Patient Extraction in the Civilian Environment

Over the past several months, we’ve been heavily involved in conversations, committees, and organizations seeking to solve the unique challenge of providing emergency care and patient extraction in a tactical environment. Fire departments and law enforcement organizations in fact are setting up their officers to either provide tactical field care, or at a minimum take patients out of harms way to enough cover to provide “tactical field care” per the Tactical Combat Casualty Care (TCCC) guidelines.

It’s an unfortunate reality that there has been so much violence in our communities lately, especially those involving our children. It wasn’t long ago where a shooting at a school would cover the airwaves as a top story for days, yet now these events have become so common that they are secondary news. What that means for responders however, is that the challenges have changed. Most paramedics, fire-fighters, and EMTs didn’t sign on for involvement in urban combat operations. There are few civilian circumstances where medics and rescue personnel operate with a security team, or wearing ballistic vests and helmets. It’s also unique, given all the added challenge of tactical operations, that time is so critical for the victims.

There are a lot of great organizations working on developing response procedures and training for non-tactical responders, like the Special Operations Medical Association and Committee for Tactical Emergency Casualty Care. However, the most difficult challenge response is patient movement. First, getting the patient to safety, then to a point where an injured person can receive immediate life-saving care, and finally getting to an ambulance for transport to a hospital. In these mass casualty events, the challenge is to move many patients quickly and out of harms way to receive life-saving treatment, as soon as responders are able to get access to them.

The equipment options for this are limited. Often people use backboards which require 2-4 people to operate and slow Drag-able litters are difficult to setup, difficult to maneuver over uneven terrain and might even be impossible for 2 people to move. It was that challenge that kick started the Rex R-1 in the tactical environment. One person can load and move a patient leaving more people on the objective and getting the patient rapidly out of harms way toward the critical care they need.