Att_2_-_Tactical_Paramedic_Refresher-_SOW.pdf

U.S. Air Force 31st Rescue Squadron Support to Pre-deployment Sustainment Training

26 November 2018

1.0 Scope. USAF 31stth Rescue Squadron has the requirement to be capable of rapid planning, coordination and execution of a broad array of conventional and special operations-oriented taskings as part of their organizational mission to conduct combat search and rescue by providing specially trained, combat ready, highly mobile forces. USAF Rescue Forces are employed in a variety of operations, across a wide spectrum of warfare areas, in the execution of this mission. The Commander, 31st Rescue Squadron requires contracted support to provide its personnel with development, sustainment, refinement, and enhancement of their existing skill sets in preparation for their upcoming deployments.

The requirements for a Paramedic Refresher followed by advanced medical training and full mission urban combat scenario integration course is needed to provide 31st RQS an intense immersion program of instruction. The course shall be structured to provide additional attention to junior personnel, who may need further instruction to overcome basic challenges allowing for successful integration alongside more experienced peers. This is accomplished by providing participants with a twelve (12) day comprehensive multidiscipline course combining classroom lecture, demonstration and practical application of instructed skill sets. Further, the course integrates Paramedic refresher didactics, advanced medical training, and culminates with advanced urban combat tactics integrating all trained skill sets in full mission profiles. This course shall encompass those proven tactics, techniques, and procedures that promote mission success and survivability under stress induced tactical situations. This outsourced training will include current tactics, techniques, and procedures delivered by subject matter expertise (SME) / instruction (in multiple disciplines), materials, facilities and miscellaneous support.

2.0 Applicable Documents and References.

2.1 NREMT, National Continued Competency Program, National component

2.2 AF CFETP 1T2X1

2.3 Pararescue Medical Operations Handbook, 6th Edition, November 2014

2.4 AFTTP 3-3 Guardian Angel

2.5 SOF Medical Handbook, 2009

2.6 FM 3-05.221 (Special Forces Advanced Urban Combat Field Manual)

2.7 AFI 10-3502 (Pararescue and Combat Rescue Officer Training)

2.8 AFI 16-1202 (Pararescue Operations, Techniques, and Procedures) USDA Class R Research Certification

2.2 CAPCE Institutional Accreditation Documentation

2.3 USSOCOM Directive 350-29 Special Operations Forces Medical Training

2.42 USSOCOM Final Approval Letter for ATP re-certification curriculum and approved vendor

2.5 USSOCOM Tactical Medical Emergency Protocols (TMEP) for ATP’s

2.6 AAALAC Approval Documentation

2.7 References: Pre-Hospital Trauma Life Support/Tactical Combat Casualty Care

(PHTLS/TCCC) protocols as established by the American College of Surgeons Committee on Trauma, the National Association of Emergency Medical Technicians

2.8 The Animal Welfare Act 9 CFR

2.9 American Heart Association (Basic/Advanced Cardiac Life Support) curricula

2.10 Pediatric Education for Prehospital Professionals (PEPP) or Pediatric Advanced Life Support

(PALS) Curricula

2.9 Current Committee Guidance on Tactical Combat Casualty Care

3.0 Requirements.

The contractor will provide a twelve (12) consecutive day training package at a private training complex that satisfies all requirements of the SOW. 31st Rescue Squadron’s window of availability for this training course is from 4 Feb 2019 through 15 February 2019. 31st Rescue Squadron requires a single complex that can provide all of the consolidated resources (personnel, materials, facilities, ranges and training areas) to enhance the individual and collective team level skills of the unit being trained.

Individual, team, unit, detachment, and squadron Standard Operating Procedures (SOPs) and Tactics, Techniques, and Procedures (TTPs) will be refined and validated upon completion of the training package. The use of a single contractor provided training complex will be utilized IOT minimize the cost of Transportation of Personnel and Things (TOP/TOT) within the designated period of performance parameter and be executed in such a manner that maximizes the training time 31st RQS has available to exercise and accomplish its interoperable and time sensitive training objectives for the 7 person unit being trained.

3.1 Two (2) days of Advanced Medical Training designed to refine, further develop and enhance those basic-advanced medical and surgical techniques. This training should complement and achieve the end-state of the requisite speed and accuracy required to enhance mission success and survivability by continuing to build upon the sound foundation established in the units preceding blocks of medical training.

