Page 84 - PJ MED OPS Handbook 8th Ed

8. Tactical Medical Emergency Protocols (TMEPs)

The protocols below were selected because they are used in Combat and Civil SAR Missions. They
were originally created by specialists from US Special Operations Command and are clear, concise,
and focused. The term PJ has been used to replace SOCM (Special Operations Combat Medic) and
appropriate modifications have been made for relevancy based on data and expert opinion. Patrol
medicine protocols have been deleted. The entire Advanced Tactical Paramedic Protocols Hand-
book (ATP-P) is available digitally on the Journal of Special Operations Medicine Online website at
https://jsomonline.org via the PJ login or a hardcopy of the handbook can be bought on the
JSOM Online Store at https://www.jsomonline.org/jsomstorefront/index.php. References and a list
of contributors and authors are available in the ATP-P Handbook. Revisions were made to the ATP
protocols specific to Pararescue.
The Protocols outlined in the following pages carry the following assumptions:
• The PJ is in an austere environment where a medical treatment facility or a unit sick call
capability is not available. If a medical treatment facility or a Medic authorized to treat pa-
tients independently is available, then the patient should be seen in those settings rather
than by a PJ.
• Immediate evacuation may not be possible and, even if it is, may still entail significant de-
lays to definitive treatment. The medical problem may worsen significantly if treatment is
delayed.
• The PJ will contact a consulting physician as soon as feasible.
• PJ treatment will be performed under the appropriate Protocol.
• Medication regimens are designed to minimize the number of medications PJs are required
to learn and carry. Medications can have several indications. Refer to the PJ Med list in the
following section.
• Appropriate documentation of diagnosis and treatment rendered in the patient’s medical
record will be accomplished and handed over with the patient to the forward operating base
or MTF.
• Note these Protocols are not designed to allow PJs to conduct Medical/Civic Action ( MEDCAP)
missions independently.
• Evacuation recommendations are based on the appropriate therapy per Protocol being initi-
ated on diagnosis.
• The definitions of Urgent, Priority, and Routine evacuations are based on the recommended
maximum evacuation timelines found in Joint Publication (FM) 4-02.2 of 1, 4, and 24 hours
respectively. The terms immediate, delayed, minimal and expectant, as well as Cat A, B or C
are also used and dependent on the Area of Operations.
• For any infection, limit contact and use universal precautions.

82 n Pararescue Medical Operations Handbook / 8th Edition