States and EMT-B Morphine Administration

[RocketMedic]

Who says army medics are "poorly trained EMT-b's"?? Thats quite an insult and i hope you have some proof to back it up.

Do you disagree?

 

[paradoqs]

Why are they poorly trained? I would imagine there are alot if opportunities to get experience, especially trauma.

 

[RipCity]

Do you disagree?

I would totally disagree. How can you say that after 5 months of training they are merely "poorly trained emt-b's"? Even brand new cherry medics have have a huge amount of knowelage compared to a civilian trained basic. IV/IO access, needle decompression, cric, morphine/antibiotics, chest tubes just to name a few skills.

 

[JPINFV]

Because dealing primarily with traumatic injuries, and the corresponding infection, in generally healthy and young patients is totally a similar patient population and presentation as found in civilian EMS.

 

[Tigger]

Why are they poorly trained? I would imagine there are alot if opportunities to get experience, especially trauma.

Plenty of experience in dealing with trauma I am sure. However how much significant trauma is the average EMT-B dealing with? Not that much...

I would totally disagree. How can you say that after 5 months of training they are merely "poorly trained emt-b's"? Even brand new cherry medics have have a huge amount of knowelage compared to a civilian trained basic. IV/IO access, needle decompression, cric, morphine/antibiotics, chest tubes just to name a few skills.

You don't judge a provider's competency by their list of skills. If my dog was a touch smarter, I'd teach him to crich too.

 

[RipCity]

Because dealing primarily with traumatic injuries, and the corresponding infection, in generally healthy and young patients is totally a similar patient population and presentation as found in civilian EMS.

Was that sarcasm? Deal primarily with traumatic injuries? Well there arent many GSW's and blast injuries back on base in the states. So what do medics do? They run sick call. They write soap notes on anything from chronic pn, injuries and illness. I cant even remember how many times some of the older soldiers came in after physical training with dizziness and chest pn. Who does the immunizations for the whole unit of 300 soldiers? Medics. Blood draws? Medics. In iraq i had to deal with civilian medical problems when out on patrol, all through in interpreter. I can go on all day. As long as were comparing military EMS to Civilian EMS, almost everything a medic does in the field is out of a aid bag the size of a normal backpack. They dont have the luxury of a fully stocked ambulance. So to merely give them the title "poorly trained emt-b's" to me is BS. Thats all im sayin.

 

[JPINFV]

Oh, immunizations and blood draws? Wow, SOAP notes too! [sarcasm]Oh, impressive. [/sarcasm] So, how many antibiotics do you have access to and to treat which diseases, or are you simply shotgunning everything with a second generation cephalosporin? Do you get a culture before throwing antibiotics at the situation, or is this more of a "does it burn when you pee? Oh, look, positive for leukocyte esterase and nitrates, here's some trimethoprim-sulfoximide" style straight up clinical diagnoses?

 

[Handsome Robb]

I would totally disagree. How can you say that after 5 months of training they are merely "poorly trained emt-b's"? Even brand new cherry medics have have a huge amount of knowelage compared to a civilian trained basic. IV/IO access, needle decompression, cric, morphine/antibiotics, chest tubes just to name a few skills.

Can your average 68W explain the physiology about what's happening? Or is it a "monkey see, monkey do" type thing? None of those skills are really that difficult to perform...It's the knowing when and why that becomes the more complex part.

Not an attack, I truly am wondering.

 

[ffemt8978]

It's the knowing when and why that becomes the more complex part.

Not an attack, I truly am wondering.

I'd argue that even more important than that is when NOT to do them.

 

[Handsome Robb]

I'd argue that even more important than that is when NOT to do them.

Touche salesman.

 

[RocketMedic]

I would totally disagree. How can you say that after 5 months of training they are merely "poorly trained emt-b's"? Even brand new cherry medics have have a huge amount of knowelage compared to a civilian trained basic. IV/IO access, needle decompression, cric, morphine/antibiotics, chest tubes just to name a few skills.

68w's are trained to recognize and apply initial aid to massive life threats. They aren't taught how those interventions work, why they work, or what to do next. They are not trained as to what medications they commonly carry, what those medications do, or how to give them. They are not trained on medical assessments or on focused exams. They are not trained to think beyond a nine-line. Their charts are simplified nearly to the TC3 card. Their "sick call" consists of following algorithms or taking vitals and a spoomfed history and asking a PA or NCO. They are not trained at triage, treatment of non-typical wounds, or most medical maladies.

A 68w is trained to CLS+. They are taught a few skills and sent out. The burden of training is on the individual and the receiving unit.

If I have a limb amputated or a penetrating chest wound, a 68w can provide good BLS care and mediocre ALS. Anything else is a crapshoot.

Before you ask, I am an exception to the rule. I'm an active E4, a paramedic, and I work part time outside. IIlve also been a line medic downrange in Hawkish Province, Iraq

 

[RipCity]

Can your average 68W explain the physiology about what's happening? Or is it a "monkey see, monkey do" type thing? None of those skills are really that difficult to perform...It's the knowing when and why that becomes the more complex part.

Not an attack, I truly am wondering.