3.1.1 Advanced Medical Training to consist of the following subject areas:

3.1.1.1 Academic lesson and hands on fresh human tissue procedures to include cricothyrotomy, chest tube, needle decompression, fasciotomy, and escharotomy.

3.1.1.2 Academic lesson and hands on bleeding control, suturing, and stapling.

3.1.1.3 Academic lesson and hands on blood typing, whole blood administration, Plasma, and PRBC administration (Whole blood, Plasma, and PRBC may be simulated by using a dyed liquid in the actual container) Massive Transfusion Protocols (MTP) for different AO’s.

3.2 Six (5) days of Paramedic Refresher training designed to develop, sustain/recertify and enhance the basic to advanced skills of a Paramedic. The contractor shall place emphasis upon established and relevant medical procedures.

3.2.1 Paramedic re-certification with LTT/AMT Course

3.2.2 Training courses will be required for up to 7 personnel.

3.2.3 The course shall be taught over a 6-day block that satisfies NREMT

PHTLS/TCCC guidelines, to include Live Tissue Training. Training shall include, but not be limited to, all the sub-components of TCCC.

3.2.4 Training shall include didactic instruction and practical hands-on training and should equal at least 48 hours in length.

3.2.5 Instructor to student ratio not to exceed 1:4 for group skills training.

Practical exercises in patient assessment and live tissue training shall not exceed 1:4 instructors to student ratio.

3.2.6 Following specific subjects must be covered:

3.2.6.1 AHA Basic Life Support with AED provider certification

3.2.6.2 AHA Advanced Cardiac Life Support provider level

certification

3.2.6.3 Pediatric Education for Pre-hospital Personnel certification

3.2.6.4 Geriatric Medicine

3.2.6.5 K-9 Medicine

3.2.6.6 Trauma in Pregnant Patients

3.2.6.7 Orthopedic Medicine

3.2.6.8 Regional Anesthesia

3.2.6.9 Dental Emergencies and Treatments

3.2.6.10 Dental Anesthesia

3.2.6.11 Altitude Illness

3.2.6.12 Behavioral Emergencies

3.2.6.13 Kinematics of Trauma: Patterns of Injury

3.2.6.14 Overview of Tactical Medicine Training

3.2.6.14.1 History of TCCC

3.2.6.14.2 Phases of TCCC

3.2.6.14.3 Casualty Transport Techniques

3.2.6.14.4 Hemorrhage Control

3.2.6.14.5 Surgical Interventions

3.2.6.14.6 Advanced Airway:

3.2.6.14.6.1 Surgical / Rapid Sequence Intubation

3.2.6.14.6.2 Advanced procedures

3.2.6.14.7 Breathing

3.2.6.14.8 Fracture management

3.2.6.14.9 Head Trauma

3.2.6.14.10 Burns

3.2.6.14.11 Ballistic Injuries

3.2.6.14.12 Blast Injuries

3.2.6.14.13 Damage Control Resuscitation/Shock

3.2.6.14.13.1 IV/IO and fluid therapy

3.2.6.14.13.2 Blood Products and Transfusions

3.2.6.14.14 TCCC Skills Stations

3.2.6.14.15 Extended Care Protocols

3.2.6.14.16 Planning

3.2.6.14.17 Input and Output

3.2.6.14.17.1 Nasogastric Tubes

3.2.6.14.17.2 Chest Tubes

3.2.6.14.17.3 Urinary Catheters

3.2.6.14.18 Nutrition

3.2.6.14.19 Nursing Care and Reporting

3.2.6.14.20 Surgical Procedures

3.2.6.14.21 Stabilizations

3.2.6.14.22 Battle Field Pharmacology IAW TCCC

3.2.6.14.23 USDAAT Table Top

4.0 Five (5) days of Full Mission Profile (FMP) / Situational Training Exercise (STX) to fully integrate and evaluate the skills acquired / refined / enhanced during the preceding weeks of training. Scenarios will include the use of multiple target / mission sites to include a theater specific MOUT site, role players, MESL fed triggers / branches to closely replicate the operational situations these forces can expect to encounter in-country. Scenarios shall be derived from the frequently executed mission profiles that expeditionary forces are currently experiencing in theater. Combat Trauma Mannequins, Moulage Patients and USDAAT models will be incorporated into the FMP/STX for sustainment of operational medicine skills and enhance team treatment, stabilization and CasEvac procedures. Emphasis of this culminating phase of the training package is on correct procedural performance and timely, efficient, successful execution of TTPs.

