Tactical Medic Training

[PG506]

Emergency Dental Care

The dental care,canine care and other topics are part of the extended care. With expanded scopes of practice it is the responsibility of the team medic to keep the team healthy and if a gap analysis is performed and dental was seen on a higher frequency then it is a topic that should be covered. Eye injuries, sports type injuries, infections were some of the items seen in areas such as Katrina, Haiti and on overseas contracts. Tactical Medicine is much more that clearing houses ands weapons manipulation it is a way of life for a select few who chose this a their profession. I hope this helps answer why emergency dental care.

 

[bigbaldguy]

The dental care,canine care and other topics are part of the extended care. With expanded scopes of practice it is the responsibility of the team medic to keep the team healthy and if a gap analysis is performed and dental was seen on a higher frequency then it is a topic that should be covered. Eye injuries, sports type injuries, infections were some of the items seen in areas such as Katrina, Haiti and on overseas contracts. Tactical Medicine is much more that clearing houses ands weapons manipulation it is a way of life for a select few who chose this a their profession. I hope this helps answer why emergency dental care.

So it focuses on a long term mission support idea rather than a strictly emergent care idea. Makes sense.

 

[PG506]

one or two week courses

Yeah Its a different approach to what I thought civilian Tactical Medicine was. I was an Army Medic for 13 years and for the past few years I have had my eyes opened. I realized that the medicine was the same the environments the only real difference is the Scope of practice and the aggressiveness. Right now is an exciting time to be apart of Tactical Medicine. I can tell you that all of the big news arrest involving violent offenders have tactical trained medics real close to the action or on the objective. This is a great post i just became aware of EMTLIFE. I have a Facebook page with videos and pics named Tactical Combat Casualty Care (TC3) check it out sometime. I can not post links yet. as soon as I figure out how to post vids and pics I will.

 

[Vetitas86]

Bump because I just liked the page.

Cool stuff.

Any word about the contracting thing though?

 

[DrankTheKoolaid]

There are other Tactical/operational programs that meet or excede recommended requirements available in the US that are excellent programs. I posted a link to one of those courses. The link takes you to a course in Texas conducted by Cypress Creek Advanced Tactical Team's it is he Basic Tactical Operational Medical Support Course. I have consulted with similar programs but this is one of the only courses that includes the NAEMT TCCC curriculum with topics that are based on current task performed by Tactical Medicine Operators that support LEO at a federal and local levels. With the need to bring medicine into tactical situations these programs are becoming more valuable everyday.

What other programs? I was present when Dr. Heiskell received member #000001 of the American College of Tactical Physicians (not to be confused with ACEP) and the Presiding President stated the only way to get into it at the moment is through ISTM Module A and B which covers standard tactical operation and medicine while module C covers executive protection, shotguns and concealed weapons. Unfortunately the one you posted does not concentrate on weapons which would be the issue with it. Why go to a tactical medicine course if weapon safety and use are not part of the concentrated course.

 

[PG506]

Misspoke

I apologize I did make a mistake I was speaking of Another recommendation for tactical training. Every program has own emphasis weapons manipulation is covered in BTOMS but not the focus. Medicine is the major focus the thought behind that is every team is different and if you are on a team SWAT school is where you get your tactics and training days is where you combine good medicine and tactics. I train SWAT teams all over the US and their tactics are all different. The course you are describing sounds like a great course and I am going look into it. Sorry again for misrepresenting the BTOMS program earlier.

 

[PG506]

Looks good

The program looks good from what I can see on the website. The only thing that concerns me is there is a lot of products companies sponsoring the course. Do they utilize different varities of products such as cats vs softt and hyfin vs h&h chest seals. If they do then that's great. I went to a course a few years back and I thought it was an infomercial. With their reputation I am sure that's not the case. But like I said before its an exciting time to be in Tactical
Medicine and if you find good training it's better than no training.
I trained some contractors that had no medic
Traing two weeks from shipping date. I know some
One asked about contract jobs create a linked in page and you will
Find multiple groups posting jobs daily. SOC
Seems to be active. Africa seems to be a hot spot
For medics. The NAEMT Card helps since it
Is recognized Internationaly I get tons of
Request by contractors.

