# Tactical Medic Training



## Vetitas86 (Mar 22, 2012)

I'm sure this has been asked before, but I've got a million things to do before I Google it. 

Anyone know about the TacMed schools, how they train, etc?

Also, are there any in Texas or the Southwest?

Thanks as always, guys and girls.


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## DrankTheKoolaid (Mar 23, 2012)

That depends on what you are looking for.  First if your serious about getting involved with a team, contact their training officer and start from there.  Typical teams will have in house training + formal training at X course.  East coast seems to just use TCCC.  Understand that TCCC is only part of tactical medicine.  But if you want full recognition look for a full Tactical program.  

With the newly formed American College of Tactical Physicians this year there is only 1 program that meets their requirements for admission so far with that being Module A,B and C of the International School of Tactical Medicine.  They are already working on allowing Medics and LEO officer who go through them to be recognized through the college also.  

Module A, B and C will take a FULL 3 weeks to complete.

Www.tacticalmedicine.com 

I went through A and B earlier this year and it was worth every penny,  going to C later this year to qualify to test for board recognition


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## Vetitas86 (Mar 23, 2012)

Thanks! I'll give it a look. 

I had taken a basic law enforcement course, but due to life...had to drop. Loved it and loved the guys and girls in it. I figure it'd be a way to get involved in that end again.


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## DPM (Mar 23, 2012)

I'm missing the point here... Are you a civilian? What does a tactical medic do? I can't imagine PD would have you up front kicking doors in with them...


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## Vetitas86 (Mar 23, 2012)

Yeah, civ. 

From what I understand, tactical medics deal with casualties in LE operations. 

Clarification is welcome.


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## DrankTheKoolaid (Mar 23, 2012)

Yes, depending on the team you will either be in the stack (kicking doors in) or will be outside in the hot zone or in the warm zone waiting to enter after initial entry has been made.  

It is all team and state guideline dependent  on if  you will be armed.  At ISTM you will train heavily on tactics and will qualify using a Sig 229 and a MP4 sub machine gun


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## DPM (Mar 23, 2012)

So what sort of tactical training would you require? In my mind it would be cheaper to train a bunch of cops as EMTs rather than training EMTs as cops


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## DrankTheKoolaid (Mar 23, 2012)

DPM said:


> I'm missing the point here... Are you a civilian? What does a tactical medic do? I can't imagine PD would have you up front kicking doors in with them...



Go to the link I posted.  You will get a ton of information about SWAT medicine and care in austere conditions


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## Vetitas86 (Mar 23, 2012)

To me it seems six one way, half a dozen the other. Either way, you're cross training.


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## DrankTheKoolaid (Mar 23, 2012)

Correction on the sub gun. You'll use the MP5


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## DrankTheKoolaid (Mar 23, 2012)

There was 1 airforce EMT in our 2 week cycle.  All others were MD and Paramedic.  No, an EMT doesnt have the scope to do what would be needed when people started getting shot or exposed to chemicals etc etc.  And non tactical crews wouldnt be able to do anything until it was completely rendered a safe area, where as a tactical medic can provide care underfire as needed.


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## Vetitas86 (Mar 23, 2012)

Just sayin, Corky. You're the bomb. 

And MP5? :thumbup:


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## DrankTheKoolaid (Mar 23, 2012)

Lol Im new to the tactical world other then military training (wasnt medical in the service).  And only reason I went into it is to support our local LEO's.  They like us deserve to go home at the end of their shifts.


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## PG506 (Mar 25, 2012)

*Here is an excellent course*

This course includes the NAEMT TCCC card


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## AnthonyM83 (Mar 25, 2012)

Great in theory, but what is the actual job outlook like? I've heard of many civilians taking these courses at expensive rates with no jobs.

Almost all the tactical medics I know are cops on the SWAT team and on for 20+ years often. SWAT is a harder position to get and getting picked for paramedic training even harder. The civilian tac medics I've heard of are prior military. And if I was a cop on the SWAT team I'd much prefer another cop with years and years of experience with very specific medical training being on any scene that might require a tactical component in order to treat...


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## Vetitas86 (Mar 25, 2012)

I would think it'd be a better chance of getting the job as either current it previous LE. Either that or advanced certs for EMT-P.

I may look into it. I have a buddy who works SWAT.