4.1 Contractor shall provide SMEs / Instructors in sufficient quantity to effectively design, monitor, assess and evaluate the fully integrated operational scenarios of the force being trained for all aspects of the FMP/STX. FMP/STX training objectives shall include at a minimum;

4.1.1 Rapid Response Planning Process (R2P2)/ Crisis Action Planning Spin-ups

4.1.2 Actions in the Marshalling Area and Element Launches

4.1.3 Movements to Target/Objective Areas

4.1.4 Actions in the Objective Area and on the Objective

4.1.5 Exploitation of Target Sites

4.1.6 Evacuation & Exfiltration

4.1.7 Actions on Reception and Debrief

4.1.8 Live Fire and Force on Force Simulated Munitions (SESAMS) Exercises

4.1.9 Vehicle Extrication and Crowd Control

4.1.10 Mass Casualty with vehicle extrication

4.1.11 Urban scenarios with confined space

4.1.12 Urban and woodland scenarios with convoy operations

4.1.13 Urban and woodland scenarios with High Angle rope rescue work

4.1.14 Instruction in vehicle IADS and convoy operations

5.0 Minimum Contractor Facility Requirements: The awarded contractor’s training complex shall be located within 30-minute drive time of a Military Air Base to facilitate the arrival, departure, rest, refit and refueling requirements of the platforms providing the TOP/TOT of the force being trained and possess at a minimum, the below listed Specialty Ranges, Target Arrays, Training Areas and Facilities to fulfill the multidiscipline training and logistical requirements of this SOW.

5.1 Minimum of 300yd 270⁰ Multipurpose range of approximately 21,000 square feet that facilitates scenario focused live-fire or simunitions exercises to refine, enhance, or validate the force’s Standard Operating Procedures and Immediate Action Drills. Range should be capable of supporting simultaneous round robin stations as well as the execution of individual, team and detachment sized movements to contact, contact, immediate action and break from contact drills. Range should also possess adjacent at least two (2) and five (5) story multipurpose towers that allow exercises/drills involving elevated/over-watching target engagements to be safely and efficiently exercised and which are de-conflicted for safety by the contractor. Range should possess a variety of paper target stands and reactive steel targetry.

5.1.1 Adjoining Multipurpose Towers should have multi-level platforms with a variety of shooting positions available

5.2 Surveyed Drop Zone Capable of Day/Night SL, MFF & CDS ParaOps/Drops to support the long-range airborne infiltration objectives of the force to be trained

5.3 Multiple Surveyed HLZs to Support the long-range offload & on-load arrival / departure profiles of non-jumping personnel and things (TOP / TOT) that will not be airdropped / delivered.

5.4 1+ Mile Off-road Rally Track capable of supporting the vehicle dynamics, control and multiple vehicle aspects of the training.

5.5 5 Mile (minimum) Off-road Track with Engineered Obstacles capable of supporting the obstacle negotiation, vehicle preservation, 4x4 operation, Max Gradient / Vehicle Roll-over Threshold and vehicle recovery aspects of the training

5.6 Minimum of two stand-alone 360o fully ballistic to 7.62mm, interior and exterior explosive, mechanical and ballistic breaching capable shoot houses.

5.6.1 Houses shall possess overhead catwalks for evaluative and observation purposes and be quickly reconfigurable to change house layouts in support of rapid house re-configuration cycles to minimize down time.

5.6.2 Houses shall be no greater than 20m apart to facilitate simultaneous multi-house assaults and be surrounded by 9’ walls with indigenous gates for in-theater realism

5.6.3 Houses shall possess multiple explosive exterior entry points and interior explosive and mechanical breaching points.

5.6.4 Compound wall shall possess multiple explosive and vehicular breach points (indigenous gates and breaching sections)

5.6.5 Compound wall shall possess multiple personnel vehicular ingress and egress points / gates

5.7 Multilevel Confined Space Collapsed Structure Trainer

5.8 10+ Acre Theater Specific Maneuver Range that facilitates live fire and simmunitions movement profiles for the force to designated targets ISO Full Mission Profiles / Situational Training Exercises.

