Air Force Pararescue Experience in Wilderness Medicine: Relevance for the Deployed Environment.

In the realm of military special operations, the practice of medicine extends beyond the conventional boundaries of healthcare. Operating within remote and often hostile environments demands a unique fusion of medical expertise, tactical acumen, and adaptability. In this report we review three distinct pararescue missions executed by the 212th Rescue Squadron in which the complexities of wilderness medicine and operational demands are examined. The relationship of Special Operations Forces (SOF) medical skills to wilderness medicine is examined in each mission: wound care for soft tissue injury from a bear mauling; airway management in a patient with severe traumatic brain injury at high altitude and extreme cold; and analgesia and appropriate field management of a mid-femur fracture from a snow machine accident in remote Alaskan wilderness. Currently, there is a paucity of literature discussing the critical role of wilderness medicine in SOF medical practice. By examining the role of wilderness medicine principles and techniques in this case series, we seek to contribute to the evolving discourse surrounding SOF medical practice as a unique union of wilderness and combat medical skills.