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## PG506 (Mar 26, 2012)

*Tactical Medic Training Options*

There are other Tactical/operational programs that meet or excede recommended requirements available in the US that are excellent programs. I posted a link to one of those courses. The link takes you to a course in Texas conducted by Cypress Creek Advanced Tactical Team's it is he Basic Tactical Operational Medical Support Course. I have consulted with similar programs but this is one of the only courses that includes the NAEMT TCCC curriculum with topics that are based on current task performed by Tactical Medicine Operators that support LEO at a federal and local levels. With the need to bring medicine into tactical situations these programs are becoming more valuable everyday.


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## Vetitas86 (Mar 26, 2012)

For what its worth, I kind of see it as a way for EMS to get into international contracting as well.


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## bigbaldguy (Mar 26, 2012)

PG506 said:


> This course includes the NAEMT TCCC card



Emergency dental care?


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## Vetitas86 (Mar 26, 2012)

"I've got a nasty chipped tooth, you see, Mr. Paramedic."


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## PG506 (Mar 26, 2012)

*Emergency Dental Care*

The dental care,canine care and other topics are part of the extended care. With expanded scopes of practice it is the responsibility of the team medic to keep the team healthy and if a gap analysis is performed and dental was seen on a higher frequency then it is a topic that should be covered. Eye injuries, sports type injuries, infections were some of the items seen in areas such as Katrina, Haiti and on overseas contracts. Tactical Medicine is much more that clearing houses ands weapons manipulation it is a way of life for a select few who chose this a their profession. I hope this helps answer why emergency dental care.


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## bigbaldguy (Mar 26, 2012)

PG506 said:


> The dental care,canine care and other topics are part of the extended care. With expanded scopes of practice it is the responsibility of the team medic to keep the team healthy and if a gap analysis is performed and dental was seen on a higher frequency then it is a topic that should be covered. Eye injuries, sports type injuries, infections were some of the items seen in areas such as Katrina, Haiti and on overseas contracts. Tactical Medicine is much more that clearing houses ands weapons manipulation it is a way of life for a select few who chose this a their profession. I hope this helps answer why emergency dental care.



So it focuses on a long term mission support idea rather than a strictly emergent care idea. Makes sense.


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## PG506 (Mar 26, 2012)

*one or two week courses*

Yeah Its a different approach to what I thought civilian Tactical Medicine was. I was an Army Medic for 13 years and for the past few years I have had my eyes opened. I realized that the medicine was the same the environments the only real difference is the Scope of practice and the aggressiveness. Right now is an exciting time to be apart of Tactical Medicine. I can tell you that all of the big news arrest involving violent offenders have tactical trained medics real close to the action or on the objective. This is a great post i just became aware of EMTLIFE. I have a Facebook page with videos and pics named Tactical Combat Casualty Care (TC3) check it out sometime. I can not post links yet. as soon as I figure out how to post vids and pics I will.


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## Vetitas86 (Mar 26, 2012)

Bump because I just liked the page.

Cool stuff. 

Any word about the contracting thing though?


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## DrankTheKoolaid (Mar 26, 2012)

PG506 said:


> There are other Tactical/operational programs that meet or excede recommended requirements available in the US that are excellent programs. I posted a link to one of those courses. The link takes you to a course in Texas conducted by Cypress Creek Advanced Tactical Team's it is he Basic Tactical Operational Medical Support Course. I have consulted with similar programs but this is one of the only courses that includes the NAEMT TCCC curriculum with topics that are based on current task performed by Tactical Medicine Operators that support LEO at a federal and local levels. With the need to bring medicine into tactical situations these programs are becoming more valuable everyday.



What other programs?  I was present when Dr. Heiskell received member #000001 of the American College of Tactical Physicians (not to be confused with ACEP) and the Presiding President stated the only way to get into it at the moment is through ISTM Module A and B  which covers standard tactical operation and medicine while module C covers executive protection, shotguns and concealed weapons.  Unfortunately the one you posted does not concentrate on weapons which would be the issue with it.  Why go to a tactical medicine course if weapon safety and use are not part of the concentrated course.


