Combat Lifesaver vs. EMT/Medic

[82nd medic]

even medical platoon leaders arent medical providers, they're just admin officers.

 

[Afflixion]

even medical platoon leaders arent medical providers, they're just admin officers.

You sure your in the army? He said PSG not PL, a PL is a Medical Service Officer the military equivalent to a hospital administrator, a PSG in a medical platoon is a 68W40, which is a E7 with extensive medical knowledge, though they are typically not directly involved with patient care.

 

[armedic]

Having taught several of these programs while in Afghanistan because the courses are contracted out to civilian instructors in theater, Linus is mostly correct.

It is a very short first aid class with some advanced skills added in. We teach a lot of mnemonics, memory aids and we drill it over and over. There is no time to teach "medicine", this is the most cookbook program you will ever see.

They are taught IV's (sorry, large bore IV in AC for everything with liter of fluid), they are taught chest needle decompression, and they get airway skills by practicing with King Lts or combitubes.

They do carry morphine and the typical nerve agent pharmacy (atropine).

Then there is lots and lots of time spent on bandaging and splinting, every soldier carries a CAT. This is a base wide mandate where I am regardless of which nation you are from.

They also get to spend hours in the simulator. It is a darkened room (all walls, ceiling painted black), the floor is covered in gravel, loud music (war combat sounds) and I do mean loud is blasted while they tend to several victims as a result of explosives or overturned vehicle. There is also a HUMVEE and MRAP overturn simulator.

While most would view this as inadequate, a lot of lives have been saved by putting everyone through the course as directed by the US Army. Mostly due to bleeding control and rapid recognition, however it is still effective. The negative is you end up with a lot of guys claiming to be medics at times when what you really need is a real medic.

put a broad band-aid on a big boo boo. it is worthwhile but i hated watching soldiers walk out of my class thinking they were the new unit medics.

 

[Afflixion]

put a broad band-aid on a big boo boo. it is worthwhile but i hated watching soldiers walk out of my class thinking they were the new unit medics.

I hate watching medics walk out of classes thinking they are medical providers, To many medics these days think they know everything and do not like to learn more about medicine. Hence the "forever specialist"

 

[Combat_Medic]

I've seen some really good medics but I've also seen medics I wouldn't trust with a band-aid. Thats one reason I hang around here. I don't post a lot but I try and learn all I can. I want to earn my title as Medic. Not just have it handed to me.

 

[Afflixion]

I've seen some really good medics but I've also seen medics I wouldn't trust with a band-aid. Thats one reason I hang around here. I don't post a lot but I try and learn all I can. I want to earn my title as Medic. Not just have it handed to me.

It is true, like in every profession you have some that are good and continually striving for more and then you have those that hold some sort of disdain for what they do and try to drag others down.

 

[RocketMedic]

+1 to that. My CLS guys are trained to do everything my PA says they can do...and what I think they can handle. A huge tool I use in my classes is graphic pictures and examples of dead Americans. "This man died because his buddies messed up here, here, and here" tends to focus a lot of my students.

The Army really needs to focus on continuing education for all levels- CLS, medics, NCOs, and leaders/providers alike. I haven't had any official continuing education in three years- I've had to get it myself.

 

[Combat_Medic]

Damn you haven't had in continue ed from the army in 3 years. I thought all medics had to do table VI training every year to keep MOS Qed. I think I've done over 300 hours in the last 18 mos. My unit even sent me to an ACLS class. The hospital on post should have some class you can jump in if you call them.

 

[RocketMedic]

I've gone out and gotten my own from WBAMC and civilians, but the only things we've done are the mandatory live-tissue labs and stuff. Grr @ 3-41 IN!

 

[Combat_Medic]

Well I haven't got to do the live tissue lab yet Grrr Korea :angry:.

 

[LoneStarSoldier]

Honestly, you can't compare CLS to EMT-B. They treat patients/casualties in completely different environments. Combat Medics are trained to the NREMT EMT-B level at a minimum before they even learn the combat side of field medicine. Combat Medics are a kind of hybrid, they know and can do more than an EMT-B but they're not quite up to the Paramedic level. Also, I have been told that CLS no longer teaches IVs, I'm not sure if this is true though but in my unit we have not been teching any skills other than CAT application/bleeding control and neddle chest decompressions.

 

[Dre]

Most of the EMT training has changed. I don't know what it is for CLS and Medic. NJ is mostly ran by Paramedics and Nurses who think most emt's are too stupid to do chest tubes. We can't even get them to give us LMA's. We can assist with some medications and everything we do, has to be a protocol, weeks of training and then still have to wait for the state to roll over and accept it.

I'm a Medical Assistant, CERT, and EMT. I can't even do have the things I am trained without a paramedic.... And I worked SCTU. So I know how these things work now. 5 years it is ok, next 5 it's bad for the patients.

