Why REMS Teams Should Be Medics First, Rope Rescue Second (Controversial Take)
Manage episode 516148202 series 3687514
REMS teams should be medics first, with rope capability second—not the other way around.
We make the case for why medicine must lead when extraction takes hours, air assets are grounded, and patients can't wait for perfect rigging. Lean systems and strong people outperform bulky redundancy when time is tissue.
What we cover:
REMS Philosophy & PACE Planning
Why med-first with rope capability is the right stance
Building PACE planning as a daily habit and team culture
Safe-to-fail testing: blowing anchors, reading soils, logging real loads
Rope Systems That Move Fast
Lightweight, multi-use gear over heavy redundancy
8mm aramid-sheathed ropes and single rope technique tradeoffs
Reducing human error through simpler systems
Meat anchors that get the first rescuer down in minutes
Medicine That Saves Lives
Point-of-injury care and prolonged field care for protracted evacuations
Analgesia, hypothermia prevention, bleeding control, airway strategies
Packaging that actually moves in steep country
Integrating air, ground, UTVs, and dozers for extraction
The Bottom Line:
Turn recoveries into rescues by investing in people, testing until failure, simplifying the system, and putting medicine at the center. We challenge rope dogma with data, principles, and reps—and steal smart practices from canyoneers, cavers, arborists, and tactical medics along the way.
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[00:00:00] Opening Hot Take: Medics First
[00:06:28] ICS Lessons From Wildland Campaigns
[00:12:16] PACE Planning As A Habit
[00:19:50] What Makes REMS Work In Reality
[00:23:08] Prevail Rescue: Origins And Philosophy
[00:27:07] Erasing Dogma With Data And Principles
[00:31:05] Single Rope, Twin Tension, And Tradeoffs
[00:38:50] Meat Anchors, Edges, And Speed
[00:45:20] The Controversy: Medicine Inside REMS
[00:49:10] Prolonged Field Care And Closing
10 episodes