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## PG506 (Mar 26, 2012)

*Misspoke*

I apologize I did make a mistake I was speaking of Another recommendation for tactical training. Every program has own emphasis weapons manipulation is covered in BTOMS but not the focus. Medicine is the major focus the thought behind that is every team is different and if you are on a team SWAT school is where you get your tactics and training days is where you combine good medicine and tactics. I train SWAT teams all over the US and their tactics are all different. The course you are describing sounds like a great course and I am going look into it. Sorry again for misrepresenting the BTOMS program earlier.


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## PG506 (Mar 26, 2012)

*Looks good*

The program looks good from what I can see on the website. The only thing that concerns me is there is a lot of products companies sponsoring the course. Do they utilize different varities of products such as cats vs softt and hyfin vs h&h chest seals. If they do then that's great. I went to a course a few years back and I thought it was an infomercial. With their reputation I am sure that's not the case. But like I said before its an exciting time to be in Tactical
Medicine and if you find good training it's better than no training.
I trained some contractors that had no medic
Traing two weeks from shipping date. I know some
One asked about contract jobs create a linked in page and you will
Find multiple groups posting jobs daily. SOC
Seems to be active. Africa seems to be a hot spot
For medics. The NAEMT Card helps since it
Is recognized Internationaly I get tons of
Request by contractors.


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## PG506 (Mar 26, 2012)

Sorry the NAEMT TCCC card


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## Vetitas86 (Mar 26, 2012)

While we're on the subject...

Cross training TEMS with law enforcement? And for that matter, unarmed vs medics packing heat?


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## DPM (Mar 26, 2012)

I still feel like training PD to be medics is easier and cheaper. This way you don't require an extra guy on scene. I'm looking at things in the same way the we did in the army. Not every patrol had a medic, but they all had infantry types who were team medics. They wouldn't know how to deal with a stroke, or a normal 'medical' call but then they didn't have to. They dealt with things at the tactical level, which was IED strikes and GSW 90% of the time. I don't see the need for tactical dentistry, or any of this primary care type stuff, at the tactical level.

Why does a SWAT team need a tactically trained Medic for their primary care? If these guys aren't old enough to recognize that they are sick / injured then you've got bigger problems.

Train the LEO's how to deal with gun shot wounds. Issue pressure dressings and train them how to use them. That would be cheaper, and if everyone knows what to do then it doesn't matter who gets hit.


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## DrankTheKoolaid (Mar 26, 2012)

DPM said:


> I still feel like training PD to be medics is easier and cheaper. This way you don't require an extra guy on scene. I'm looking at things in the same way the we did in the army. Not every patrol had a medic, but they all had infantry types who were team medics. They wouldn't know how to deal with a stroke, or a normal 'medical' call but then they didn't have to. They dealt with things at the tactical level, which was IED strikes and GSW 90% of the time. I don't see the need for tactical dentistry, or any of this primary care type stuff, at the tactical level.
> 
> Why does a SWAT team need a tactically trained Medic for their primary care? If these guys aren't old enough to recognize that they are sick / injured then you've got bigger problems.
> 
> Train the LEO's how to deal with gun shot wounds. Issue pressure dressings and train them how to use them. That would be cheaper, and if everyone knows what to do then it doesn't matter who gets hit.



Well not all Tactical is urban.  Primary care comes into play out here in the sticks when a LEO team has been camping crops or whatever for days.  Do you really think they want to leave cover and expose themselves on foot to go to a dentist for example?  And not only will he leave alone he will have to take another member with him for safety.  Primary care comes into play when they receive a laceration that needs to be managed on the spot, or a fracture is causing to much pain.  Would the typical medic know how to do a regional block?  What if they were allergic to lidocaine, did you know you can use diphenhydramine for local anesthetic.  Walla tooth ache gone long enough to finish mission or broken finger no longer his sole focus and he can concentrate on the task at hand.

There is so much more to tactical EMS then you know.  Go take a class and find out for yourself why it is a specialty


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## DPM (Mar 26, 2012)

Corky said:


> Well not all Tactical is urban.  Primary care comes into play out here in the sticks when a LEO team has been camping crops or whatever for days.  Do you really think they want to leave cover and expose themselves on foot to go to a dentist for example?  And not only will he leave alone he will have to take another member with him for safety.  Primary care comes into play when they receive a laceration that needs to be managed on the spot, or a fracture is causing to much pain.  Would the typical medic know how to do a regional block?  What if they were allergic to lidocaine, did you know you can use diphenhydramine for local anesthetic.  Walla tooth ache gone long enough to finish mission or broken finger no longer his sole focus and he can concentrate on the task at hand.
> 
> There is so much more to tactical EMS then you know.  Go take a class and find out for yourself why it is a specialty



I did that, as my job, in places that we far more dangerous than you find over here. If we had tooth ache, we manned up and dealt with it. If you have a broken leg, what good are you anyway?

