Joint Action Guide

Question 1

phrase for the JAG

Answer 1

stop the killing and stop the dying

Question 2

four primary methods to provide high threat patient care

Answer 2

1. escorted warm-zone care (RTF)
2. protected corridor
3. protected island
4. law enforcement rescue

Question 3

escorted warm zone care / rescue task force

Answer 3

• RTF = fire/EMS + PD (min of 2; preferred 4)
  — goal: rapid patient treatment (within a warm zone); may transition to extract patients
  — team will be identified by number (example: RTF1; RTF2…)
  — developed from the Unified Forward Deployment Area
  — may require ballistic gear for all responders
  — highest risk / highest lvl of coordination

Question 4

Protected Corridor

Answer 4

• pathway secured by PD (clears then remains posted)
• Fire/EMS does not require an escort
• may/may not require ballistic gear
• requires more PD
  — considered a longer time interval to pt care

Question 5

Protected Island

Answer 5

• PD established CCP within structure/area of ops
• PD conducts rescue ops to move pts from unprotected areas
• Fire/EMS ops within CCP
  — pts moved out of CCP through a protected corridor or PD escorted extraction
• may not require ballistic protection for fire/EMS
• potential delay in care (PD must secure area/estb CCP/interventions may not be performed prior to moving to CCP)

Question 6

Law Enforcement Rescue

Answer 6

• PD primary mission is to eliminate threat (could pull PD from this)
• PD may remove pts when resources/circumstances are not available
• PD may initiate TECC care
• additional PD needed for ops
• potential delay in PT care

Question 7

Extraction Team

Answer 7

• groups of inds (assigned to remove pts rapidly ideally to the ambos)
  — min 3 individuals and one must be PD
  — PD provides protection
• identified by number (Extraction 1; Extraction 2 … )
• deployed from the Unified Forward Deployment Area ASAP (following RTF)
• consider bringing TECC bags/pt carrying equipment
• may need ballistic gear
• need to be easily identifiable

Question 8

Casualty Collection Point (CCP)

Answer 8

• area estb to provide tx/triage while waiting evac
• can be estb in warm zone
• goal: rapidly treat / transport wounded

Question 9

Considerations for CCP Location

Answer 9

• proximity to evac assets
• pt and provider flow
• ability to search patients for IED/weapons
• ensure proper/adequate personnel are available
• ensure adequate medical and evacuation supplies are readily available

Question 10

Evacuation

Answer 10

• systematic removal of non-injured under PD direction

Question 11

Patient Marking by RTF within warm zone

Answer 11

Dead = Black and white striped ribbon

Critically Injured / priority for extraction = orange and white striped ribbon

Question 12

Tactical Emergency Casualty Care (TECC)

Answer 12

• set of best practice treatment guidelines for trauma care in the high-threat prehospital environment
• goals:
  — estb medical care framework that balances threat/civilian scope of practice/differences in civilian population/medical equipment limits/variable resources for all atypical ER and mass casualties
  — provide for aggressive forward deployment and principles for point of wounding mgmt of trauma in high-threat and mass casualty environments
  — provide care guidelines that account for ongoing threat and ops to min provider risk while max pt benefit
  — identify and tx those casualties with preventable causes of death and keep them alive long enough to reach the ED