Many people know about or have personal experience with first responders, those dedicated and selfless individuals who are among the first to arrive and assist at the scene of an emergency. First responders receive training and typically include paramedics, emergency medical technicians and rescuers. But most people, even those in the military, are unaware of a special type of first responder, the Air Force Special Operations Pararescue (PJ) specialists, who are trained to do all these things, and in a combat environment. These EMT-Paramedic-certified national treasures provide personnel recovery capabilities and life-saving medical treatment as expert combat medical professionals in the world’s most remote areas and hostile environments. Pararescuemen are among the most highly trained tactical rescue and emergency trauma specialists in the U.S. military and the world.
PJs provide emergency and life-saving services for the most dangerous missions the U.S. military performs. They are trained to shoot, move and communicate alongside other special operations forces, while also saving lives with their rescue techniques and medical expertise. Although they most often operate as independent teams, these 500 selfless service members frequently deploy with U.S. Navy SEALS, Army Special Forces and Allied Special Operations Forces. As such, they are the most highly decorated Air Force enlisted force with one Medal of Honor, 12 Air Force Crosses and 105 Silver Stars. As of January 2012, 10 have been killed in action, making the ultimate sacrifice during Operation Enduring Freedom and Operation Iraqi Freedom.
PJs specialize in search and recovery dives, DNA and classified material gathering, swift water rescue, confined space rescue and high-angle rescue. They have such extraordinary and unique capabilities that they have been called upon, according to the Air Force, to rescue more than 5000 civilians worldwide during natural disasters and other responses in addition to executing more than 12,000 lifesaving, combat rescue missions since 9/11.
A Gallant History
According to the U.S. Air Force, pararescue began August 1943 in the China-Burma-India Theater (CBI). During this time, “The Hump” route consisted of cargo flights leaving India carrying vital war supplies, which had to cross the Himalayas to reach China. Thousands of flight crews and their passengers risked their lives daily, working their way to their final destination in C-46 and C-47 aircraft. Many never arrived due to a combination of mechanical problems, weather and human error. As a result, many crews were forced to either bail out or crash land in one of the most inhospitable areas of the world, loosely held by Japanese forces. Those who survived tried to find their way back to civilization, as they endured harsh weather, agonizing treks and little food; those with injuries fared far worse.
Capt. John L. Porter is credited with commanding one of the first organized air rescue missions in the CBI area. According to the Air Force, 21 U.S. military members bailed out of a disabled C-46 August 2, 1943, over an unchartered jungle near the China-Burma border. CBS reporter Eric Sevareid was on board the Curtiss-Wright C-46 Commando and grabbed a bottle of gin before parachuting out of the plane. The crash site was so remote that the only means of getting help to the survivors was by paradrop. Wing flight surgeon Lt. Col. Don Flickinger and two medical corpsmen, Sgt. Richard Passey and Cpl. William MacKenzie, volunteered for the assignment and parachuted from the search plane to assist and care for the injured. For a month these men, aided by natives, cared for the injured until the party was brought to safety. This paradrop of medical corpsmen was the seed from which the concept of pararescue was born. Sevareid said of his rescuers: “Gallant is a precious word; they deserve it.” A few short months later, Capt. Porter was killed on a rescue mission when his B-25 was shot down.
The U.S. Army Air Force recognized the need for a unified search and rescue organization and formed the Air Rescue Service (ARS) in May 1946. The ARS mission was to save the lives of aircrews involved in crash landings, accidents, ditchings and abandonments, as well as aircraft disasters. This was to occur only away from an air base and included worldwide deployment ability in order to respond globally to any operational need.
North Korea’s 1950 attack across the 38th parallel, which began the Korean War, provided a unique opportunity for PJ teams to put practice into practical application, develop theories and institute policies. Two new key concepts included rescuing stranded military personnel from behind enemy lines and evacuating the critically wounded close to front lines. In addition, PJs were beginning to leave the helicopters that carried them to their search and rescue missions, which often involved extended stays behind enemy lines, the longest of which lasted 72 hours during this historical time period.