5.9 30+ Acre Theater Specific MOUT Complex with adjacent DZ and HLZ to support force on force aspects of the FMP / STX training package

5.10 Trailer-able HH-60 CASEVAC Trainer / Advanced Simulator

5.11 Contactor’s facility will be an approved DoD/BATF Class V Receiving Authority

5.12 Contractor’s facility shall not have any day/night/weekend noise restrictions due to the type of training to be conducted

5.13 Contractors facility will possess a secure storage area for securing Class-II and III narcotics

IAA with AFI 41-209 (Medical Logistics Support)

5.14 An onsite Fitness Center with fully functional gym complete with weights, nautilus machines, treadmills, medicine balls, kettle bells and other appropriate weight lifting equipment, a Combative Dojo, and outdoor recreational area must also be provided.

5.15 Contractor’s facility will possess DoD Compliant Arms, Ammunition Storage Rooms, Magazines and Bunkers IAW the DoD 5100.76-M (Physical Security Manual)

5.16 Contractor’s facility will possess billeting structures large enough to house a minimum of 7 students in open-bay style buildings and will have a minimum of 1 semi-private room available for up to 2 SNCOIC/OIC/VIP personnel.

5.16.1 Billeting will have adequate shower, restroom and laundry facilities for same number of students within walking distance of the training areas

5.16.2 Billeting Units will be able to provide internet access and be compatible with DoD computer systems

5.16.3 Billeting units shall possess a team room large enough for gear stowage with enough tables, chairs, and white boards to accommodate 7 students and mission planning for FMP / STX scenarios.

5.16.4 Billeting units shall possess a minimum of one television with cable or satellite

5.17 Contractor’s facility will possess a dining facility large enough to serve a minimum of 7 students within a short walk from the Billeting Units.

6.0 Contractor Provided Exercise Support Personnel Requirements: Contractor will provide all vetted male and female role players to perform scripted support to exercises and scenarios during the tactics-oriented blocks of instruction and FMP/STX.

6.1 Contractor will ensure all role players have been sufficiently briefed on their initial actions / responses to successful / unsuccessful actions from teams

6.2 Contractor will supply real time Command and Control of the role players during all scenarios and exercises.

6.3 Contractor will provide Theater Specific Garments and equipment items to role players.

7.0 Contractor Provided SME/Instructor Minimum Qualification Requirements:

7.1 Medical SMEs and Scenario Support Instructors shall be current or prior medic / corpsman qualified in one of the following MOS’s / NEC’s (18D/8491/8403/8425/PJ). Instructors considered highly qualified if they possess experience as an operator within Special Forces or Special Missions Units and have conducted urban operational profiles during GWOT.

7.2 Subject Matter Expertise (SME) in CQC/Tactical/CQB/Sniper Marksmanship Instruction.

7.3 SME within USSOCOM or Special Missions Units in USSOCOM/USASOC/Marine Force

Recon/NavSpecWar as a NCO, SNCO/CPO or Officer with multiple successful tours within a Special Missions Unit.

8.0 Minimum Contractor Material Requirements: The awarded contractor will provide;

8.1 Contractor will provide all supplemental Sedan, SUV and Tactical Vehicle support for driving, tactics training and FMP/STX aspects of the package

8.2 All USDAAT Models, Meds & Scenario Support Materials

8.3 All Fresh Tissue Human models

8.4 Fuel for Vehicular Platforms supporting Training

8.5 Parts Blocks for Vehicle Platforms supporting Training

8.6 Special Effects Shot materials supporting designed realism of aspects of the training package

9.0 Government provided Transportation, Items of Equipment and Materials:

9.1 Unit specific items of equipment will be provided by the unit per their organizational Table of Equipment, i.e.; 31st RQS issued load-out items:

9.2 Individual and Team Uniforms and Equipment per SOPs & TE (Night Vision, Body Armor/Assault Vests, Optics, RCOS/Keyhole Suites, etc.)

9.3 M4 Carbine, M9 Pistol per student

9.4 All Communications Equipment Items, GPS, NVG’s & Specialty NavAid Electronics

9.5 Transportation of personnel and things to the awarded contractor’s training complex

10.0 Student Meals. The contractor will provide on-site full hot breakfasts, full hot lunches and full hot dinners for the attending students of the force being trained and will be served in a cafeteria style manner. This includes arrival & departure days.