I dunno, you clearly see the need but I don't.


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## PG506 (Mar 26, 2012)

*Cross training*

Cross training is very important all team members should be able to control bleeding, breathing and other life threats. If you are making entry you should be in the armed if you are armed you should be a leo/tacmed. There are several teams that are highly successful unarmed and armed as well. The key is knowledge Sharing. Now I briefly read a comment about training Leo to be Emts. Either way it takes time to balance the two. The medic should have medical expierence but again either way it takes time to be tactically and medically sound.


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## DrankTheKoolaid (Mar 26, 2012)

DPM said:


> I did that, as my job, in places that we far more dangerous than you find over here. If we had tooth ache, we manned up and dealt with it. If you have a broken leg, what good are you anyway?
> 
> I dunno, you clearly see the need but I don't.



The unfortunate reality is in the military casualties are not only acceptable it is expected.  Such is life as a soldier, you are simply a pawn in someones elses chess game.  I was a Forward Observer and fully understand the consequences of being a soldier.

In Civilian life a casualty is never expected nor is it ever accepted.


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## Vetitas86 (Mar 26, 2012)

Dunno how I feel about the primary care bit. Oversteps scope of practice to me.

But that's how I see it. Tac teams should be trained in at least some level of medical care, but having a medic there could improve survival rate if something went south, as well as providing emergent care to casualties beyond the range of first aid/BLS. 

Sure, not every operation goes south, but not every ambulance call is a "true" emergency. Just because its not common doesn't mean it isn't helpful or necessary. 

As far as cross training, I do believe medics should be armed and trained at least in personal defense, and have at least a working knowledge of law enforcement procedure to be able to function as a member of a tac team.


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## zmedic (Mar 27, 2012)

One way of looking at it is that if a tactical team isn't full time, training a medic in the SWAT part isn't that expensive. Many of them want to do it and would do it as a volunteer, or their ambulance service pays their hours with SWAT as part of the contract with PD. Contrast that with the expense of taking a police officer and spending lots of money putting them through a paramedic course. Futhermore, if you want someone who will provide good medical care in stressful situations there are advantages to those who are full time medics as they run calls every day. 

I've heard from those who are MDs and work with SWAT that much of what they are doing is basically sports medicine, helping the team with nutrition plans and dealing with injuries like strains and tendonitis from training.


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## DPM (Mar 27, 2012)

Realistically, does you tactical provider need the full training / scope of a paramedic? In the tactical situation. Dealing with bleeding and life threats and maybe hanging an IV... would they need ACLS? Would they need to push any drugs? Medical Aid in a tactical situation is very limited. Deal with / stabilize the ABC's and then evac the casualty. You aren't definitive care, and neither is the Ambulance. This guy needs a hospital, there's not a lot any of us can do, let alone in the tactical environment.


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## EpiEMS (Mar 27, 2012)

DPM said:


> Deal with / stabilize the ABC's and then evac the casualty. You aren't definitive care, and neither is the Ambulance. This guy needs a hospital, there's not a lot any of us can do, let alone in the tactical environment.



Makes sense. And it fits with TCCC guidelines — they're essentially

1. Deal with major hemorrhage
2. ABCs come after — when you're not getting shot at

Source:
http://www.naemt.org/Libraries/PHTLS TCCC/TCCC Guidelines 101101.sflb


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## DPM (Mar 27, 2012)

EpiEMS said:


> Makes sense. And it fits with TCCC guidelines — they're essentially
> 
> 1. Deal with major hemorrhage
> 2. ABCs come after — when you're not getting shot at
> ...



This makes sense to me, and I don't think it unreasonable to expect your SWAT etc to be able to do this.

It's the broken leg / tooth ache stuff that I don't understand.


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## DrankTheKoolaid (Mar 29, 2012)

*re*

Follow me on this one.  