During the Vietnam War, demand for PJs expanded tremendously due to the Air Force’s scope of operations. Increased use of helicopters allowed for new tactics involving speed, distance and support. To support this, rescue “packages” were created using forward air controllers, rescue escorts and protective combat air patrols. PJs were a critical component of these packages since they not only provided medical assistance for injured crews but also patrolled for missing service members – alive, unconscious or dead.
Some of the Toughest Training in the Military
PJ training and education is exhaustive, and includes some of the toughest in the military. Insiders call it “Superman School” because it is almost two years long, making it one of the world’s longest special ops training courses. It also has one of the highest attrition rates, about 80 percent. According to the Air Force, PJ training includes the following:
Indoctrination Course, Lackland Air Force Base (AFB), Texas – This 9-week course recruits, selects and trains future PJs through extensive physical conditioning. Training includes physiological, obstacle course, marches, dive physics and tables, medical terminology, cardiopulmonary resuscitation, weapons qualifications, PJ history and leadership reaction.
Paramedic Course, Kirtland AFB, N.M. – This 22-week course teaches how to manage trauma patients prior to evacuation and how to provide emergency medical treatment. Upon graduation, an EMT-Paramedic certification is awarded through the National Registry.
U.S Army Airborne School, Fort Benning, Ga. – This 3-week course teaches trainees basic parachuting skills required to infiltrate an object area by static line airdrop.
Pararescue Recovery Specialist Course, Kirtland AFB, N.M. – This 24-week training includes field medical care and extrication basics, field tactics, mountaineering, combat tactics, advanced parachuting and helicopter insertion/extraction.
U.S Air Force Combat Diver School, Panama City, Fla. – This 6-week course teaches trainees how to become combat divers to depths of 130 feet. They learn to use scuba and closed-circuit diving equipment to covertly infiltrate denied areas, conduct sub-surface searches and basic recovery operations.
U.S. Navy Underwater Egress Training, Pensacola Naval Air Station, Fla. – This one-day instruction teaches how to safely escape from an aircraft that has ditched in the water and includes principles, procedures and techniques necessary to get out of a sinking aircraft.
U.S. Air Force Basic Survival School, Fairchild AFB, Wash. – This 2.5-week course teaches basic survival techniques for remote areas, including principles, procedures, equipment and techniques that enable survival, regardless of climatic conditions or unfriendly environments.
U.S. Army Military Free Fall Parachutist School, Fort Bragg, N.C., and Yuma Proving Grounds, Ariz. – This 5-week course provides training in free fall parachuting procedures and includes wind tunnel training, in-air instruction focusing on student stability, aerial maneuvers, air sense and parachute opening procedures.
Special Tactics Training Squadron, Hurlburt Field, Fla. – During this specialized course for PJs going through initial training to special operations, Airmen receive five-level training, including infiltration, exfiltration methods and additional combat training.
State-of-the-Art Medical Technology
In addition to the best training in the world, PJs use technologically advanced medical equipment to save lives. One of these advances is BATDOK, Battlefield Assisted Trauma Distributed Observation Kit, which uses an advanced electronic patient monitoring tool that assists with providing life-saving care in any environment. It provides the ability to monitor key vital signs of multiple patients simultaneously in a remote locale. BATDOK combines a custom Android app with any FDA-approved wireless monitoring sensor. The app can run on a tablet, smartphone or the small pulse oximeter computer that PJs already carry. Essentially, BATDOK works like this: The medic places small sensors on the chest, arms and fingers of the injured person. Once the vital sensor is placed on the patient, the medic hits a connect button on the device, which begins wirelessly feeding vital signs to a tablet or smartphone mounted to the medic’s chest or wrist.
BATDOK appears as a dashboard that shows every patient and their key vitals, including heart rate, blood oxygen, blood pressure and time passed since the medic checked on the patient. He can quickly reference the display and make decisions based on his own medical training and techniques, tactics and procedures. In the event a patient’s vital signs show distress, the medic receives a vibration, visual or audible alert and can divert his attention to the patient, as needed, to provide immediate emergency care. In addition to receiving data from wireless sensors, BATDOK also can send data to forward hospitals or other medical units via a PJ’s secure tactical data network radio.
