# Combat Lifesavers



## Chrissy88 (Oct 7, 2009)

I was curious as to why Combat Lifesavers can do Chest decompressions and IV (I think it's only a week long course?) but Basics can not? Is it only because the soldiers are in such hazard environments and the likelihood of frequent mass causality incidences are extremely high?


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## akflightmedic (Oct 7, 2009)

Yes.

And once they return to a civilian world, they no longer can do those things without obtaining paramedic education.

It is a war zone...would you rather die or have a week long trained battle buddy attempt to save you? These rules and logic can not and never should be compared to EMT level in the States.


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## newguy (Oct 7, 2009)

akflightmedic said:


> Yes.
> 
> And once they return to a civilian world, they no longer can do those things without obtaining paramedic education.
> 
> It is a war zone...would you rather die or have a week long trained battle buddy attempt to save you? These rules and logic can not and never should be compared to EMT level in the States.



when Soldier (non-medic types, like me) come back to state side, we can still do IVs. it really depends on how the healthcare provider is, if the PA on call is a teacher type, he/she will let us do IVs. if not, then...all IV bags are turned in once we return from a deployment. I learned how to do CDs using a dodge ball, needle (with a syringe and saline in it, it bubbles up when you poke it through-its suppose to simulate a "real cd") but never done it on a human.

There is talk about taking the IV portion of the CLS course out, thats what I overheard from some people that work at the CSH.


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## Akulahawk (Oct 7, 2009)

The other thing to remember is that the military world is different than the civilian one. The skills learned in the military won't necessarily translate to the civilian world, without formal training for the civilian environment. What's the population you're working with? Generally healthy individuals whose major issues in theater will be trauma related. Also, the liklihood that you're going to be sued... minimal. The civilian world... you gotta deal with people from birth to old age, and while trauma happens, a whole lot of medical issues happen that CLS won't likely cover. 

Remember, starting peripheral IV's is basically a monkey skill... doing it appropriately is where the education part steps in. I've read on other forums that CLS actually is losing IV's... and will have more of an emphasis on the basic skills that, when applied/used immediately post injury, will save lives. 

Just for the record: I'm not military, and haven't been through a CLS course, but my understanding of it is that it's useful, basic stuff... very basic and geared for trauma care.


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## newguy (Oct 7, 2009)

hey I totally agree. CLS is the basic first responder stuff (more trauma). 

although it is a good course, the OEMS course is bad freaking A$$!!! 

the CLS Course is going away with the IVs soon because Soldiers are sticking each other for no reason or they don't remember how to do it...(if you don't use it, you loose it) and instead of helping troops they'll be leaving the pt with 20 track marks. :wacko:


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## HNcorpsman (Oct 7, 2009)

from what i have seen and experienced, giving IVs in a combat situation, is totally useless. as you learned in OEMS, the use if IVs in usuless in that situation, CLS's need to be taught basica PT assessment, and trauma control, and they need to know that it is more important to shoot back than to treat a PT, simple as that.


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## Chrissy88 (Oct 7, 2009)

akflightmedic said:


> Yes.
> 
> And once they return to a civilian world, they no longer can do those things without obtaining paramedic education.
> 
> It is a war zone...would you rather die or have a week long trained battle buddy attempt to save you? These rules and logic can not and never should be compared to EMT level in the States.



Ahh I see, yes that does make a lot sense. 



Thank you all for the responses


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## daedalus (Oct 7, 2009)

A wonderful thing that has come out of the Iraq-Afghanistan conflicts is the wealth of new knowledge in fluid resuscitation. Small amounts of hypertonic saline (only enough to get a palpable radial pulse) are resulting in increased survival into surgery. Surgeons have also learned that they should not repair everything in the first operation, but rather take care of the major issues and then return the patient to the SICU while stabilizing physiologic parameters for the more non urgent surgeries.


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## spisco85 (Oct 7, 2009)

Like everyone said, military world is different from the real world.


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## HNcorpsman (Oct 8, 2009)

but when it comes to medicine a human body is a human body...


