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Friday, 30 November 2012
Consider Tactical Rescue
In Care under Fire Reloaded, Step 5 states
“Consider Tactical Rescue, if realistic and required”. Rather than ‘perform’ or
‘decide’, the word ‘consider’ was carefully chosen. Consider is defined as to
think carefully about, especially in order to make a decision. Whether or not,
to perform a Tactical Rescue (TR) must be weighed against the casualty’s
condition, the ground, risk to the rescue team, tactical assets available, and
the enemies’ own actions. It is a tactical and medical assessment.
Sometimes, the decision will not be in the best interest of the casualty. Risk
to the mission and the team may be too great. There is much to consider.
US PJs performing casualty movement Click on to Enlarge
Should I stay or should I go now
From a medical standpoint, the casualty’s
condition will be a decisive factor on whether or not to perform a Tactical Rescue (TR). The
ability to ‘remote assess’ a casualty, usually through optics is a valuable
skill in the TR decision-making process. There are three casualty types as it
pertains to Tactical Rescue (TR).
Conscious, responsive and ambulatory: this casualty
can move themselves to cover and perform self-aid. If they already haven't crawled to cover and started self-aid, they are probably having a situational
awareness crisis. ‘Medicine across a barrier” may be required; a medic giving
direction to talk the casualty through the steps of their own self aid. The
perfect resolution for this casualty type is to communicate precise
instructions to perform self- rescue while providing accurate suppressive fire.
non-ambulatory: This must be remote assessed, looking for signs of respiration
and external hemorrhage, by optics. Binoculars, monoculars or weapons sight can
be used not only to see farther, but to see close objects better. The tactical
medic must decide, based on remote assessment, whether or not a tactical rescue
(TR) is reasonable medically.
Conscious, responsive but non-ambulatory:
Usually, this is as a result of a lower limb injury. A tactical rescue is
warranted medically in this case. The patient has a high chance for survival.
They should return fire to support the rescue team or stay low profile to avoid
drawing attention and enemy fire. In the cases of a casualty ‘playing possum’,
a simple standard operating procedure (SOP) within an element could be to have
a casualty repeatedly tap their leg or the ground on the friendly side. This
will allow the ‘remote assessor’ know that they are awake and aware but unable
to move. A whistle carried regularly on your person can be used to signal
friendly troops as to your location and condition when in dead ground.
Click on to Enlarge
After the casualty has been assessed and a
decision whether a TR is appropriate, the ground must be assessed. The ground must be COPPED from friendly and
enemy point of view (PoV). COPPED is an acronym for ground assessment at a
tactical level. Other environmental factors to consider are wind direction,
lighting, and collateral population.
These factors affect the use of obscurants, flares and supporting
fires. This will allow the unit
commanders make a proper risk versus benefit assessment. Taking into account
friendly assets and possible enemy action, a choice will be made and a plan
devised. Remember, the tactical decision may not be in the best interest of the
casualty. The planning process and the rescue will be covered in the next
article in this series.
The ability for
the tactical medic and other possible rescuers to remote access a casualty
needs to be practiced regularly.
Scenario play to play-test and hone SOPs is the best opportunity to
practice this skill set. “Medicine
across a barrier” is practiced every time a tactical medic instructs their team
or element. Strong instructional skills and a calm, precise technique are
paramount for success of this skill. So, when is the last time you practiced