Page 15 - PJ MED OPS Handbook 8th Ed

Off scene: US Military Physician in direct contact via audio/visual communication
Off-line Medical Control: Contact with a Physician is impossible or impractical. Care is based on
approved protocols and procedures. This is the most common scenario.
Off-line Control situations: The PJ Team Leader is responsible for all care unless delegated to
another PJ.

NOTE: These sources cover the vast majority of care PJs will provide. Instances where devi-
ation may occur more frequently would be in remote situations where certain medications
are not available, and the local medical authority has directed the use of locally available
meds and has provided the adequate in-service education with proper documentation. Also,
certain regions may have diseases and treatments that are endemic and require unique care
that should be added to the protocols in that area of operation.

Special Considerations
In instances where the Medical Control Officer is not the assigned Flight Surgeon, it is important to
review the PJ HB and other applicable protocols with the Medical Control Officer as soon as possible
to ensure authorization to perform to the level of one’s training and protocols.

In instances where a non-Air Force Special Warfare (AFSPECWAR) Surgeon is significantly at odds
with accepted protocols and wants the PJ to provide care materially different, the PJ should work
through his Chain of Command to reach a senior pararescue flight surgeon, the USAF Pararescue
Medical Director, or the HAF/A3SG.

➢ When responding to a civil SAR operation, the PJ will follow local or national (as appropri-
ate) EMS guidelines for care. Therefore, the PJ should become familiar with these proto-
cols in advance. In some instances, things like ketamine or tourniquets are not approved.
Most invasive procedures are not appropriate for civil SAR missions.
➢ If responding to an injured PJ or aircrew for training accidents, etc., practice according to
this HB.

➢ If otherwise responding to an incident in garrison, follow the locally approved protocols,
otherwise this HB.

It is the responsibility of the PJ leadership on each base to establish a relationship with the local
Medical Treatment Facility to ensure understanding and support of PJ treatment protocols. This will
support the supply of appropriate medications and supplies and prevent any confusion of scope of
practice during real world responses on base or elsewhere.

Chapter 2. Medical Command and Control (MC2) n 13