The Ranger Medic Handbook 2014-01-08

Historically in warfare, the majority of all combat deaths have occurred prior to a casualty ever receiving advanced trauma management. The execution of the Ranger mission profile in the Global War on Terrorism and our legacy tasks undoubtedly will increase the number of lethal wounds.

Ranger leaders can significantly reduce the number of Rangers who die of wounds sustained in combat by simply targeting optimal medical capability in close proximity to the point of wounding. Survivability of the traumatized Ranger who sustains a wound in combat is in the hands of the first responding Ranger who puts a pressure dressing or tourniquet and controls the bleeding of his fallen comrade. Directing casualty response management and evacuation is a Ranger leader task; ensuring technical medical competence is a Ranger Medic task.

A solid foundation has been built for Ranger leaders and medics to be successful in managing casualties in a combat environment. An integrated team response from non-medical personnel and medical providers must be in place to care for the wounded Ranger. The Ranger First Responder, Squad EMT, Ranger Medic Advanced Tactical Practitioner, and Ranger leaders, in essence all Rangers must unite to provide medical care collectively, as a team, without sacrificing the flow and violence of the battle at hand.

An integrated team approach to casualty response and care will directly translate to the reduction of the died of wounds rate of combat casualties and minimize the turbulence associated with these events in times of crisis. The true success of the Ranger Medical Team will be defined by its ability to complete the mission and greatly reduce preventable combat death. Rangers value honor and reputation more than their lives, and as such will attempt to lay down their own lives in defense of their comrades. The Ranger Medic will do no less.

Table of Contents

SECTION ONE
RMED Mission Statement 11
RMED Charter 12
Review Committees 13
Editorial Consultants & Contributors 14
Key References 15
RMED Scope of Practice 16
RMED Standing Orders & Protocol Guidelines 18
Casualty Assessment & Management 110
Tactical Combat Casualty Care (TCCC) 117
SECTION TWO
Tactical Trauma Assessment Protocol 21
Medical Patient Assessment Protocol 22
Airway Management Protocol 23
Surgical Cricothyroidotomy Procedure 24
KingLT D Supralaryngeal Airway Insertion Procedure 25
Orotracheal Intubation Procedure 26
Hemorrhage Management Procedure 27
Tourniquet Application Procedure 28
Hemostatic Agent Application Protocol 29
Tourniquet Conversion Procedure 210
Thoracic Trauma Management Procedure 211
Needle Chest Decompression Procedure 212
Chest Tube Insertion Procedure 213
Hypovolemic Shock Management Protocol 214
Saline Lock & Intravenous Access Procedure 215
External Jugular Intravenous Cannulation Procedure 216
Sternal Intraosseous Infusion Procedure 217
Hypothermia Prevention & Management Kit Procedure 218
Head Injury Management Protocol 219
Mild Traumatic Brain Injury (Concussion) Management Protocol 220
Seizure Management Protocol 221
Spinal Cord Injury Management Protocol 222
Orthopedic Trauma Management Protocol 223
Burn Management Protocol 224
Foley Catheterization Procedure 225
Pain Management Protocol 226
Anaphylactic Shock Management Protocol 227
75th Ranger Regiment Trauma Management Team (Tactical)
Ranger Medic Handbook
Ranger Medic Handbook 2007 Edition
75th Ranger Regiment, US Army Special Operations Command
Subject Page
SECTION TWO Continued
Hyperthermia (Heat) Management Protocol 228
Hypothermia Prevention & Management Protocol 229
Behavioral Emergency Management Protocol 230
Altitude Medical Emergency Management Protocol 231
Acute (Surgical) Abdomen 233
Acute Dental Pain 233
Acute Musculoskeletal Back Pain 233
Allergic Rhinitis 234
Asthma (Reactive Airway Disease) 234
Bronchitis 234
Cellulitis 235
Chest Pain (Cardiac Origin Suspected) 235
Common Cold 235
Conjunctivitis 236
Constipation 236
Contact Dermatitis 236
Corneal Abrasion & Corneal Ulcer 237
Cough 237
Cutaneous Abscess 237
Deep Venous Thrombosis (DVT) 238
Diarrhea 238
Epiglottitis 238
Epistaxis 239
Fungal Skin Infection 239
Gastroenteritis 239
Gastroesophageal Reflux Disease (GERD) 240
Headache 240
Ingrown Toenail 240
Joint Infection 241
Laceration 241
Malaria 241
Otitis Externa 242
Otitis Media 242
Peritonsillar Abscess 242
Pneumonia 243
Pulmonary Embolus (PE) 243
Renal Colic 243
Sepsis / Septic Shock 244