United States Air Force Pararescue Pararescuemen , also known as PJs ( Pararescue Jumpers ) , are United States Air Force Special Operations Command ( AFSOC ) and Air Combat Command ( ACC ) operatives tasked with recovery and medical treatment of personnel in humanitarian and combat environments . These special operations units are also used to support NASA missions and have been used to recover astronauts after water landings . They are attached to other SOF teams from all branches to conduct other operations as appropriate . Of the 22 enlisted Air Force Cross recipients , 12 are Pararescuemen . They wear the maroon beret as a symbol of their elite status , and to symbolize the blood shed by past PJs , as well as the blood current PJs are willing to shed to save lives . Part of the little - known Air Force Special Operations community and long an enlisted preserve , the Pararescue service began commissioning Combat Rescue Officers early in the 21st century . History . Pre – World War II . As early as 1922 there was a recognized need for trained personnel to go to remote sites to rescue airmen . In that year , Army Medical Corps doctor Colonel Albert E . Truby predicted that " airplane ambulances " would be used to take medical personnel to crashes and to return victims to medical facilities for treatment . However , it was another two decades before technology and necessity helped to create what would eventually become Air Force Pararescue . Even so , there were developments in critical technologies . In 1940 , two U . S . Forestry Service Smokejumper s , Earl Cooley and Rufus Robinson , showed that parachutists could be placed very accurately onto the ground using the newly invented ' steerable parachute . ' These parachutes and the techniques smokejumpers used with them were completely different from the techniques used by Army airborne units . It was in that year that Dr . ( Captain ) Leo P . Martin was trained by the U . S . Forestry Service Parachute Training Center in Seeley Lake , Montana as the first ' para - doctor ' . World War II . During the first months after America ' s entry into the War , there was very little need for air rescue . As the war progressed , a U . S . strategic bombing campaign was launched , and air rescue began to play a key role . Rescue units were formed around the globe under the operational control of local commanders . While training , techniques and equipment varied , one rule was constant : " Rescue forces must presume survivors in each crash until proved otherwise . " Search and rescue of downed aviators in the continental United States fell primarily to the Civil Air Patrol , a civilian aviation group under the command of the Army Air Corps . The CAP would usually send in ground crews after locating a crash site ; however , they would sometimes land small aircraft and they did experiment with parachute rescue teams . With Canada ' s entry into WWII in 1939 , former Canadian fighter ace Wop May was put in charge of training operations and took over command at the No 2 Air Observer School in Edmonton , Alberta . Edmonton was one of the common stops for A - 20 Boston , B - 26 Marauder and especially B - 25 Mitchell bombers being flown to the Soviet Union as part of the lend - lease program . When these aircraft went down , typically due to mechanical or navigational problems , the crew often survived only to die attempting to make it out of the bush . May ' s school was often asked to supply aircraft to search for downed planes , but even when one was spotted there was often little they could do to help . May decided to address this problem . In early 1942 May asked for volunteers from his civilian servicing crew , and about a dozen agreed to join . With basically no equipment , the instruction consisted of " jump and pull " and windage was calculated by throwing an Eaton ' s catalogue out the door . Early operations were comical , but in early 1943 May sent two volunteers , Owen Hargreaves and Scotty Thompson to the smoke jumper s school in Missoula , Montana to be trained by the U . S . Forestry Service . After six weeks they returned home with borrowed steerable equipment to train two other volunteers , Wilfred Rivet and Laurie Poulsom . Soon the unit was conducting operational jumps , and by 1944 May ' s persistence had paid off and an official para - rescue training program started . For his work , May was awarded a Presidential Medal of Freedom with Bronze Palm in 1947 by the USAAF . In the European Theater , there was very little opportunity for ground rescue . Most flights were over enemy - occupied territory , where a landing meant immediate capture . In the UK area of the European Theatre , the British military was at the time creating its own Royal Air Force Mountain Rescue Service which would be based largely on civilian mountain rescue doctrine . The RAFMRS has rescued many American aircrew , or recovered remains , from USAF crashes over its UK territory . Crashes during over - water flights created a great many casualties , the Eighth Air Force initiated a ' sea rescue ' group . From its creation in 1943 until the end of the war , the recovery rate of aircrews downed at sea rose from less than five percent to over forty percent . In the vast reaches of the Pacific Theater , a plane crash meant almost certain death from exposure to the elements . The Army formed several squadrons in theater specifically to aid and rescue downed flyers — both at sea and on islands — with great success . The China - Burma - India Theater ( CBI ) was the birthplace of what would eventually become pararescue . Here