BATDOK is a force-multiplier for Air Force pararescuemen, who, as combat medics, might parachute, scuba dive, rock climb or even snowmobile into hostile territory to save lives. Thus, as part of development testing in 2015, researchers left the lab and travelled to the field to observe pararescuemen and BATDOK in action. According to Gregory Burnett, PhD, Airman Systems Directorate, Warfighter Interface Division, 711th Human Performance Wing, who served as the lead to manage development of BATDOK for the Air Force, researchers went into the field with the operators and observed firsthand the challenges and deficiencies pararescuemen face.
Burnett says they “literally rode in the helicopters into hot landing zones and observed medical Airmen stabilize and package up patients for transport and load them back on the helicopters.” Being at the point of injury more easily allowed the Air Force Research Lab (AFRL) researchers to understand the challenges and limitations faced by the operators. With lessons learned and gaps identified through direct experience, Burnett says he and his team came back to AFRL to “devise innovative solutions to address the short falls we observed firsthand in the field.”
This on-going, dual researcher-operator integration continued long after the research team returned to their lab. They interacted with the operators continuously from their deployment – obtaining feedback throughout the process – in order to bring first-hand knowledge to the development process. This allowed them to walk through the mission step-by-step to indentify gaps and areas of improvement, and then share ideas to innovate new solutions and capabilities. Thus, every interface, button and menu was user-validated by PJs and combat rescue officers involved in the design, integration and testing process, a critical component making BATDOK a tool that seamlessly integrates mobile medical capabilities in the field.
These Things We Do, That Others May Live
“It is my duty as a Pararescueman to save life and to aid the injured. I will be prepared at all times to perform my assigned duties quickly and efficiently, placing these duties before personal desires and comforts. These things we (I) do, that others may live.”
PJs are the only Department of Defense elite combat force specifically organized, trained, equipped and postured to conduct full spectrum Personnel Recovery (PR), to include both conventional and unconventional combat rescue operations. As such, they are the most highly trained and versatile PR specialists in the world. PJs are assigned to Guardian Angel and Special Tactics Squadrons through Active Duty, Guard and Reserve Air Force components. These Squadrons are, according to the Air Force, “comprised of Combat Rescue Officers; Pararescuemen; Survival, Evasion, Resistance and Escape (SERE) Specialists and uniquely trained support personnel dedicated to the Air Force core function of Personnel Recovery.” In other words, an entire wing of people is put into action “to get one guy home.”
Whether shot down or isolated behind enemy lines, surrounded, engaged, wounded or captured by the enemy, PJs “leave no Airman, Marine, Soldier or Sailor behind,” which is the moral imperative PJs operate by. This special team helped to bring back Army Rangers and other wounded or killed in helicopter crashes in 1993 during the Battle of Mogadishu in Somalia – emulated in the Hollywood movie, “Black Hawk Down.” They also are credited with saving more than 4,000 lives during and after Hurricane Katrina, plus rescuing Texas residents during Hurricane Harvey. PJs put their own lives on the line everyday for both military and civilian families in an effort to bring Americans home. The PJ motto, “That Others May Live,” reaffirms their commitment to saving lives and self-sacrifice, without which thousands of service members and civilians would have perished.
Sources:
- Peter Holstein, Air Force Surgeon General Office of Public Affairs, “Embedded Air Force researchers develop innovative battlefield medical technology,” August 01, 2017, U.S. Air Force.
- Yolanda R. Arrington, DOD News, Defense Media Activity, “Air Force Medical Innovation Protects Infectious Patients, Crew Members,” June 1, 2017, Armed with Science.
- D. Levite, Air Force Surgeon General Public Affairs, “Changing Air Force healthcare through innovation,” June 29, 2016, U.S. Air Force.
- Staff Sgt. Stephenie Wade, Air Mobility Command Public Affairs, “Air Force continues to improve care in the air,” February 12, 2016, Air Force Medical Service.
- Eric Tegler, “The Air Force’s Parachuting Medics Are Jumping With a Genius New Triage Tool,” December 11, 2015, Popular Mechanics.
- United States Air Force Pararescue, https://en.wikipedia.org/wiki/United_States_Air_Force_Pararescue
- CNN, “Elite team rescues troops behind enemy lines,” March 19, 2007, http://www.cnn.com/2007/WORLD/meast/03/15/search.rescue/index.html, CNN.com.