So your a Tactical Paramedic assigned with the local marijuana eradication task force for example.  You and the team just spent 3 hours hiking through the forest high in the mountains with not a single dwelling within 40 miles in any direction on a rainy day. (Read, no air support).  One of the team members just (insert injury/illness here).  The mission has to be completed and with a little outside of the standard 911 box ALS treatment has been applied it can, unless obviously it is a life threatening injury or illness then plans will change.  And if it is life threatening and there is a 3 hour hike back to the nearest vehicle who do you want in the team,  A EMT with basic first aid training, or MD/Paramedic with an expanded scope of practice for Tactical Operations to take care of whatever it is.

You have to think outside of the little box you seem to have Tactical Medicine closed into.  Not all Tactical Medicine is urban and in my neck of the woods that scenario above would be the rule and NOT the exception.  

And remember TCCC is not Tactical Medicine, It's just a very small component of it and established their own minimum requirements


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## EpiEMS (Mar 29, 2012)

Corky, I follow your reasoning, certainly, but I was under the impression that even the military operates with people trained to a level less than the paramedic level, excepting special operations — the Army's 68W is basically an EMT/EMT-B plus IV fluid administration and needle decompressions, as far as I can tell.


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## DrankTheKoolaid (Mar 29, 2012)

I think your right on Military medic scope.   And how many soldiers die in the military under the care of the EMT trained medics, alot.  Not saying a Paramedic or MD at scene would have a better success rate with alot of the injuries they sustain.  Causualties are accepted in the military otherwise all military medics would be trained to the paramedic level at a minimum to ensure the least amount of deaths.  But alas it is not.

Civilian world is just that, civilian, and no LODD is to ever be accepted and that is why they need higher level of care available then BLS level care.


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## Shibumi (Apr 8, 2012)

*Tac Medic?*

Howdy,
I am new to this forum, but very interested in this topic specifically. 

I just passed EMT-B and am now in EMT-I, with the goal of Paramedic. Ultimately I would like to be a very solid medic with a specialty in Tac Med.
My background if former LEO, with the last 11 years spent in Dept of Energy SRT unit. I currently serve as a Team Leader/Instructor. In a nutshell, I spent last decade learning to make holes, and now I want to be really good at closing them!
For the record, I am not currently TacMed, however I do have the perspective to see the added value they offer.
Often times TM is brought into the hot zone of a raid, or hostage situation. Now we all know local Fire, etc. is NOT coming in until it is completely SAFE.
That leaves TM to fix and stabilize ANY problems they can, as they are the only available resource. Here are a few scenario pics which I foresee.

1-Hostage scenario with multiple hostages of various age, health levels, and injuries. These injuries may have been incured during seige, or during rescue. Either way, the high stress situation could aggravate numerous health issues.

2-Drug interdiction Direct Action raids. These tend to be helo insertions, or long hikes to target. Either way, mechanical injuries can occur, various medical problems can arise unforseen, and then you have actions on target. If you happen to have suspects in custody, who are essentially "hostages" of the cartel, then you also run into various levels of health, illness, injury, etc. 
Many of the personnel used as labor on these remote locations are told that they either stay and fight, or their family gets hit back home. 
Lets say you have an informant or undercover agent working the scene and they get hit accidentally. Or they get made and are tortured by the bad guys. Either way, it is going to be ugly. 

3-Females on scene. Many females, good or bad are involved in these situations, and that can involve voluntary or involuntary participation, but regardless, it would be beneficial to know how to treat pregnant women, etc.

4-K-9 involvement is very high in High Risk Operations, and I for one would like to at least be of some help if the pooch takes a round. Having dogs of my own, it would kill me to watch a service dog die unnecessarily due to my lack of training. 

5-Human Traffiking is on the rise and often tied into drug operations. It is very conceivable that you could be treating civilians in the interim until the scene is safe and EMS comes in. 

As far as training the cop or the emt, I would have to say EMT is very demanding, and is one of the hardest things I have done. Our class started with 26 and ended with 7. 
With that being said, you are either a shooter or you aren't. You can teach someone to shoot a weapon, but for SWAT/SRT operations, your a natural or you don't belong there. 
I was just recently told of 4 EMT medics hired to work for a top level State Dept Overseas Contractor. The medics were great on the street, but had zero tactical sense. While flying overwatch in a helo, a medic was supposed to be covering right side of aircraft. His partner, a Ex-Special Forces Medic/Sniper looks over, and sees his partner playing with is Play Station. 
Needless to say, they are not happy with the tactical proficiency that the medics bring to combat operations in a hot zone. 

