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22 AUGUST 2017 | EMSWORLD.com off the land. Next is the U.S. Army free fall parachute school to learn advanced skills such as jumping from high altitudes and at night. From here the candidate goes to the pararescue EMT-paramedic course, fol- lowed by a 20-week course in advanced medicine through the pararescue recovery specialist course. After completion of all these schools, the candidate is designated as a pararescuer. Once a new PJ arrives at his first unit, he is in training for another 450 days. This is called a progression tour. A new PJ must have an instructor with them at all times until they've completed this training. Much of it covers the same skills learned in initial training but to a higher proficiency level. This training also allows the new PJ to work as an element leader, which would put him in charge of a two-person PJ team on a helicopter. The other training is to become proficient in the local unit's equipment and skills. For instance, at the 304th they con- duct a large amount of mountain rescue work, while a unit based in Florida would perform more ocean missions. "One of the benefits of being NREMT paramedics is that it allows better access to hospitals and local EMS agencies to maintain our skills," says Blanton. "All the PJs go through a paramedic refresher class every two years, just like any other NREMT paramedic. We put some of those classes on here at our base as well as send some of our PJs to refresher classes around the country to broaden our view of medicine and what's going on in different parts of the country. We have also built a ride- along program with the paramedic service in Skamania County, Wash. This allows our PJs to assess and treat patients and get real-world experience. We also allow civilian agencies to use our human patient simulators for training. In addition we have provided Tactical Combat Casualty Care training to paramedic and law enforcement agencies. "We use the ZOLL M Series monitor/ defibrillator and Impact 3000 transport ventilator. We also can administer blood products. In addition we carry some medi- cations that are not normally found in civil- ian agencies, such as ketamine for pain control and RSI as well as antibiotics. We started carrying ketamine during the war in Inflatable boats with outboard motors can be dropped by parachute and inflated with an air tank for ocean-rescue scenarios or when using a body of water to insert a team. These beefed-up AT Vs can be deployed by parachute, helicopter or transport plane.