Page 30 - PJ MED OPS Handbook 8th Ed

5. Prolonged Field Care

1. The dynamic nature of Pararescue missions, and remote/austere environments in which they
occur, may require medical care lasting hours to days before evacuation can be achieved. Identify
the potential for prolonged care during mission planning in order to prepare increased amounts
of medical and Operator’s personal supplies (e.g., carried on vehicles, bundled, etc.) and/or re-
supply bundles.
2. Prolonged Field Care (PFC) is presumed to exist when evacuation cannot be performed within
the 4-hour time frame doctrinally dictated for urgent and priority patients, but also is a con-
cept requiring medications and equipment beyond initial care. It may occur in place or during
TACEVAC.
3. Prolonged care is characterized by:
a. Preparing and packing specific types and amounts of gear, medication, food, water source,
and personal care items
b. Establishing work-rest cycles
c. Cleaning the patient and the environment
d. Setting up the room or work space
e. Incorporating lifesaving interventions and ICU-like care with routine supportive care
f. Regular reassessment and monitoring
g. Focused interventions
h. Patient comfort, hygiene and nursing care skills
i. Meticulous documentation
j. Telecon
k. Plan and prep for exfil
4. General concepts with use of acronyms:
a. Use MARCH for patients who are unstable and for initial tactical field care.
b. Use MARCH PAWS to maintain acute care and tactical field care. Complete it fully at least
once prior to transitioning to HITMAN (see below).
c. Transition to HITMAN (prolonged care) after roughly 4 hours, integrate MARCH as needed
for unstable patients.
5. Maintaining a clean room and keeping the patient clean and comfortable are a priority. These
actions reduce risk of infection and pain med requirements, while improving morale.
6. NATO and the US SOF community have adopted the term Prolonged Field Care (PFC). Prolonged
care, or extended care, has a connotation for Pararescue to include the environments and flight
other than the “field”.

28 n Pararescue Medical Operations Handbook / 8th Edition