As soon as I have my EMT-I completed, I hope to attend the International School of Tactical Medicine. It is highly rated and outside of Airforce Pararescue, I think it would be hard to beat for an accredited training program which should be recognized elsewhere for future work. CTOMS is the poop, but very hard to get into and limited slots. 

I don't know it all, and always have more to learn, but I believe this is the best use of my skill sets in this dangerous and ever changing world.


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## duncklee5 (Apr 9, 2012)

Yes absolutely right tactical information/training is most important to learn to move forward in your field,the tips or we say the info you provide here related to tactical medical training define everything so professionally and i came to know so many things informative from here.


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## duncklee5 (Apr 18, 2012)

Thanks that you guys given so much info related to this tactical training i really appreciate your way of describing.


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## DPM (Apr 21, 2012)

Corky said:


> The unfortunate reality is in the military casualties are not only acceptable it is expected.  Such is life as a soldier, you are simply a pawn in someones elses chess game.  I was a Forward Observer and fully understand the consequences of being a soldier.
> 
> In Civilian life a casualty is never expected nor is it ever accepted.



I know you're not intending to, but your opinion on this is verging on offensive. And your later comment on soldiers dying at the hands of 'only' EMT's highlights the fact that you don't yet know a lot about this subject.

Did you ever think that the level of medical training provided on the ground was actually well thought out and entirely suitable? Combat medics don't need to be able to use an ECG, or treat a stroke, or most of the actual things that civilian paramedics do. Instead they are thought how to deal with the types of injuries that they're going to encounter, and they do a fantastic job of it. And to even suggest that troops are dying because the medics aren't trained well enough... I'd love to see some proof to back that up.


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## DrankTheKoolaid (Apr 21, 2012)

You took that a little out of context and left out a point I made. I plainly stated i doubted a paramedic or MD in the same position as a combat medic could do much better.  In the civilian world not everyone is going to be in the best shape of their lives like the military are.  

Im not sure if you have looked around at the Police/Sheriff Dept members in your areas but they are not getting any younger or thinner.  Im sure plenty are on medications and have a ton a risk factors for various things.  Not to mention the other people at the scenes who could be even older then our aging LEO's that may also require attention.  Our combat medics do the best they can with the training supplies and environment they work in.  

The civilian world is slighty different.  Are we going to have a cardiac monitor on our back, no.  Will it be at the drop spot in case something goes wrong and we need it, you bet.  These types of scenes and calls are not going to be 100% trauma, so for the other fraction of complaints/symptoms we encounter we should also be trained for and ready to provide appropriate care.  And im sorry but an EMT-B does not fit the description.  And the only reason Paramedics even are in this is because there simply isnt enough MD's willing to do this to fill all of the spots, which would be the perfect solution.


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## RocketMedic (Apr 21, 2012)

DPM said:


> I know you're not intending to, but your opinion on this is verging on offensive. And your later comment on soldiers dying at the hands of 'only' EMT's highlights the fact that you don't yet know a lot about this subject.
> 
> Did you ever think that the level of medical training provided on the ground was actually well thought out and entirely suitable? Combat medics don't need to be able to use an ECG, or treat a stroke, or most of the actual things that civilian paramedics do. Instead they are thought how to deal with the types of injuries that they're going to encounter, and they do a fantastic job of it. And to even suggest that troops are dying because the medics aren't trained well enough... I'd love to see some proof to back that up.



68Ws have almost none of the training they actually need. They're essentially CLS with an IV. Most of the ones I know have no idea how to ventilate, treat a burn, or do much of anything outside of amputation, penetrating chest trauma, or NVD. Corpsmen do it somewhat better.
As it is, I'd say 68w is adequate for cheap medical care in the trenches of WW1. Today's training standard really should be much higher.


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## RocketMedic (Apr 21, 2012)

Troops are dying every day because their medics are poorly-trained, poorly -guided, and often poorly led and mentored by their "leadership".


