Tactical Medic Training

[EpiEMS]

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.

 

[DrankTheKoolaid]

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.

 

[Shibumi]

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.

 

[duncklee5]

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.

 

[duncklee5]

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

 

[DPM]

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.

 

[DrankTheKoolaid]

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.

 

[RocketMedic]

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.

 

[RocketMedic]

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

 

[DPM]

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 ;-)

 

[kindofafireguy]

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.

 

[Flightorbust]

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?

 

[DPM]

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.

 

[Flightorbust]

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.

 

[DPM]

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?

 

[Flightorbust]

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.

 

[RustyShackleford]

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.

 

[DPM]

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.

 

[RustyShackleford]

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.

 

[jacob6493]

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?