Well they can be difficult to do while only wearing NODS(night vision) or after you just got shot at, or after a mortar landed 20 meters from you and you have been in 120 degree heat with 120 pounds of gear on all day... so yea id say a bit more difficult. And yes combat medics learn alot of anatomy and physiology. They dont just hand you equipment without explaining indications/contraindications. Im not here to try and convince you all that army medics are the most BA MF medical personell walking the earth, but when someone casually refers to something i spent 4 years working my *** off doing as just a "poortly trained EMT-Basic", then i get a bit offended.

 

[RocketMedic]

Why are they poorly trained? I would imagine there are alot if opportunities to get experience, especially trauma.

This is highly unit dependent. A medic assigned to a hospital will quickly become, at a minimum, technically competent. A line or support medic will not receive much musical training, and what training they do get will often be either tied to TC3 point of injury care or EFMB memorization.

Some units are exceptions, and some medics are far better trained.

 

[RocketMedic]

Well they can be difficult to do while only wearing NODS(night vision) or after you just got shot at, or after a mortar landed 20 meters from you and you have been in 120 degree heat with 120 pounds of gear on all day... so yea id say a bit more difficult. And yes combat medics learn alot of anatomy and physiology. They dont just hand you equipment without explaining indications/contraindications. Im not here to try and convince you all that army medics are the most BA MF medical personell walking the earth, but when someone casually refers to something i spent 4 years working my *** off doing as just a "poortly trained EMT-Basic", then i get a bit offended.

That's what a 68w is. To pretend anything otherwise is dishonest. That being said, there are exceptions. My last PA handed out medications and never bothered to explain much of anything, and somehow expected his treatment squad to understand EKGs with no instruction. My new PA is much better.

Dude, 68ws have NCOs who don't know what 10mg of MS is, much less how to give it or why/what it does. Asking what it is is a whole new level of pointless.

 

[ffemt8978]

A line or support medic will not receive much musical training,

That's a good thing. I don't want my medic serenading me with the blues.

 

[RocketMedic]

Well they can be difficult to do while only wearing NODS(night vision) or after you just got shot at, or after a mortar landed 20 meters from you and you have been in 120 degree heat with 120 pounds of gear on all day... so yea id say a bit more difficult. And yes combat medics learn alot of anatomy and physiology. They dont just hand you equipment without explaining indications/contraindications. Im not here to try and convince you all that army medics are the most BA MF medical personell walking the earth, but when someone casually refers to something i spent 4 years working my *** off doing as just a "poortly trained EMT-Basic", then i get a bit offended.

Adverse conditions are not an acceptable excuse for poor education and shouldn't be an excuse for poor care. Besides, even in an infantry role, those situations are uncommon, and the interventions are CLS-level.

I have new medics who can't tell me what an IV IS, much less how/why it works, when or where to start one, and what can be done with it. Theuly literally only know for volume replacement and dehydration, and can't even explain how fluids correct those.

 

[RipCity]

68w's are trained to recognize and apply initial aid to massive life threats. They aren't taught how those interventions work, why they work, or what to do next. They are not trained as to what medications they commonly carry, what those medications do, or how to give them. They are not trained on medical assessments or on focused exams. They are not trained to think beyond a nine-line. Their charts are simplified nearly to the TC3 card. Their "sick call" consists of following algorithms or taking vitals and a spoomfed history and asking a PA or NCO. They are not trained at triage, treatment of non-typical wounds, or most medical maladies.

A 68w is trained to CLS+. They are taught a few skills and sent out. The burden of training is on the individual and the receiving unit.

If I have a limb amputated or a penetrating chest wound, a 68w can provide good BLS care and mediocre ALS. Anything else is a crapshoot.

Before you ask, I am an exception to the rule. I'm an active E4, a paramedic, and I work part time outside. IIlve also been a line medic downrange in Hawkish Province, Iraq

I dont know know when you went through medic school, but i went through in 2005 and it was the complete opposite. Maybe they have relaxed the standards since then, i dont know. Anyways i wasnt just a "poorly trained emt-b" so thats why i said what i did.

 

[RocketMedic]

Was that sarcasm? Deal primarily with traumatic injuries? Well there arent many GSW's and blast injuries back on base in the states. So what do medics do? They run sick call. They write soap notes on anything from chronic pn, injuries and illness. I cant even remember how many times some of the older soldiers came in after physical training with dizziness and chest pn. Who does the immunizations for the whole unit of 300 soldiers? Medics. Blood draws? Medics. In iraq i had to deal with civilian medical problems when out on patrol, all through in interpreter. I can go on all day. As long as were comparing military EMS to Civilian EMS, almost everything a medic does in the field is out of a aid bag the size of a normal backpack. They dont have the luxury of a fully stocked ambulance. So to merely give them the title "poorly trained emt-b's" to me is BS. Thats all im sayin.

Blood draws and SRP immunization drives are about as cookie cutter as it gets. Screen patients, prep injections, inject and chart. I can do those in my sleep.

 

[ffemt8978]

Why don't you two take this discussion of military medics to the Military/Tactical/Wilderness Forum, where it would be more appropriate for it's own thread.

Otherwise, you two will create more work for me here.

 

[RocketMedic]

I dont know know when you went through medic school, but i went through in 2005 and it was the complete opposite. Maybe they have relaxed the standards since then, i dont know. Anyways i wasnt just a "poorly trained emt-b" so thats why i said what i did.

There's a rumor from our new guys that the NR will be optional as of this month. We get our next crop in March, so Ill know then if standards have further slipped.

Did you and/or your peers really understand what y'all were doing?