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## DPM (Apr 21, 2012)

Rocketmedic40 said:


> Troops are dying every day because their medics are poorly-trained, poorly -guided, and often poorly led and mentored by their "leadership".



That's shocking. In my experience we didn't loose anyone due to the medics not knowing what to do, it was because they had horrific injuries. Now I can't speak for everyone, but the RAF MERT, the Navy / Marine corpsmen and (of course) the USAF PJ's all did an excellent job. 

Either way, I think this is getting off topic so I'll calm down ;-)


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## kindofafireguy (Apr 21, 2012)

I'm not a tactical medic, but am closely associated with several. They all told me you're better off going get advanced SWAT qualifications over TacMed certifications, at least at first. These carry more weight with the teams. 

But again, that's just what I've been told.


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## Flightorbust (May 9, 2012)

A few things I saw in this post. In the military, a 68W is trained off of the NREMT standards and are nationally certified like any of us are. 18D (Special Forces Medic) is trained to the level of a paramedic but Im unsure if they are certified as a paramedic. I know here the police department trains one of the fire medics to be their medical on the swat team. They do stack up and make entry like other members of the swat team but they are not armed. This avoids them from having to be post certified. Ive had swat members explain it to me that its easier to train a medic to sit in the back of the stack and raid the house then it is to train a swat member to be a medic. Think about it. There are programs that can teach you the basics of a swat raid in a couple weeks. Where have you seen a medic program that lasts a couple weeks?


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## DPM (May 9, 2012)

Flightorbust said:


> A few things I saw in this post. In the military, a 68W is trained off of the NREMT standards and are nationally certified like any of us are. 18D (Special Forces Medic) is trained to the level of a paramedic but Im unsure if they are certified as a paramedic. I know here the police department trains one of the fire medics to be their medical on the swat team. They do stack up and make entry like other members of the swat team but they are not armed. This avoids them from having to be post certified. Ive had swat members explain it to me that its easier to train a medic to sit in the back of the stack and raid the house then it is to train a swat member to be a medic. Think about it. There are programs that can teach you the basics of a swat raid in a couple weeks. Where have you seen a medic program that lasts a couple weeks?



But a SWAT medic isn't going to be responding to "unknown Medical"... I'd bet a weeks wages it's all Trauma. So a full Paramedic Qual isn't really required.


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## Flightorbust (May 9, 2012)

DPM said:


> But a SWAT medic isn't going to be responding to "unknown Medical"... I'd bet a weeks wages it's all Trauma. So a full Paramedic Qual isn't really required.



What about the hostage situation where some one has asthma of a heart attack ect. Yes most of it would be trauma. But think about the narcs you can pus. Im not sure I want some one to push those that just went through a crash course thats shorter then the basic course. Also if you have them attached to a fire department or an ambulance then yes they will respond to unk medical.


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## DPM (May 9, 2012)

Flightorbust said:


> What about the hostage situation where some one has asthma of a heart attack ect. Yes most of it would be trauma. But think about the narcs you can pus. Im not sure I want some one to push those that just went through a crash course thats shorter then the basic course. Also if you have them attached to a fire department or an ambulance then yes they will respond to unk medical.



Talk me though this hostage situation then. If there was a way that the SWAT guys can get in, then you've got a way to get the hostages out. So why hang around and treat people there? Evacuate them. We are not definitive care, they need a hospital.

And where are you going to carry all this kit? Monitor, 02, Jump bag and your drugs...?

Why not let the guy with the guns secure the scene and then call in actual paramedics, with ambulances?


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## Flightorbust (May 9, 2012)

I dont know if they carry a monitor but here they do carry a jump bag on their back. I agree we arn't  definitive care and they need to get to the hospital. But that pt that had an asthma attack can be handled once the threat is taken care of.  Im not saying that it works for all departments. Im saying its what works for my city.


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## RustyShackleford (May 10, 2012)

DPM said:


> That's shocking. In my experience we didn't loose anyone due to the medics not knowing what to do, it was because they had horrific injuries. Now I can't speak for everyone, but the RAF MERT, the Navy / Marine corpsmen and (of course) the USAF PJ's all did an excellent job.
> 
> Either way, I think this is getting off topic so I'll calm down ;-)




Not to spin this out anymore but my experiences with "field medics" in Afghanistan was absolutely terrible, I witnessed one stick himself with morphine by incorrectly holding the old style auto injector type morphine upside down.  It was one thing that motivated me to go to medic school and possibly provide tactical/combat medical interventions after my time in the infantry.