was a unique combination of long overland flights through territory that was loosely held by the enemy and survivable . Dominating the flying in the CBI was ' The Hump ' route : cargo flights that left India carrying thousands of tons of vital war supplies had to cross the spine of the Himalayas to reach their destinations in China . Every day thousands of flight crews and their passengers risked their lives making this passage in C - 46 and C - 47 aircraft . Many of these flights never arrived at their destinations due to mechanical problems , weather and mistakes . Crews forced to bail out or crash land faced weeks of hardship in tracing a path back to civilization , enduring harsh weather , little food , and the injuries they sustained during the crashes . Capt . John L . " Blackie " Porter — a former stunt pilot — is credited with commanding the first organized air rescue unit in the theater . Known as " Blackie ' s Gang " and flying out of Chabua , India , they were equipped with two C - 47 aircraft . One of their first rescue missions was the recovery of twenty people who had bailed out of a stricken C - 46 in August 1943 in the Naga area of Burma ; an area that contained not just Japanese troops , but tribes of head hunters as well . Among the twenty was CBS reporter Eric Sevareid . The men were located and supplies were dropped to them . The wing flight surgeon , Lt . Col . Don Flickinger , and two combat surgical technicians , Sgt . Richard S . Passey and Cpl . William MacKenzie , parachuted from the search planes to assist and care for the injured . At the same time , a ground team was sent to their location and all twenty walked to safety . Although parachute rescues were not officially authorized at the time , this is considered by PJs to be the birth of Air Force pararescue . Eric Sevareid said of his rescuers : " Gallant is a precious word : they deserve it " . A few short months later , Capt . Porter was killed on a rescue mission when his B - 25 was shot down . In 1944 , General William H . Tunner took command of Air Transport Command operations in CBI . Declaring the rescue organization to be a ' cowboy operation ' , he appointed Maj . Donald C . Pricer commander of the 3352nd Air Search and Rescue Squadron and assigned him several aircraft for the mission . In addition to fixed - wing aircraft , early helicopter s were deployed to the CBI for use in rescue , marking the start of a long association between rotary - wing aircraft and air rescue . Post – World War II . Recognizing the need for a unified organization to perform search and rescue , the Army Air Force formed the Air Rescue Service ( ARS ) . Officially established on 29 May 1946 , the ARS was charged with saving the lives of aircrews who were involved in aircraft disasters , accidents , crash landings , ditchings or abandonments occurring away from an air base , and with being world - deployable to support far - flung air operations . In the area around an air base , the air base commander had search and rescue jurisdiction through the Local Base Rescue ( LBR ) helicopter units . However , these were limited to a radius around the base due to the range and payload limitations of the aircraft . In order to reach beyond this limitation , Pararescue teams were authorized on 1 July 1947 , with the first teams to be ready for fielding in November . Each team was to be composed of a Para - doctor and four Pararescue technicians trained in medicine , survival , rescue and tactics . Pararescue was given the mission of rescuing crews lost on long - range bomber and transport missions and to support other agencies when aerial rescue was requested . A mission earlier in 1947 was the final impetus for the formal creation of Air Force Pararescue . In May , Dr . ( Capt . ) Pope B . ' Doc ' Holliday parachuted out of an OA - 10 Catalina into the Nicaraguan jungle to aid a crewmember who had parachuted from a crippled B - 17 Flying Fortress . His actions earned him the Bronze Star and made him another of Pararescue ' s early legends . Shortly after Pararescue teams were authorized , the 5th Rescue Squadron conducted the first Pararescue and Survival School at MacDill Air Force Base in Florida . The core of instructors were experienced officers and enlisted men who were recruited from all branches of service . The commandant of that first school was pilot Lt . Perry C . Emmons , who had been assigned to the Office of Strategic Services ( OSS ) during World War II . At the close of the war , Emmons and six sergeants flew prisoners of war out of Thailand , earning his group the nickname " Perry and the Pirates " , after the popular comic strip " Terry and the Pirates " . After the war , Emmons completed Airborne School at Fort Benning , Georgia , becoming only the second jump - qualified Air Force pilot . Clobbered Turkey . In late 1947 , the crash of the B - 29 " Clobbered Turkey " in Alaska brought home the need for specialized , well - trained Pararescuemen . On 21 December , the " Clobbered Turkey " hit a mountain and when the wreck was spotted on the 27th , Medical Corps Lt . Albert C . Kinney , First Sergeant Santhell A . London premier Army Air Corp cold weather expert and T - 5 Leon J . Casey — none of whom were trained Pararescuemen — volunteered to jump onto the crash site , located 95 miles north of Nome . The team encountered poor visibility , extreme temperatures and high winds on the site and as a result , all three perished . Casey ' s body was found seven miles ( 11 km ) from the crash site , swept there by the surface winds . Two members of the crew of the " Clobbered Turkey " who set out to seek assistance also perished a few miles from the site . When ground rescue crews finally arrived at the crash site two days later , they found that the remaining six members of the crew — who had stayed with the aircraft — had all survived . Dr . Kinney ' s body was not located until July of the next year . In 1949 , due to a shortage of available doctors , Medical Service Corps officers replaced Para - doctors on the teams , receiving the same training as the enlisted Pararescuemen . One of the first of these officers was John C . Shumate , a pharmacist , who was appointed commandant of the Pararescue and Survival School . At this time the Air Rescue Specialist Course was created at the School of Aviation Medicine , Gunter Air Force Base , Alabama . Designed to teach Pararescuemen the skills needed to determine the nature and extent of injuries and to administer treatment , the course was taught by Medical Corps officers with previous Pararescue experience , including : Dr . Pope B . ' Doc ' Holliday , Dr . Rufus Hessberg , Dr . Hamilton Blackshear , Dr . Randal W . Briggs and Dr . Burt Rowan . Korean War . As Pararescue grew , PJ teams were assigned to every Air Rescue Service squadron to provide global coverage . By 1950 , the unification of all the formerly independent Air Rescue Squadrons under the umbrella of the Air Rescue Service was complete . In 1950 , North Korea attacked across the 38th parallel and began the Korean War . This was an opportunity for Air Rescue to put training into practice and to develop theories into policies . One of the key new concepts was rescue of stranded personnel from behind enemy lines . This , along with evacuating critically wounded men from aid stations close to the front , were Air Rescue ' s primary missions . Pararescuemen were a normal part of Air Rescue crews for these missions . Their medical and tactical skills made them invaluable for evacuation and rescue missions of this type . Pararescuemen were often called upon to leave the helicopters that carried them in order to assist the personnel they were sent to rescue . This might call for an extended stay behind enemy lines and overland travel of several miles . The longest of these ' Lone Wolf ' missions lasted seventy - two hours . By the end of the war in 1953 , Air Rescue had evacuated over eight thousand critical casualties and rescued nearly a thousand men from behind enemy lines . Vietnam War . The Vietnam War was a pivotal conflict for the Pararescue teams . The Air Force ' s scope of operations became so large that demand for Pararescue teams expanded as well . The use of helicopter s caused new tactics utilizing the speed , distance , and support they could provide . Rescue " packages " were created utilizing FACs ( Forward Air Controller s ) , rescue escorts ( such as AH - 1 Cobra s or A - 1 Sandys ) , protective fighter CAP ( Combat Air Patrol ) , HC - 130 " King " Hercules for Rescue Mission Coordination and helicopter refueling , and the HH - 3 Jolly Green Giant and HH - 53 Super Jolly Green Giant helicopters to provide fast rescue for pilots shot down far behind enemy lines . Pararescue personnel were part of these packages to provide medical assistance for injured aircrew as well as the ability to patrol for missing aircrew that might have been unconscious or dead . Pararescue team members would be inserted to conduct LSO ( Limited Surface Operations ) searches while the escorts maintained an aggressive patrol to provide instantaneous support . Sometimes they would be inserted to search for personnel who were being forced to escape and evade ; in such cases the mission might last for days . The Pararescue teams racked up an impressive record ; during the conflict only 19 Airmen were awarded the Air Force Cross . Ten of those were awarded to Pararescuemen . Pararescue training and structure . The process of becoming a " PJ " is known informally as " the Pipeline " or " Superman School . " Pararescue trainees are first required to pass the Pararescue Indoctrination Course at Lackland AFB , commonly referred to as " indoc " . Following that is a long string of courses including Combat Dive School , Army Airborne , National Registry for Paramedic , Survival ( SERE ) , and Military Free - fall Parachutist . Upon completing the aforementioned , a pararescue trainee is required to then complete the Pararescue Apprentice Course , which combines all the prior skills and adds a few more . Once a Pararescueman has completed the pipeline , he is assigned to a Rescue or Special Tactics team where he will receive informal on - the - job training . Additionally if a pararescueman is assigned to a special tactics team he will receive additional training along with Air Force Combat Controllers in what is known as Advanced Skills Training . The mission of the Indoctrination Course is to recruit , select and train future PJs and CROs . At this school , participants undergo extensive physical conditioning with swimming , running , weight training and calisthenics . This course helps prepare students for the rigors of training and the demands of these lifestyles . Other training includes obstacle courses , rucksack marches , diving physics , dive tables , metric manipulations , medical terminology , dive terminology , cardiopulmonary resuscitation , weapons qualifications , history of PJs , and leadership reaction course . Graduation of this course is the " ticket to ride the pipeline , " where Pararescuemen begin learning the special skills that make PJs highly regarded special operators . Students learn the basic parachuting skills