Friday, 30 November 2012

Tactical Rescue

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
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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.

Unconscious and 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.

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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 these skills?

Take care out there.

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