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## Akulahawk (Oct 8, 2009)

spisco85 said:


> Like everyone said, military world is different from the real world.





HNcorpsman said:


> but when it comes to medicine a human body is a human body...


Both statements are true, as far as I'm concerned. One of the biggest things I've noticed is that outside the military... one must engage in this complex ritual called "CYA". I have no doubt that this ritual exists in the military as well... but over different issues.


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## spisco85 (Oct 8, 2009)

I totally agree Akula, in the military CYA was small and insignificant overall.

In the civilian world it is to keep you from losing your job and from getting sued which is much worse.


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## akflightmedic (Oct 8, 2009)

newguy said:


> when Soldier (non-medic types, like me) come back to state side, we can still do IVs. it really depends on how the healthcare provider is, if the PA on call is a teacher type, he/she will let us do IVs. if not, then...all IV bags are turned in once we return from a deployment. I learned how to do CDs using a dodge ball, needle (with a syringe and saline in it, it bubbles up when you poke it through-its suppose to simulate a "real cd") but never done it on a human.
> 
> There is talk about taking the IV portion of the CLS course out, thats what I overheard from some people that work at the CSH.



My comment meant that as a civilian you can not do IVs despite being trained in the military unless you go through a proper higher level recognized course.

You can not go CLS to medic on a challenge basis, you will still need education starting at the Basic level first.


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## SuaSponte (Oct 11, 2009)

*hmm*



Chrissy88 said:


> I was curious as to why Combat Lifesavers can do Chest decompressions and IV (I think it's only a week long course?) but Basics can not? Is it only because the soldiers are in such hazard environments and the likelihood of frequent mass causality incidences are extremely high?




I see a digression forming here...too much grey matter folks.

The answer is money, in the military each person has a value (training, food, housing, etc. add up significantly and a total is kept for records) & the simple truth is a $10 IV kit is a value minded monetary risk to keep that investment(soldiers life) affloat. 
On the other hand in the private world that $10 IV kit can be $1000 or $10,000 liability on something that is supposed to be making money (investment on care, trans & treatment).

-It has nothing to do w/ skills.
-they come up with this stuff after reviewing cost to value numbers over time


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## ExpatMedic0 (Nov 2, 2009)

I was a Combat Life Saver in a Infantry unit. As far as I recall we never got trained on needling a chest or anything very invasive other than IV's. But that was a few years ago in 2003 at fort carson. our unit was very short on infantry medics and the CLS was a big help at times for minor issues or starting an iv on you because you drank to much the night before ;-)


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## mycrofft (Nov 2, 2009)

*I liked to see Daedelus's post.*

Some of that wisdom was learned in Korea also, but lost as there was no "best practices" or whatever after that.
The first day of our Desert Storm deploymnt to Travis, the then-top nurse in the USAF came through, gave us a pep talk, and asked if we had anything.
"Yes Maam. Please take concrete steps to preserve what we learn in this war so we don't have to relearn it next time".
Got really quiet.


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## zmedic (Nov 30, 2009)

daedalus said:


> A wonderful thing that has come out of the Iraq-Afghanistan conflicts is the wealth of new knowledge in fluid resuscitation. Small amounts of hypertonic saline .



Do you have a cite for this? I haven't heard of hypertonic being used anywhere. The standard prehospitally most places is .9 NS, the military has been using some volume expanders like Hextend and in hospital a lot of people like LR, but haven't seen hypertonic talked about. If you have a paper I'd love to see it.


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## dmdenike (Dec 9, 2009)

I just got out of the Marines in November 2009 and I got my CLS right before our deployment.  We learned the basic stuff as well as  tension pneumothorax's, how to start IV's, and how to insert nasopharyngeal's.  It was pretty in depth for a grunt unit.  Then we got to try ur skills during Live Tissue on pigs ahhhh those where the days


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## HNcorpsman (Dec 20, 2009)

yes sir... nothin as good as the OEMS course using live tissue... probably the best training I have recieved as a corpsman... It has come in handy several times while here in Afghanistan...


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