civillian vs military trauma treatments

[Akulahawk]

Because it is shown to work no better than NS, but costs significantly more.

In the military if you may not want to carry around a bunch of liters of water you cannot drink, so for them it is a reasonable expense.

Because it doesn't work any better than NS, is lighter, and you can shove more bags of it into your kit than NS... the line guys don't care that it costs more than NS.

 

[Doczilla]

There's always a turd in the punch bowl somewhere. The best medics are self motivating and self improving. Ive just resigned myself to making the biggest difference I can before my time is up--- for other medics, and for the people we deal with.

And ive treated every age group while wearing this flag. If a medic is sitting in an aid station playing x box, there's usually a reason. Probably a turd.

I dont think the civilian world should go too far emulating military medicine, at least as far as EMS is concerned. There seems to be a mistaken belief that being a medic in the military means youve seen it all. In reality, a civilian EMS provider probably sees and treats a much greater variety and number of medical and trauma emergencies. Those medical emergencies military medics do occasionally treat are generally things you rarely see in the civilian world, and virtually all of their patients are otherwise healthy, relatively fit younger males, not exactly widely representative of the typical civilian EMS patient.

In the Marine Corps I recall Corpsman generally being about as useful as tits on a boar. I hate to say that, and it flies in the face of the hollywood image of the combat doc who is an indispensible member of the unit, but to most of us they were little more than mobile motrin dispensers who spent most of their time sitting around a branch aide station giving vaccines and finding ways to get out of formations, work details, and PT.

A civilian paramedic and EMT sees sick and injured patients pretty much every shift they work. A military medic generally doesnt gain a whole lot of experience, and what experience they do gain isnt necessarily applicable to the civilian world.

 

[Veneficus]

Because it doesn't work any better than NS, is lighter, and you can shove more bags of it into your kit than NS... the line guys don't care that it costs more than NS.

Isn't that what I said?

 

[Veneficus]

There's always a turd in the punch bowl somewhere. The best medics are self motivating and self improving. Ive just resigned myself to making the biggest difference I can before my time is up--- for other medics, and for the people we deal with.

And ive treated every age group while wearing this flag. If a medic is sitting in an aid station playing x box, there's usually a reason. Probably a turd.

In my interactions with military medicine, it is not the enlisted folks causing the problems.

It is the politicians who call themselves officers appointed above them.

 

[RocketMedic]

in my interactions with military medicine, it is not the enlisted folks causing the problems.

It is the politicians who call themselves officers appointed above them.

+20

 

[MackTheKnife]

Bp cuff

How often do you use them? I'm not arguing that we shouldn't carry TKs or quickclot. But when was the last time that you had bleeding you couldn't control with direct pressure. (or a blood pressure cuff inflated just to the point where bleeding stopped.)

For all intents and purposes, a BP cuff used to stop uncontrollable hemorrhage is a tourniquet. I am no longer in the civilian EMS arena (now a private military contractor) but the TK is a very useful tool when needed. I also am curious as to the number of EMS services/companies that use them.

 

[MackTheKnife]

Good point

Velcro is an amazingly strong and reliable product. I can see a pneumatic tourniquet working very well in the upper extremities. Does one work as well in the lower extremities? A standard tourniquet works very well in the legs if it is applied high enough to compress the femoral artery. The most common mistake with tourniquets in the recent past in the military is not applying them high enough to capture the artery against a bone.

I teach my military students to place them high on an extremity for the very reason you mention. Placing them high also facilitates conversion to a pressure dressing if one decides to try later, tactical situation permitting. However, our approved curriculum still says 2-3 inches above the wound.
As for a BP cuff, they work but are not good in a tactical situation obviously. The guys carry a blowout kit with one TK. I tell them to carry at least two. They are issued the CAT but I prefer the MET.
Also, Quickclot and Celox were also mentioned. Celox works better but either one is good for wounds that are not amenable to a TK.

 

[MackTheKnife]

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.



The civilian world is simply not the military.

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 am curious as to where you came up with the idea that only officers are professionals, and enlisted rates are vocations? Please share your basis for this. Having spent 31 years in the military, from 1976-2007, I have never heard anyone make such a delineation between officers and enlisted. Nor is there any statutory basis for what you say. Regardless of rank/rate, all military members are part of a profession; the profession of arms. Senior enlisted members often act in an officer's capacity (i.e., Navy Chief Petty Officers frequently act as Division Officers). I was the Assistant Weapons Officer at a shore duty post.