required to infiltrate an objective area by static line airdrop . This course includes ground operations week , tower week , and " jump week " when participants make five parachute jumps . Personnel who complete this training are awarded the basic parachutist rating and are allowed to wear the Parachutist Badge . The course is divided into four blocks of instruction : ( 1 ) Diving Theory , ( 2 ) Infiltration / Exfiltration Methods , ( 3 ) Open Circuit Diving Operations , and ( 4 ) Closed Circuit Diving Operations . The primary focus of AFCDC is to develop Pararescuemen / Combat Rescue Officers and Combat Controller / Special Tactics Officers into competent , capable and safe combat divers / swimmers . The course provides commanders with divers / swimmers capable of undertaking personnel recovery and special operations waterborne missions . AFCDC provides diver training through classroom instruction , extensive physical training , surface and sub - surface water confidence pool exercises , pool familiarization dives , day / night tactical open water surface / sub - surface infiltration swims , open / closed circuit diving procedures and underwater search and recovery procedures . The session culminates with a waterborne field training exercise . This course teaches how to safely escape from an aircraft that has landed in the water . Instruction includes principles , procedures and techniques necessary to escape a sinking aircraft . This course teaches basic survival techniques for remote areas using minimal equipment . This includes instruction of principles , procedures , equipment and techniques that help individuals to survive , regardless of climatic conditions or unfriendly environments , and return home . This course instructs free fall parachuting ( HALO ) using a high performance parafoil . The course provides wind tunnel training , in - air instruction focusing on student stability , aerial maneuvers , air sense and parachute opening procedures . Each student undertakes a minimum of 30 free fall jumps including two day and two night jumps with supplemental oxygen , rucksack and load - bearing equipment . This course teaches how to manage trauma patients prior to evacuation and provide emergency medical treatment . Phase I is four weeks of emergency medical technician basic ( EMT - B ) training . Phase II lasts 20 weeks and provides instruction in minor field surgery , pharmacology , combat trauma management , advanced airway management and military evacuation procedures . The airmen are then sent to Tucson , Arizona for hands - on medical training . Trainees work alongside paramedics with the Tucson Fire Department as well as local hospitals . Graduates of the course are awarded National Registry of Emergency Medical Technicians - Paramedic ( NREMT - P ) certification . Qualifies airmen as pararescue recovery specialists for assignment to any Pararescue unit worldwide . Training includes field medical care and tactics , mountaineering , combat tactics , advanced parachuting and helicopter insertion / extraction qualifications . At the completion of this course , each graduate is awarded the maroon beret . Pararescue and Advanced Pararescue Orientation Course . Since the 1950s , Air Force Pararescueman have provided training and mentorship for Civil Air Patrol cadets . This was formalized in 1977 with the introduction of Pararescue Orientation Course ( PJOC ) at Kirtland AFB , New Mexico . PJOC was later taught at Fort Knox , Kentucky and George Washington National Forest , Virginia . The course teaches CAP cadets fundamental survival and rescue skills such as shelter building , land navigation , and rock climbing . Advanced Pararescue Orientation Course ( APJOC ) began in the 1980s and was taught only at Kirtland AFB . In 2003 , both programs were cancelled . PJOC returned in 2004 , but APJOC did not see its return until 2008 when the course was moved to Davis - Monthan AFB , Arizona . APJOC builds upon the skills learned at PJOC and exposes cadets to life in an operational Pararescue or Special Tactics Squadron . It plays with a Combat Rescue Training Exercise . During APJOC , Both PJOC and APJOC are Civil Air Patrol National Cadet Special Activities provided by United States Air Force Pararescue . Traditions . Pararescue Creed . Originally titled " The Code of the Air Rescueman " , it was penned by the first commander of the Air Rescue Service , ( then ) Lt . Col . Richard T . Kight and is also still used by the Air Force Rescue Coordination Center ( AFRCC ) . This tradition arose during the Vietnam War , at which point in time the most commonly used helicopter was the CH - 3E , nicknamed the Jolly Green Giant due to its enormous size and olive drab exterior . The tradition came about when pilots or other military personnel were in need of rescue . After these personnel were rescued , they would proceed to receive the tattoo of the green feet on their buttocks due to the fact that the Para Jumpers " saved their ass . " Origin of term " Para Jumper " . The term " Para Jumper " is a retronym of the initials ' PJ ' that were used on an Air Force Form 5 ( Aircrew Flight Log ) to identify anyone who is on board in order to jump from the aircraft . Pararescuemen originally had no ' in flight ' duties and were listed only as ' PJ ' on the Form 5 . The pararescue position eventually grew to include duties as an aerial gunner and scanner on rotary wing aircraft , a duty now performed by aerial gunners . Currently , aircrew qualified Pararescuemen are recorded using aircrew position identifier ' J ' ( ' Pararescue Member ' ) on the AFTO form 781 .