-on training, Ranger medics pres- medic on his strengths, weaknesses, and future within the 75th
ent before a formal board in which they undergo a battery Ranger Regiment. Counseling will occur upon conclusion of
of questions intended to evaluate medical and tactical knowl- the formal board and the Ranger medic will receive his scope
edge, leadership qualities, composure, and military bearing. of practice for the upcoming deployment. A Ranger medic
This board is the culminating event of RMAV and is composed will not be released from the formal board without signing his
of the battalion medical directors (physician, physician assis- counseling statement, narcotics memorandum, and Ranger O
tant), battalion senior medic, and two company senior medics. low titer (ROLO) blood transfusion program memorandum.
At least one board member will be a Regimental medical sec- The planning and support for RMAV requires continual com-
tion representative. Battalions may also extend an invitation munication and coordination between the Regimental and
to external units to provide individuals to serve on the RMAV battalion medical sections.

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