Page 20 - 2022 Ranger Medic Handbook

ADVANCED RANGER FIRST RESPONDER (ARFR) – The ARFR medical capability is a nonmedical Ranger trained on
specific first responder medical skills beyond the RFR level, to provide a higher level of trauma response during Ranger
SECTION 1 trauma and emergency care in a tactical or austere setting; they may work independently or in support of a medical pro-
operations. This is the highest level of capability for nonmedical Rangers. The ARFR is expected to provide limited scope
vider. They are proficient at advanced medical procedures and basic medication administration.
PLATOON MEDIC – The Ranger Platoon Medic is the minimum standard for an individual serving as sole medical support
for a Ranger mission. The Ranger Platoon Medic is a Special Operations-Advanced Tactical Paramedic (SO-ATP). The
Ranger Platoon Medic provides advanced emergency medical care for critical and emergent casualties in a tactical setting
with a specific focus on trauma for patient care less than 4 hours duration. These personnel are employed in disaggregated
operations to ensure tactical elements have adequate advanced trauma medical capabilities. The Ranger Platoon Medic
also provides medical support to the platoon outside of tactical operations, is able to treat basic medical conditions inde-
pendently and difficult medical conditions with oversight or medical direction. Ranger Platoon Medics are responsible for
training and validating Ranger First Responders.
COMPANY SENIOR MEDIC – The Company Senior Medic is a Ranger Medic serving in the capacity of Provider-Extender
Primary Medic for a Special Operations maneuver element. The Company Senior Medic is expected to independently man-
age multiple complex traumatic and medical problems on the modern battlefield and in remote or austere conditions. While
deployed, the Company Senior Medic independently delivers a selected level of healthcare normally provided by mid-level
practitioners. The Company Senior Medic is expected to manage and lead the company level casualty collection point (CCP).
The Company Senior Medic is responsible for training and validating Ranger Platoon Medics and Advanced Ranger First
Responders.
BATTALION SENIOR ENLISTED MEDICAL ADVISOR – The Battalion SEMA is a Ranger Medic capable of providing
critical care and advanced resuscitative care to a Ranger maneuver element. He is an integral member of the Ranger
Resuscitation Team who provides far forward critical care for complex trauma and medical patients. The Battalion SEMA
is expected to manage and lead the battalion-level CCP. He also trains, validates, and employs all Ranger Medics and
nonmedic providers.
DAMAGE CONTROL RESUSCITATION TEAM – The Damage Control Resusitation Team provides a team-based ap-
proach capable of providing critical care and advanced procedures during SOF missions. The team is composed of a
medical provider and senior medic. The team can care for two critical care patients simultaneously for up to 6 hours while
providing advanced airway interventions, ventilation, cardiovascular support, and advanced hemorrhage control.
Ranger Medics provide routine garrison care to include assisting unit medical officers with daily sick call. This requires
advanced knowledge in common orthopedic problems, respiratory illnesses, gastrointestinal disorders, dermatological
conditions, and environmental hazard illnesses. Ranger Medics train nonmedical personnel on first responder skills and
preventive medicine. Ranger Medics conduct their scope of practice under the licensure of a medical director and are not
independent healthcare providers. Ranger Medics should always obtain medical director advice and supervision for all
care provided. However, on rare occasions Ranger Medics may be required to operate relatively independently with only
indirect supervision in remote, austere, or clandestine locations. In these cases, it is still extremely rare that a Ranger Medic
will be unable to communicate by radio, phone, or computer.
STANDING ORDERS – Advanced life support interventions, which may be undertaken before contacting online medical
control.
PROTOCOLS – Guidelines for out-of-hospital patient care when a medical director is not locally available. Only the por-
tions of the guidelines that are designated as “standing orders” may be undertaken before contacting an online medical
director.
MEDICAL CONTROL/MEDICAL DIRECTOR/MEDICAL OFFICER – This is a licensed and credentialed medical provider,
physician or physician assistant, who verbally, or in writing, states assumption of responsibility and liability and is available
on-site or can be contacted through established communications. Medical care, procedures, and advanced life-saving
activities will be routed through medical control in order to provide optimal care to all sick or injured Rangers. Medical
Control will always be established, regardless of whether the scenario is a combat mission, a training exercise, or routine
medical care. Note that, ultimately, all medical care is conducted under the licensure of an assigned, attached,
augmenting, or collocated PHYSICIAN.

6 SECTION 1 THE RANGER MEDIC & CASUALTY RESPONSE SYSTEMS