Special Operations Aid & Rescue, Ltd.

You know what the weather warming up means? It means that the International Tactical Medicine Competition is gearing up. Registration for ITMC 2025 teams opens in 30 days (April 11th, 2025). Find your teammate, request your PTO, and set a reminder to register. We're headed to Charleston this year! More info: www.tacmedcompetition.com

EAP is here! Join us for one of our most sought-after courses. Five days of training, subjects ranging from basic interventions to critical care management in an austere environment.

Every year, our roster gets fuller, with more agencies bringing our training directly to themselves. While our calendar is bursting, our open classes are limited! Interested in a class that has an open seat? Don't wait! See what our students are raving about. Have you taken a class with us recently? Drop your experience in the comments.

Tactical teams operate in high-stakes environments where trust, coordination, and resilience are critical. One of the lesser-discussed psychological dynamics in these teams is trauma bonding—an intense emotional connection formed through shared high-adrenaline experiences. At the core of this bond are powerful neurochemicals, including oxytocin, dopamine, cortisol, and adrenaline, which influence team cohesion and emotional resilience. In life-threatening situations, adrenaline and cortisol surge, sharpening focus and preparing the body for immediate action. This "fight-or-flight" response not only enhances performance but also creates a deep sense of shared survival. At the same time, dopamine—the brain’s reward chemical—reinforces the high that comes from successfully overcoming danger, further solidifying bonds between team members. Most importantly, oxytocin, often called the "bonding hormone," plays a key role in strengthening trust and loyalty within the unit. The repeated cycle of stress and relief fosters a level of camaraderie that is difficult to replicate outside of high-risk environments. Understanding the hormonal foundation of trauma bonding is essential for SWAT leaders, mental health professionals, and tactical trainers. By acknowledging both the psychological strength and potential challenges of this intense connection, teams can better support their members' mental well-being while maintaining the trust and cohesion needed for operational success. van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking. Taylor, S. E. (2006). Tend and Befriend: Biobehavioral Bases of Affiliation Under Stress. Current Directions in Psychological Science, 15(6), 273–277.

Tactical Medical Practitioner (TMP) prepares pre-hospital providers to support tactical teams during missions, and lays the foundation for students to build on for incident command. Our third TMP cycle for the year, SOARescue will be in Harrisburg, PA April 7th-11th. Don't miss us! Register at www.soarescue.com/courses.

Our Extended Austere Provider (EAP) is one of our most sought after classes. Join us for one of only two scheduled EAP courses April 7th-11th in Charleston, SC. Five days of intensive education and scenarios designed to expand your practice to include sustaining critical patients in pre-hospital environments. Register at www.soarescue.com/courses.

TMP in Baton Rouge, LA starts in 5 weeks! We have some open seats. Last TMP class before NREMT recent hours are due...

During a mass casualty incident (MCI), quick and effective airway management is critical to save lives. Among the various options available—nasopharyngeal airways (NPA), oropharyngeal airways (OPA), blind insertion airway devices (BIADs), and tracheal intubation—the NPA stands out as the preferred intervention in many scenarios where an airway adjunct is needed. Here's why: 1. Ease of Use and Rapid Deployment: In an MCI, time is of the essence. NPAs are quick to insert, requiring minimal equipment and training. Unlike OPAs or BIADs, they can often be placed without disrupting other critical interventions. 2. Patient Tolerance: NPAs are better tolerated by semi-conscious or unconscious patients with an intact gag reflex than other airway devices. 3. Minimized Risk of Complications: Tracheal intubation requires advanced training, equipment, and time, which may not be feasible in chaotic MCI settings. It also carries a higher risk of complications. NPAs are less invasive and pose fewer risks, especially when personnel are working under pressure. 4. Effective Airway Maintenance Across Situations: Blind insertion airway devices, such as supraglottic airways, can be effective but are bulkier, require more space to store, and can be harder to manage in multi-patient settings. NPAs, by contrast, are compact and can effectively maintain airway patency in most patients without specialized equipment. 5. Versatility in Difficult Scenarios: NPAs can be used in patients with suspected cervical spine injuries or facial trauma (provided there’s no contraindication like a basilar skull fracture), making them a versatile tool for first responders. Key Takeaway: In the dynamic environment of an MCI, prioritizing simple, effective, and efficient airway interventions should be . NPAs check all these boxes, making them a cornerstone of airway management in disaster scenarios.

While it's natural for healthcare providers to want to jump in and directly help patients, the lead provider at an MCI has a much greater responsibility: orchestrating the response to save as many lives as possible. Here’s why the lead provider should prioritize coordination over hands-on care: -The lead provider is the cornerstone of effective decision-making. They must assess the overall situation to determine resources needed and where they should be allocated, and adapt the response strategy as the incident unfolds in real-time. Being tied up in patient care can limit their ability to maintain situational awareness. -From directing triage teams to ensuring supplies are available, the lead provider must think several steps ahead. A clear head is needed to oversee patient flow, coordinate with EMS and hospitals, and resolve bottlenecks. -In an MCI, communication is critical. The lead provider needs to liaise with multiple teams—emergency responders, hospitals, and command centers. This role requires full attention to ensure seamless information flow and prevent delays in care. -By stepping back, the lead provider empowers other skilled team members to focus on individual patients. Delegating tasks allows everyone to operate at their highest level, improving outcomes for all. -When the lead provider focuses on the "big picture," the response effort becomes streamlined, ensuring no one is left behind and resources are utilized effectively.

Originally a concept from aviation, a “sterile cockpit” refers to limiting all non-essential communication and activities during critical phases of operations to maintain focus and safety. This principle has expanded beyond the skies—into ambulances, tactical environments, and other high-intensity professions. In EMS, it ensures paramedics focus solely on receiving scene information as it comes in and beginning to form a primitive plan of action to begin on arrival. Depending on the objective patient condition, it may even continue through the entire call to reduce distractions that could jeopardize treatment during transport, and to protect communication with hospitals. In the tactical environment (LE, federal, DoD, etc.), it’s about precision—minimizing chatter ensures mission-critical instructions are clearly heard and executed, especially in high-stakes scenarios. Have you seen this principle in action or even practice it yourself?