Forgive me if I sound unduly harsh, that is not my intent, but I want to be rather forthcoming on this post as I think it is a large area of EMS that needs some reason interjected.
Let's face it, we'll always follow what the military finds to some extent.
Some military things work. Some do not. But doing something the military does "because the military does it," is just stupid.
Some ideas are also followed because there is this crazy civilian idea if the military does or uses something it must be superior.(Law enforcement is notorious for this, but it is not limited to any industry)
I always love these "next best treatment" and "we need to use TK" threads. The military needs these devices everyday. I am willing to bet you would not find more than a handful of cases where all US civilian EMS actually needed a tk last year. (Though I concede there may be times when it was used and not needed for legitimate reasons)
The only 2 times I have used a TK in US EMS a BP cuff worked perfectly.
Many of the combat medics and corpsmen I have spoken with use crics regularly, should we start doing that in the civilian world?
It's quick, easy, tube doesn't dislodge often, there are lots of benefits. (but a few major drawbacks that make it unacceptable too)
When it comes to cost or efficiency the military is certainly not to be emulated.
Civilian EMS does not have billions of dollars to throw at high dollar equipment that can be done cheaper by already existing equipment. Especially when it will rarely ever be needed.
As for medical acumen, while the military does have some amazing contributions to medicine, some of what it finds acceptable, even preferable, is not the minimum accepted standards in developing countries, much less the first world.
Just because some people want to play soldier on an ambulance doesn't mean it is acceptable. If providers fantasize about combat medicine, I know more than a few places hiring for that. I can get you the phone numbers if you really need.
The civilian world is simply not the military.
After all, our profession evolved from Navy Corpsmen and Combat Medics.
EMS is not a profession, it is a vocation.(full stop) It has the potential to be a profession, but blindly implementing military equipment and procedures in the civilian world will not help that.
Professionals (not to be confused with career soldiers) in the military are all officers.
Enlisted rates are all vocations.
If you want to be a professional, you will need many of the same requirements the military requires, like a 4 year degree.
I do like the concept of tourniquets for major traumas like amputations as it is definitely quick and efficient, and based on recent research it's actually safe
.
So do I. But I also have a firm hand and experience on what major trauma is and looks like.
I have also been around a while and enough places to know most civilian EMS providers in many parts of the world do not. They often massively over estimate the seriousness of many traumas.
Overtreatment is a medical error. We don't do CABGs on everyone with chest pain. We should not be implementing surgical intervention (like a TK) on a massive scale when it is not needed. (I accept in emergency medicine some over treatment is required, but not all the time)
A professional understands and practices (to use a military term) economy of force. "Don't use a cannon to kill a mosquito."
Plus, at least where I work, we all like to think we're high speed - low drag operator types
Happens a lot.
But I have noticed the real operators like that are usually rather chill and low key.
