From Combat to Search and Rescue: The Modern Air Force Pararescue Medical Experience

Abstract

Introduction: This manuscript provides a comprehensive overview of modern Pararescue (PJ) medical experiences and capabilities, focusing on the period from 2012 to 2024. Pararescues, unique within the Department of Defense, are specifically trained for personnel recovery and provide rapid medical response in adverse conditions. Their extensive training pipeline equips them to handle a wide range of medical emergencies as advanced-scope paramedics that are also equipped with a broad scope of rescue skills.

Materials and methods: This retrospective review analyzes data from the Air Combat Command's Lessons Learned Repository, encompassing 197 human PJ-patient encounters spanning from 2012 to 2024. After-action reports and patient care reports available for this time were utilized to generate a patient registry. Relevant data was then collated and utilized for this manuscript.

Results: Key findings include a 12.2% case fatality rate, with 86% of cases involving trauma. Missions occurred within the continental United States, in combat zones overseas, Alaska, and at sea, highlighting the diverse operational environments PJs encounter. Mechanisms of injury varied significantly, including hiking/climbing injuries, plane crashes, gunshot wounds, and improvised explosive devices. Pararescue interventions included tourniquet placement, wound packing, cricothyrotomies, and blood product transfusions. Non-standardized methods of documentation was a noted problem that made depth of patient documentation inconsistent.

Conclusions: Despite the challenges, PJs' unique skill set and rapid response capabilities make them invaluable in both combat and non-combat scenarios. The survival rate for patients alive at PJ contact was 97.2%, underscoring the effectiveness of their training and procedures. However, documentation practices were inconsistent, with limited standardization for patient care documentation. The manuscript emphasizes the need for improved data capture to enhance medical planning and operational effectiveness.