Chapter 1
Introduction

• Foreword
• PJ Medical History

Chapter 2
Medical Command and Control (MC2)

• Special Considerations

Chapter 3
PJ Patient Assessment and Treatment

• Establish Situational Awareness
• Primary Assessment and Treatments
• Secondary Assessment
• Documentation and Verbal Report
• Phase of Care Notes

Chapter 4
PJ Medical and Trauma Protocols (MTPs)

• Combat Shock Protocol (Hemorrhagic Shock)
• Severe TBI
• Mild TBI
• Basilar Skull Fracture (Skull base fracture)
• Oro-pharyngeal hemorrhage
• Thoracic trauma
• Acute Abdomen
• Burns - 9, 10, 20, 30 Principle
• Penetrating Eye Trauma
• Abdominal Evisceration
• Flail Chest
• Extremity Trauma
• Shock: Non-hemorrhagic
• High Altitude Pulmonary Edema
• High Altitude Cerebral Edema
• Acute Mountain Sickness
• Frostbite
• Hypothermia
• Hyperthermia

Chapter 5
Prolonged Field Care

• Detailed Aspects of Reassessments and Treatment
• PFC Sedation Loadout
• PFC Teleconsultation

Chapter 6
Surgical and Medical Procedures

• Procedural Sedation
• Airway
• Breathing
• Circulation
• Burn Management
• Field Amputation for Extraction/Extrication
• Fracture Hematoma Block
• Lateral Canthotomy
• Nasogastric Tube
• Urethral Catheterization (Foley)
• Suprapubic Needle Cystotomy
• Wound Care

Chapter 7
Blood Administration and Protocol

• Overview
• Transfusions – General Information
• Reactions
• Indications for a Blood Transfusion

Chapter 8
Tactical Medical and Environmental Emergency Protocols (TMEPs)

• Abdominal Pain
• Altered Mental Status
• Altitude Illness
• Anaphylactic Reaction
• Asthma (Reactive Airway Disease)
• Back Pain
• Barotrauma
• Behavioral Changes (Psychosis, Depression, and Suicidal Impulses)
• Blast Injuries
• Bronchitis/Pneumonia
• Cellulitis/Cutaneous Abscess
• Chest Pain
• Cold Injury
• Crush Syndrome Protocol
• Deep Venous Thrombosis (DVT)
• Dehydration
• Dental Pain
• Determination of Death / Discontinuing Resuscitation
• Envenomation
• Epistaxis
• Flank Pain (Includes Renal Colic, Pyelonephritis, Kidney Stones)
• Gastroenteritis
• Headache
• Head and Neck Infection (Includes Epiglottitis and Peritonsillar Abscess)
• Heat Illness
• HIV Post Exposure Prophylaxis (PEP)
• K-9 Evaluation and Treatment
• Lightning Injury
• Loss of Consciousness (Without Seizures)
• Malaria
• Meningitis
• Nausea and Vomiting
• Pain Management
• Pneumothorax – Acute (Atraumatic)
• Rhabdomyolysis Protocol
• Seizure
• Sepsis / Septic Shock
• Smoke Inhalation
• Subungual Hematoma
• Testicular Pain

