Page 16 - PJ MED OPS Handbook 8th Ed

Trauma Care for Hostile Combatants

PJs may be called upon to render initial care for enemy combatants. Medically speaking, this pres-
ents only a logistical problem because the tenets of trauma care do not change. Tactical, legal and
ethical considerations, however, make this a complex issue. The recommendations presented below
may help medics and their mission commanders formulate their plans for handling wounded enemy
combatants during pre-mission planning.

• Care for wounded Hostile Combatants
○ Though wounded, enemy personnel may still act as hostile combatants.
○ They may employ any weapons or detonate any ordnance they are carrying.
• Care Under Fire
○ Enemy casualties are hostile combatants until they:
n Indicate surrender
n Drop all weapons
n Are proven to no longer pose a threat – complete body search for weapons and ord-
nance, trauma naked if able
n Are removed from reach of weapons
n Are restrained with flex cuffs or other devices
○ No care rendered until:
n TFC phase
n Casualties and scene rendered safe
n Tactical situation permits

• Tactical Field Care Phase Management: Medic should not attempt treatment until sure that
the wounded hostile combatant is rendered safe by other members of unit.
○ Restrain rear as medically and tactically feasible
○ Search for weapons and/or ordnance
○ Silence to prevent communication with other hostile combatants
○ Segregate from other captured hostile combatants
○ Safeguard from further injury. Provide care IAW TFC guidelines for US forces after securing
the enemy casualty as described above
○ Speed to the rear as medically and tactically feasible

Guidelines for Initiation of Resuscitation
Medical treatment and resuscitation of victims should be initiated under all circumstances, with the
following qualifications:
1. Combat (Direct Fire)
• Immediately unresponsive patients with no pulse or respirations, regardless of cause, should
not have resuscitation initiated.
• Unresponsive patients with a pulse but no respirations should have resuscitation initiated if
it can be accomplished in relative safety.

14 n Pararescue Medical Operations Handbook / 8th Edition