Discussion in 'Military/Tactical/Wilderness EMS' started by RocketMedic, Dec 13, 2011.
That place is never going to leave
Sweet god, these people @ my unit do not understand that I am NOT the NREMT! It's not MODS or MEDPROS, I can't write to it!
Why they can't document their training I don't know, but it's annoying.
Jeez, I hope you're not their training NCO... Between Table VIII validation, and all the MEDIC tables we have to do every year, they should be gtg. Yeah, the hacienda... that was a good time... Well, that and the burger place right off base... The marriott at the riverwalk wasn't bad either.
I'll put my 2 cents in since I graduated from "Factory Sam" this past week.
First off, I was a prior EMS coming into the military and have had experience on both the civilian and tactical side of the spectrum as well. Before I went to the company I graduated with, I had to sit things out, with a few other EMTs and Paramedics who were fasting-tracking also, with another company. So we sat in on the EMT side of the course (Yes - NREMT is required. 3 shots or you're reclassed nowadays). Personally, I thought the 6-7 weeks EMT course they were teaching was BS, from the two weeks myself and the other prior EMS had to sit around and watch. The instructors, so-called Paramedics, were alright, but we were questioning alot of what they were teaching. Not to mention, we were correcting them many times, and they would come up to us at the end of class and ask us "Hey did we teach this right?" Also, once I got to our new company when we finally did fast-tracked, I was amazed at how little the other students retained. Needless to say, all of us prior EMS stuck together as most of these kids didn't know what they were doing. Not going to say it's entirely their fault - it's just how the Army does things, not to mention with the budget cuts nowadays.
Now to the Whiskey side - some of it was fun, but it was boring at the same time. All we were really taught was Cric's, IVs (saline and direct line), NCD, a brief overview of intubations (but we never practiced them...), and a few other skills. Our rapid trauma's were heavily focused on HABC guideline and so forth. I think we did close to 40-50 sticks on each other and then 4-5 on final FTX. Yet even with that amount, there were alot of those were still very incompetent at even the EMT side of the game.
Overall - good course, but I barely learned anything. Looking forward to getting to my unit and actually learning alot more. Sad thing is how many folks were actually pushed through and passed - they tried to scare us all the time by saying that "such and such" would fail you out of the course, yet I was amazed at how many people were couldn't even tell you when you should vent a patient made it through...
Trauma, mainly on our side of the business, is sexy, but it gets old. Stop bleeding, secure an airway, shock, fluids - give or take. I, personally, like the medical aspect of EMS. Why I will be getting my civi Medic and then RN.
As far as the "new" flight medic program. It's interesting - it's the big push they're doing now for Whiskeys. I think out of my class, they had 20 or so going into the new course that starts in April or March. Not entirely sure. Hell, even some of our Whiskey instructors are enrolled in the same class as these new Medics are. And some of the instructors have been flight medics for past few years, yet without the EMT-P cert. I was offered a slot, but I decided to turn it down at this time. I wasn't too keen seeing how the military was going to do with getting a typical 1-2 yr course down these guy's throats in 7-8 months. Not saying it will be unsuccessful, but if it is anything like how they teach the EMT-B course for NREMT, I would rather take a civi-course elsewhere. Granted, it is taught at UT-San Antonio, but still.
Anyways - just my thoughts.
Oh and P.S. - hacienda was torn down lol a new "Student Activity Center" is now being built.
Good to hear your perspective- what's your duty station? I'm 3-41 IN 1st AD at Bliss.
I'm the SPCIC of training- can't write to MODS because I'm an E4, can't get time to train a lot of our new guys because I'm one of the few licensed on the Stryker MEV, can't teach anything beyond TC3 without getting reamed. Had to teach EFMB textbook crap for two months straight because the platoon leadership got retarded. I have E5s trying to teach ETTs by virtue of a day in BNCOC or ALC, then a PA who doesn't think a line medic should be allowed morphine...
I've got a lot of work to do to get them ready. A few have learned well though.
Shipping out to CP Casey, Korea (fml...) with 2nd ID in a month for a year tour. Should be interesting, to say the least. Good time to explore and see another culture, though I suppose.
Yea I agree - even in TRADOC spectrum, each E5 and above had a different standard on how they teach and expect things done, which I understand to an extent; but that's the military for you...
I dunno - to be honest, I would've graduated about 25 folks out of the company (about 220 folks). Half of them don't even want to be Medics, and another quarter have a permanent alerted mental status. Only a few I see worthy of actually going hands-on a real patient. Maybe it's my background in civi-EMS, but so far, not entirely too impressed with military medicine. Hopefully it gets better, but so far, I need to see a chiropractor for how much I just shake at my head at the system and many of the folks involved.
The best I can tell you is that the Army will give you a combination of the best and worst training you have ever had--- learn how to filter out the :censored::censored::censored::censored:ty advice you'll get from burnt-out medics.
Also, don't expect to be trained adequately by your unit. Latch on to your PA and do nothing but ask questions. Don't get upset if you get sniped on something medical, just go home, study, and come back ready for more. Before long, you'll find that your effort pays off.