 

[Veneficus]

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.



The civilian world is simply not the military.

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 am curious as to where you came up with the idea that only officers are professionals, and enlisted rates are vocations? Please share your basis for this. Having spent 31 years in the military, from 1976-2007, I have never heard anyone make such a delineation between officers and enlisted. Nor is there any statutory basis for what you say. Regardless of rank/rate, all military members are part of a profession; the profession of arms. Senior enlisted members often act in an officer's capacity (i.e., Navy Chief Petty Officers frequently act as Division Officers). I was the Assistant Weapons Officer at a shore duty post.

Both my recruiter and company commander told me.

The explanation they gave sounded very reasonable at the time and still does.

I don't recall it verbatim, but it basically had to do with the difference between NCOs and commisioned officers in method of education(vocation based vs institutional), recognized professional requirements in the civillian world, etc.

I would agree that the military is the only place where a vocational education has the opportunity to become a professional. But as I am sure you are aware, a professional soldier or sailor is very different and a much more select group, not anyone who enlists.

 

[MackTheKnife]

Both my recruiter and company commander told me.

The explanation they gave sounded very reasonable at the time and still does.

I don't recall it verbatim, but it basically had to do with the difference between NCOs and commisioned officers in method of education(vocation based vs institutional), recognized professional requirements in the civillian world, etc.

I would agree that the military is the only place where a vocational education has the opportunity to become a professional. But as I am sure you are aware, a professional soldier or sailor is very different and a much more select group, not anyone who enlists.

Thanks for the reply. I would say that while there is some subjectiveness to what defines a professional, in any field, the military has never been viewed, let alone defined, as a vocation. It has always been a profession. Your recruiter and company commander were offering their opinion, in my view. As far as I know, no vocation requires a sworn oath to support and defend the Constitution of the United States as does the military.

 

[Veneficus]

Thanks for the reply. I would say that while there is some subjectiveness to what defines a professional, in any field, the military has never been viewed, let alone defined, as a vocation. It has always been a profession. Your recruiter and company commander were offering their opinion, in my view. As far as I know, no vocation requires a sworn oath to support and defend the Constitution of the United States as does the military.

A sworn oath is not a requirement of any profession. Though some professions do have them.

I disagree that the military was never defined as a vocation or is not defined as a vocation around the world and throughout history.

Particularly of enlisted ranks below NCO.

As was brought up in this post, there is a difference between professionalism and a profession.

While US military persons of all branches are held to a high standard of professionalism, it des not automaticall equate to being a professional.

As I type this and give thought to the matter, the title of Dr. professor, etc, is never lost or qualified by retirement.

In US military service only senior officers retain their title without qualifcation.

 

[MackTheKnife]

Enjoying the discussion

As I type this and give thought to the matter, the title of Dr. professor, etc, is never lost or qualified by retirement.

In US military service only senior officers retain their title without qualifcation.

This is not true. Acoording to US Code (Title 10), retired military members are still subject to the Uniform Code of Military Justice and recall at any time to active duty. If we didn't retain our rank/title, it would be impossible to hold us accountable to the UCMJ or recall. Additionally, our monthly check as a retiree is called "retainer pay", not retired pay or a pension as we are being retained. That is why we retain our rank as retirees. I am a retired Navy Senior Chief Petty Officer and my ID card says the same with an "Indefinite" expiration date on it.
I'm not sure where you are getting your information but it's not accurate.

 

[Veneficus]

This is not true. Acoording to US Code (Title 10), retired military members are still subject to the Uniform Code of Military Justice and recall at any time to active duty. If we didn't retain our rank/title, it would be impossible to hold us accountable to the UCMJ or recall. Additionally, our monthly check as a retiree is called "retainer pay", not retired pay or a pension as we are being retained. That is why we retain our rank as retirees. I am a retired Navy Senior Chief Petty Officer and my ID card says the same with an "Indefinite" expiration date on it.
I'm not sure where you are getting your information but it's not accurate.

I aways see people sign their documents and formal titles as rank....name....(retired) unless they are an 0-3 or above. In which case there is never (retired) as a qualification.