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## DPM (May 10, 2012)

RustyShackleford said:


> Not to spin this out anymore but my experiences with "field medics" in Afghanistan was absolutely terrible, I witnessed one stick himself with morphine by incorrectly holding the old style auto injector type morphine upside down.  It was one thing that motivated me to go to medic school and possibly provide tactical/combat medical interventions after my time in the infantry.



I've heard that story about 50 different times, from Iraq to Afghan to Kosovo... Shot it through his thumb right? 

I saw a 5'6'' female Medic win the Military Cross back in '06 after pulling a 200lb man out of the Turret after he took a round to the face. I've worked with USMC, USAF, Canadian Army, Esontian Army and Danish Army soldiers on Operations. We all took casualties and no one used a morphine autojet upside down. Although I did see solid squad level Battle Casualty and evacuation drills, right across the board, and not once did I feel that ANY of the medics were out of their depth.


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## RustyShackleford (May 10, 2012)

I wish I was around your medics I really do because after numerous deployments I had bad experiences with "inexperience" mainly.  The Estonian medics were leaps and bounds ahead of our medics in both training and knowledge and how to apply these things properly.  Most other medics that I ran into were more about memorizing rather than understanding.


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## jacob6493 (May 28, 2012)

*Weapons Training*

I know EMT-P is a requirement but how heavily does one need to be trained with weapons prior to TacEMS/SWAT EMS training? Could someone with minimal experience be able to jump into this course or is it a situation where one needs to show up his own M1911?


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## DrankTheKoolaid (May 28, 2012)

That depends on your prior experience and the unit you hope to get on with.  If you will be armed while working as a Tac Medic you will need to qualify with firearms with whatever team you go with.  As to being a master at arms prior to Tac Medic school,no you do not to be a eagle shot.  It will certainly help if you arm at least familiar with whatever weapons you are expected to deploy and train with initially though. 

Any particular tac program your looking at going to?


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## MackTheKnife (May 30, 2012)

Flightorbust said:


> A few things I saw in this post. In the military, a 68W is trained off of the NREMT standards and are nationally certified like any of us are. 18D (Special Forces Medic) is trained to the level of a paramedic but Im unsure if they are certified as a paramedic. I know here the police department trains one of the fire medics to be their medical on the swat team. They do stack up and make entry like other members of the swat team but they are not armed. This avoids them from having to be post certified. Ive had swat members explain it to me that its easier to train a medic to sit in the back of the stack and raid the house then it is to train a swat member to be a medic. Think about it. There are programs that can teach you the basics of a swat raid in a couple weeks. Where have you seen a medic program that lasts a couple weeks?



WOW!  Making entry in the stack, even at the rear, unarmed is not what I would want to do. If unarmed, I can't see going in until the "CLEAR" is given.


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## DPM (May 30, 2012)

MackTheKnife said:


> WOW!  Making entry in the stack, even at the rear, unarmed is not what I would want to do. If unarmed, I can't see going in until the "CLEAR" is given.



I can't see the point in that either. Unless they want you there as an extra target... :unsure:


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## DrankTheKoolaid (May 30, 2012)

Agreed unarmed in a stack is just a liability.  We almost have out protocols and policies finalized where im at.  Reserve Level III is the requirement to be a Tactical Medic so there are no issues with carrying a weapon and having arrest capabilities.  Now were figuring out what the ISTM Module A & B will cover of California Reserve III.  Nobody should ever be in the hotzone unarmed, ever.


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## ironco (May 30, 2012)

Yeah I Agree, and if your in a wilderness situation even with Leo why not have a wilderness trained emt to provide care. Also, if a hostage is having an mi or an asthma attack or whatever for one if they are still a hostage your probably not going to be providing any treatment and even if you were If there's a threat I doubt your going to take out the monitor and do a 12 lead,bp,nitro, or a breathing treatment right there behind a counter getting shot at lol. Sorry for pushing the issue further I just wanted to point out some issues to the people who think they need a medic and especially an emd in any situation that they are describing. Plus if your way out in before with no air support and someone codes or has any serious issue they're gonna die no matter what the level of care they receive. Thank you i am done going now


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