This handbook incorporates requirements, information, and procedures formerly contained in AFSOC SG policy letters. This Handbook applies to all active duty AFSOC 4F0X1 and 4N0X1 personnel, certified at the Emergency Medical Technician- Intermediate and Paramedic level, as outlined in AFSOCI 48-101. Medical Control Care of injured personnel in combat or rescue situations requires medical command and control by licensed medical providers. Paramedical and Emergency Medical Technician-Intermediates providing care in these situations are acting under the principal of ‘delegated authority’, where the provider(usually a physician) allows appropriately trained personnel to perform specified diagnostic and therapeutic interventions. There are several types of medical control: - On Line Medical Control: A physician is either present on the scene and personally directs patient care, or is contacted by radio or other means and gives ‘live’ instructions. -Off Line Medical Control: Contact with a control physician is impossible or impractical, care is given based on specific physician approved protocols. The medical control chain for AFSOC medical technicians assigned to Operations Support Squadron Medical Flights(OSS/OSM) is in the following precedence: On Line Medical Control: - Senior AFSOC Flight Surgeon present at the scene. - Special Tactics Flight Surgeon present at the scene. - Senior US military physician present at the scene. - Qualified(training equivalent to US physician) Allied country senior military physician present at the scene - Qualified civilian physician(training equivalent to US MD or DO) present at the scene, provided he/she agrees to assume responsibility for care and accompany the patient to higher level of care. - Senior AFSOC Physician Assistant present at the scene - Any of the above in direct radio contact Off Line Medical Control: On line medical control is the preferred means of medical control for all casualty situations. In the event on line control is not possible the following will apply: - The Senior medic is responsible for directing medical care at all scenes where on line control is not possible. He/she will direct medical control in strict adherence to the established protocols contained herein. - AFSOC medical technicians assigned to OSS/OSM flights will attempt to contact on line medical control in all situations prior to reverting to protocol use, with the exception of an immediate life threat and then will attempt to establish on line control as soon as possible after the patient is stabilized.