I nearly snapped today- I have to teach "all of your paramedic airway stuff, but only how you do it, and you're also going to have to do it in two hours".
That was today. Last week was a brand new SPC trying to pull his rank on a PV2 doing the right thing when he messed up, then complaining I was unfair to expect homework and intelligence from him.
Five more months. .
I ran into this post looking for information on how whiskey school used to be because of how stupid easy basic was I thought maybe ait had gotten easier as well. It seems this is the case.
I began ait here at ft Sam a few weeks ago we are just moving into pharmacology and just finished the primary assessment module. Our instructors seem to do a decent job but I have no basis for comparison. There are many incompetent soldiers who don't seem to put forth effort. I hope none of us get cut any slack. I feel our mos requires a full commitment and should never be subject to being filled with warm bodies. I realize I don't know :censored::censored::censored::censored: about what's going on yet but well see how ait pans out
Welcome to the herd.
Saw this and figured I'd chime in. Anyone who's been to 68W school (or any of its predecessors) knows you spend more time in class trying to stay awake and waiting for the next gut truck break for more coffee than you spend actually learning. That being said how "good" new students come out of it depends on your viewpoint. If you think that school exists JUST to teach new medics enough so they can go to their unit and learn then it does its job. If you're expecting competent medics straight out of it, then it fails pretty badly. Just to put my own 2 cents into it, I think they need to cut out a lot from the 68W program and leave it to units to train their new medics. A program that spends 8-10 weeks drilling JUST TC3 will get a lot better results than one that tries to cram pharmacology, sick call medicine, clinical medicine, etc etc etc into that time frame. The medical skills used in TC3 are the only ones a brand new medic would need to have down to a T, anything else there will be plenty of other medics/providers around to teach him and push him out of the way if needed.
Dear God, the new ones are even worse!
How do you graduate four people who don't even understand how tourniquets work?
New generation of medics
I feel AIT focuses more on TC3 than NREMT, as it should. Most of these new medics will go off to a battle field where they will need more of the trauma skills than anything else. Combitubes, King LTs, Cric's, IV's, splinting, tourniquets, etc. . . Most of these soldiers will first be line medics. They'll be with a casualty no more than 20 minutes. By that time they should be MEDEVAC'd to a CSH where they'll receive higher level of care from a PA, M6's and RN's. In that first 20 minutes there's hardly any time for medical assesments and there aren't too many drugs they'll be pushing, except maybe morphine. Stop the bleeding, secure that airway, move out.
That's also why they're emphasising Hextend. They're probably going to be dealing with some major blood loss considering the injury is probably from trauma. 1 or 2 bags of Hextend is my first choice as opposed to 4 L of NS, absent radial pulses.
I wish we could abolish the NREMT requirements, but that's a political/fiscal decision.
The views and attitude expressed above are why we have horrible medics and extremely poor knowledge bases.
20 mins, eh? If you're lucky. Air assets are finicky. Had to sit on someone for 14 hours who got stitched up by an AK, and while we were doing transfusions, RSI, F.A.S.T exams, treating arrythmias, placing two chest tubes,the " whiseys" were standing around bull:censored::censored::censored::censored:ting.
Thats what continuing education if for, because if youre only good for 20 mins, your spot is better filled by a SAW gunner.
I'm not a 68W by any stretch, I'm a Paramedic that hasn't gone through TCCC (PHTLS yes) but 20 minutes is a LIFETIME in terms of amount of time to do an assessment. Really. Open an airway, check for and stop life-threatening bleeding, head to toe, secure an airway, start a line, have someone call in MEDEVAC, package for transport... Ok, now about that next 10 minutes?
Hextend is being emphasized for (IMO) one reason: it's light and small in volume for the plasma expansion you can get from it. You can fit more bags of the stuff in your pack than you can of Normal Saline. Can you precisely control the amount of expansion that will occur once the hextend is infused? Can you guarantee that said volume expansion won't cause clots to pop, leading to further hemorrhage and thus you needing to administer another bag of hextend?
Doczilla and Rocketmedic40 are right... and sometimes, you won't be able to get that person out in 20 minutes for lots of reasons, not the least of which is that the area you're in is too dangerous/risky for the MEDEVAC to occur at that time...
I had to make sure I read the "20 minutes" part correctly. A cat A doesn't have 20 minutes prior to air to be stabilized. Any cat A that I ever saw unfortunately died within the first 5 min from being categorized as such. Hextend isn't a god send, I'm not sure what they brainwashed new 68w with but there is lots of literature on its "actual" efficacy in the field which isn't propped up by the military. So you better learn that 20 minutes in the field is a decade in real time, you had better learn to work and do assessments in less than 5 minutes because unfortunately that is all some poor soul including yourself may be faced with one day.
20 mins blows by when you're still in heavy contact. Time warps when bullets are whipping the leaves in the trees around you.
In the infantry 20 minutes flew by...as a medic with multiple cat a it's an eternity
[SARCASM]That's all Doc-level stuff, I only need to worry about TC3![/SARCASM]
Don't be too mad, Doczilla. Most of them aren't in it for good medicine.
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