 

[Afflixion]

Most of the EMT training has changed. I don't know what it is for CLS and Medic. NJ is mostly ran by Paramedics and Nurses who think most emt's are too stupid to do chest tubes. We can't even get them to give us LMA's. We can assist with some medications and everything we do, has to be a protocol, weeks of training and then still have to wait for the state to roll over and accept it.

I'm a Medical Assistant, CERT, and EMT. I can't even do have the things I am trained without a paramedic.... And I worked SCTU. So I know how these things work now. 5 years it is ok, next 5 it's bad for the patients.

I'm sorry but I wouldn't let most EMTs near me with an IV cath much less a scalpel required to do a chest tube. a chest tube does not do much more than a NCD in a field environment without a vacuum and time it is not going to do much. There is no reason for EMTs or paramedics to use one in a prehospital environment.

 

[ZootownMedic]

From serving in special operations units, being an EMT-B currently and also currently attending Paramedic school heres how I would break it down and its pretty common sense. EMT-B's can handles just about anything a combat medic would. Their training is about equal and that is what 68W's are certified too anyways. In the order of people I would allow to care for me:

First Responder
CLS
Combat Medic
EMT-B
Special Operations Medic (18D, SOCM graduate)
Paramedic

I won't argue the reasons but its pretty simple. EMT-B's and Paramedics are trained in trauma and medical emergencies. Combat medics are trained to quickly handle emergency battlefield injuries. Slapping on tourniquets, starting IV's, maintaining the airway, triage, transport, and the like are all things that Combat medics AND EMT-B's can do. EMT-B's can also handle a wide variety of medical emergencies that I think many Combat medics learn how to handle and then never practice or study again. Spec Ops medics like my best friend (18D) are amazing especially at PT assessment and trauma emergencies. They are however NOT certified to the NREMT-P standard despite what many say. My friend however who was a 18D just graduated from Paramedic school and his internship was waived and he was able to sit for the NREMT test immediately after class because Ft. Bragg SOCOM is recognized by the NREMT to the Paramedic level. Hope this clears things up a bit, and it is just my opinion based on vast experience with care providers at all of those levels.

 

[RocketMedic]

Combat medics get a good initial education, but the follow-on is very inconsistent, and there's no real formalized career progression in terms of patient care. By the time most medics get good at it, they're promoted to E-5/6 and positioned in administrative roles.

 

[ZootownMedic]

Exactly rocket. Continuing training in the military sucks especially when it comes to 'advanced' medicine. Probably 99% of combat medics couldn't trace the blood through the heart. Not a knock on them....they don't need to know it.

 

[LoneStarSoldier]

I'm going to have to disagree with the statement that EMT-Bs and Comat Medics are similar. Yes they're both technically EMT-Bs, but a Combat Medic is more of a hybrid between and EMT-B an EMT-I. EMT-Bs cannot start IVs (at least by NREMT standards, might be different by state), Combat Medics can. Combat Medics can issue and assist with a wide variety of meds (with PA approval) while EMT-Bs can only assist with the administrative of select medications. I do agree though that the retention of knowledge for medics is really sub-par. I can barely remember some of the stuff we learned at EMT training. Most of the things that are engrained in my mind are the things we actually use (i.e. transporting, starting IVs, wrapping sprains/strains, bandaging, etc.)

 

[RocketMedic]

Exactly, LoneStar. The system as-is really doesn't help with knowledge retention- every bit of military training is on tangentially-related subjects like weapons, tactics, vehicles, or the dreaded "Soldier/NCO development". Being told that WLC would make me a better medic was pretty funny though.

Some programs like MPT and the live tissue labs are steps in the right direction, but MPT is just utilization of other skills (they aren't allowed to assess or treat, at least at WBAMC) and Live Tissue/BCT3 is a short course. The only way to stay proficient is to moonlight.

BTW, did you ever get that issue straight? I ran into the gentleman you were asking about at Wal-Mart and he damned near sold me on his place- I heard they might be getting the El Paso County 911 contract.

 

[ZootownMedic]

Yeah I guess I can see your point. True the average EMT doesn't start IV's but here in Colorado you have to be IV certified to even get hired by the ambulance companies. I guess my point was that if it was a trauma related injury than I'd rather have the combat medic but if it was for chest pain and Im a 60 YOM i'd rather have the civilian EMT-Basic. In the end though I would still rather have a civilian paramedic than just about anything else. The level of training, knowledge, and experience in both trauma and medical emergencies is at its peak. They are the most balanced with the most things I guess is what it boils down to.

 

[LoneStarSoldier]

.BTW, did you ever get that issue straight? I ran into the gentleman you were asking about at Wal-Mart and he damned near sold me on his place- I heard they might be getting the El Paso County 911 contract.

No I'm still waiting to hear back. It was the company owner's call to put a hold on any more shifts for 3rd riders, not the fleet managers. It's true though, the company is trying to get the county contract, which would hopefully mean more money and more shifts.