Edit: Considering requirements to be a CPO, including as I understand an act of congress, I would not doubt they are professional sailors. I am just not sure that I would qualify more junior ranks as such. Especially consdering that like EMS, the US military is a transient population.

 

[mycrofft]

There's retired and retired. Under General (maybe Colonel?) once you are ten years post-retirement, you are permanently retired, unless the President signs an order or something.

I think a thirty year active duty Marine gunny-sar would argue about only we offices being professionals. Right or wrong, I wouldn't argue.

The military on paper maintains excess capacity to meet unexpected requirements. In the event, however, they tend to fail to follow through with true training and management, and reward paperhangers better than operationally ready and pragmatic line people.

The best thing for a military (and by extension their medical corps) is a short successful campaign. The worst is a long peace, The VERY worst is a long protracted campaign without a definite and positive outcome other than getting out with our skins and still having an ocean separating us from the bad guys.

 

[Veneficus]

The best thing for a military (and by extension their medical corps) is a short successful campaign. The worst is a long peace, The VERY worst is a long protracted campaign without a definite and positive outcome other than getting out with our skins and still having an ocean separating us from the bad guys.

Yea,

I think I read something along those lines in my first go through of "the art of war" in 7th grade.

unfortunately it is not a popular read.

 

[mycrofft]

If you lived through the Vietnam debacle and can compare it with the SW Asian conflicts, you can see for yourself. I'm trying to remember really significant medical advances which are still in use from Vietnam, and other than prompt medieval I'm coming up dry. Oh, other than many tourniquets used were unnecessary (so says a guy not under fire while trying to stop bleeding), and moving essential basic medical knowledge as far across the board ("self aid and buddy care" being the watchwords then) so no one had to wait for "the Doc" for any useful care.

 

[Doczilla]

Yea,

I think I read something along those lines in my first go through of "the art of war" in 7th grade.

unfortunately it is not a popular read.

Ven, any chance I can get a brain transfusion brother?

 

[Veneficus]

Ven, any chance I can get a brain transfusion brother?

As soon as they figure out a way to plug information into the brain like in the movie matrix I am first in line.

Best I can promise you is second.

 

[Veneficus]

If you lived through the Vietnam debacle and can compare it with the SW Asian conflicts, you can see for yourself. I'm trying to remember really significant medical advances which are still in use from Vietnam, and other than prompt medieval I'm coming up dry. Oh, other than many tourniquets used were unnecessary (so says a guy not under fire while trying to stop bleeding), and moving essential basic medical knowledge as far across the board ("self aid and buddy care" being the watchwords then) so no one had to wait for "the Doc" for any useful care.

Modern trauma systems came from 'nam.

There were more advances in burn reconstruction.

The military practice of prescreened "walking blood banks" were developed earlier but were formalized in 'nam.

One advance that was lost was that glass syringes tranmitted less disease than plastic ones, but that discovery was lost to industry which hasa higher profit margin manufacturing plastic over glass.

There is actually an interesting story that one of the major medical manufacturers (I forget which one of 2) was run by a guy who was in "nam.

He swore his company would never produce plastic syringes as long as he had the helm, and they didn't until shortly after he died.(not sure of the details, but the source I got it from is usually credible.)

 

[MackTheKnife]

Cpo

I aways see people sign their documents and formal titles as rank....name....(retired) unless they are an 0-3 or above. In which case there is never (retired) as a qualification.

Edit: Considering requirements to be a CPO, including as I understand an act of congress, I would not doubt they are professional sailors. I am just not sure that I would qualify more junior ranks as such. Especially consdering that like EMS, the US military is a transient population.

No, it does not take an act of Congress. Chief Petty Officers are appointed by the Bureau of Naval Personnel. It does take a courts-martial to "bust" a Chief to a lower paygrade. Commanding Officers do not have the authority.
The only thing that is congressionally related is DOMA (Goldwater-Nichols Act). Under the provisions of DOMA, senior enlisted (E8 & E9), are limited to 1% and 2%, respectively, of the force.
As for signing your name with your rank and appending retired, any military member, officer or enlisted, is allowed to do so. If you happen to read any of the military-related periodicals, the authors (admirals, generals, other officers and enlisted) append "Retired" so as to distinguish themselves from active duty.