Page 23 - 2022 Ranger Medic Handbook

General Guidelines For Protocol Usage
1. Documentation should not delay the treatment of the injured patient. Life-threatening problems detected during the
primary assessment must be treated first.
2. Cardiac arrest due to trauma is not treated with medical cardiac arrest protocols. Trauma patients should be transported SECTION 1
promptly to the previously coordinated medical treatment facility with control of external hemorrhage, blood product
resuscitation, bilateral finger thoracostomies, and other indicated procedures attempted en route. CPR should be a
last resort.
3. In patients who require a saline lock or intravenous fluids, only two attempts at IV access should be attempted in the
field. Intraosseous infusion should be considered for life-threatening emergencies. Patient transport to definitive care
must not be delayed for multiple attempts at IV access or other advanced medical procedures.
4. Medics will verbally repeat all orders received and given prior to their initiation. It is preferable that medical personnel
work as trauma teams whenever practical.
5. Due to the high level of physical fitness of Rangers and Special Operations personnel, there may be a prolonged period
of mental lucidity and apparent stable vital signs despite a severe injury. Always treat the injury at hand and be prepared
under the assumption that the patient’s condition will worsen.
6. It is understood that though oxygen is indicated only for respiratory distress or SpO 2 desaturations. It will be a rare occa-
sion in which oxygen is available during a ground tactical operation. If oxygen is available and indicated, the expectation
is that a Medic will administer it appropriately.
7. Highly trained Ranger Medics have a clear understanding of the circumstances to determine the appropriate level of
protocol usage. During combat operations in an austere environment, a medic will fully utilize the protocols contained
within this handbook and within his scope of practice. In the non deployed training environment within CONUS, a
Ranger Medic is expected to implement the US standards of care and evacuate to an appropriate medical treatment
facility as previously planned. However, whether executing protocols in an austere environment or at a training exercise
on a military installation, the goal of the Ranger Medic is to provide the most up-to-date standard of care.

After Action Reviews (AAR) And
Ranger Prehospital Trauma Registry (PHTR)
In accordance with RTC 350-29, Ranger medical personnel will submit a casualty after action review for any injury/illness
that occurs on a combat target. The timeframe for reporting begins on departing the staging base, through the combat
operation, and ends on return to staging base. SECTION 6
Medical personnel are required to submit the casualty AAR no later than 72 hours post mission. Casualty AARs will also be
completed for injuries that occurred during the mission but are not reported or observed until after returning to the stag-
ing base. All casualty AARs are to be self-critical and lead to medical education. No comments in an AAR will be used in
disciplinary matters against a medic.

2022 RANGER MEDIC HANDBOOK 9