Chapter 9
Pararescue Drug Formulary

• Drug Formulary Guidelines and Considerations:
• Acetaminophen – PO (Tylenol®), IV (Ofirmev®)
• Acetazolamide (Diamox)
• Adenosine (Adenocard)
• Albuterol Inhaler (Ventolin®, Proventil®)
• Amoxicillin/Clavulanic Acid (Augmentin®)
• Aspirin (ASA)
• Atovaquone 250mg/Proguanil 100mg (Malarone®)
• Atropine Sulfate
• Azirthromycin (Zithromax®, Z-Pak®)
• Calcium Gluconate
• Ciprofloxacin (Cipro®)
• Dexamethasone (Decadron®)
• Diphenhydramine HCl (Benadryl®)
• Doxycycline (Doxy®)
• Epinephrine
• Ertapenem IV (Invanz®)
• Famotidine (Pepcid)
• Fentanyl
• Gatifloxacin 0.3% Ophthalmic Liquid (Zymar)
• Glucose (Glutose®) or an energy gel
• % Hydrocortisone Cream (Cortaid®).
• Hydromorphone (Dilaudid®)
• Ibuprofen (Motrin®)
• Ketamine (Ketalar®)
• Ketorolac (Toradol®)
• Levetiracetam (Keppra®)
• Lidocaine HCl (Xylocaine®)
• Loperamide HCl (Imodium®)
• Meclizine (Verticalm)
• Meloxicam (Mobic®)
• Metronidazole (Flagyl®)
• Midazolam (Versed®)
• Morphine Sulfate (Opioid)
• Moxifloxacin (Avelox®)
• Mupirocin Ointment 2% (Bactroban®), other antibiotic ointment
• Naloxone HCl (Narcan®)
• Nifedipine (Procardia®)
• Nitroglycerin
• Ondansetron (Zofran®)
• Oxymetazline HCl (Afrin® Nasal Spray)
• Pseudoephedrine (Sudafed®)
• Rocuronium (Zemuron)
• Sodium Bicarbonate
• 23.4% Sodium Chloride
• Succinylcholine Chloride (Anectine)
• Tetracaine 0.5% Drops
• Tranexamic Acid (Cyklokapron®) – TXA
• Vecuronium Bromide (Norcuron)

Chapter 10
Pediatric Care and OB-GYN

• Pediatrics
• Obstetrics Trauma

Chapter 11
Palliative Care

Chapter 12
Recovery Operations

• General
• Aircraft Crash Response
• Critical Incident Stress Debrief

Chapter 13
Packaging and Splinting

• Packaging
• Splinting and Orthopedic Issues
• Sprained Ankle
• Shoulder Dislocations

Chapter 14
Triage and Mass Casualty Management

• Triage Categories
• Civil SAR CCP Set-up
• CCP for Combat Operations

Chapter 15
Flight Operations

• AE Concerns, Flight Stressors
• Fixed Wing Operations

Chapter 16
Diving Emergencies

• Guidelines and Considerations
• Open Circuit Diving Emergencies
• Barotrauma
• Closed Circuit Diving Emergencies

Chapter 17
Aerospace Accident and Injuries

• Pilot Ejection Injuries
• Parachute Injuries
• Rotary Wing Injuries
• The Space Mission

Chapter 18
Weapons of Mass Destruction (WMD)

Chapter 19
Pararescue Neurological Exam

• Components and Format
• Performing the Exam
• Dermatomes Quick Reference Chart
• Military Acute Concussion Evaluation

Chapter 20
Eye Injuries

• Laser Injuries
• Amsler Grid

Chapter 21
Tropical Disease Reference Guide

Chapter 22
Documentation

• PJ Treatment Card
• Canine Tactical Combat Casualty Care Card (TCCC)
• PJ Prolonged Field Care Nursing Chart
• Joint Trauma System TACEVAC PCR and POI AAR

Chapter 23
Mnemonics, Conversion Charts and Cheat Sheets

• Mnemonics
• Airway and Critical Care References
• IV Drip Rate Chart
• Conversions
• GCS and APGAR Score
• Shock Table
• 9-Line MEDEVAC Request
• Medications Cheat Sheets – Attach to Monitor

Appendix 1
TCCC Protocols

• Principles of Combat Casualty Care
• Basic Management Plan for Care Under Fire/Threat
• Basic Management Plan for Tactical Field Care
• Basic Management Plan for Tactical Evacuation Care (TACEVAC)

Appendix 2
Emergency Cardiovascular Care

• Adult BLS/CPR
• Adult ACLS Cardiac Arrest
• Adult ACLS Cardiac Arrest (Circular)
• Adult ACLS Post Cardiac Arrest Care
• Adult ACLS Bradycardia
• Adult ACLS Tachycardia
• PALS BLS Single Rescuer
• PALS BLS 2 Rescuers
• PALS Cardiac Arrest
• PALS Tachycardia
• Stroke

Appendix 3
Pararescue Medical Skills Certification

• Medical Skills Certification Scoring/Grading Guide

Bibliography