 

[PG506]

Sorry the NAEMT TCCC card

 

[Vetitas86]

While we're on the subject...

Cross training TEMS with law enforcement? And for that matter, unarmed vs medics packing heat?

 

[DPM]

I still feel like training PD to be medics is easier and cheaper. This way you don't require an extra guy on scene. I'm looking at things in the same way the we did in the army. Not every patrol had a medic, but they all had infantry types who were team medics. They wouldn't know how to deal with a stroke, or a normal 'medical' call but then they didn't have to. They dealt with things at the tactical level, which was IED strikes and GSW 90% of the time. I don't see the need for tactical dentistry, or any of this primary care type stuff, at the tactical level.

Why does a SWAT team need a tactically trained Medic for their primary care? If these guys aren't old enough to recognize that they are sick / injured then you've got bigger problems.

Train the LEO's how to deal with gun shot wounds. Issue pressure dressings and train them how to use them. That would be cheaper, and if everyone knows what to do then it doesn't matter who gets hit.

 

[DrankTheKoolaid]

I still feel like training PD to be medics is easier and cheaper. This way you don't require an extra guy on scene. I'm looking at things in the same way the we did in the army. Not every patrol had a medic, but they all had infantry types who were team medics. They wouldn't know how to deal with a stroke, or a normal 'medical' call but then they didn't have to. They dealt with things at the tactical level, which was IED strikes and GSW 90% of the time. I don't see the need for tactical dentistry, or any of this primary care type stuff, at the tactical level.

Why does a SWAT team need a tactically trained Medic for their primary care? If these guys aren't old enough to recognize that they are sick / injured then you've got bigger problems.

Train the LEO's how to deal with gun shot wounds. Issue pressure dressings and train them how to use them. That would be cheaper, and if everyone knows what to do then it doesn't matter who gets hit.

Well not all Tactical is urban. Primary care comes into play out here in the sticks when a LEO team has been camping crops or whatever for days. Do you really think they want to leave cover and expose themselves on foot to go to a dentist for example? And not only will he leave alone he will have to take another member with him for safety. Primary care comes into play when they receive a laceration that needs to be managed on the spot, or a fracture is causing to much pain. Would the typical medic know how to do a regional block? What if they were allergic to lidocaine, did you know you can use diphenhydramine for local anesthetic. Walla tooth ache gone long enough to finish mission or broken finger no longer his sole focus and he can concentrate on the task at hand.

There is so much more to tactical EMS then you know. Go take a class and find out for yourself why it is a specialty

 

[DPM]

Well not all Tactical is urban. Primary care comes into play out here in the sticks when a LEO team has been camping crops or whatever for days. Do you really think they want to leave cover and expose themselves on foot to go to a dentist for example? And not only will he leave alone he will have to take another member with him for safety. Primary care comes into play when they receive a laceration that needs to be managed on the spot, or a fracture is causing to much pain. Would the typical medic know how to do a regional block? What if they were allergic to lidocaine, did you know you can use diphenhydramine for local anesthetic. Walla tooth ache gone long enough to finish mission or broken finger no longer his sole focus and he can concentrate on the task at hand.

There is so much more to tactical EMS then you know. Go take a class and find out for yourself why it is a specialty

I did that, as my job, in places that we far more dangerous than you find over here. If we had tooth ache, we manned up and dealt with it. If you have a broken leg, what good are you anyway?

I dunno, you clearly see the need but I don't.

 

[PG506]

Cross training

Cross training is very important all team members should be able to control bleeding, breathing and other life threats. If you are making entry you should be in the armed if you are armed you should be a leo/tacmed. There are several teams that are highly successful unarmed and armed as well. The key is knowledge Sharing. Now I briefly read a comment about training Leo to be Emts. Either way it takes time to balance the two. The medic should have medical expierence but again either way it takes time to be tactically and medically sound.

 

[DrankTheKoolaid]

I did that, as my job, in places that we far more dangerous than you find over here. If we had tooth ache, we manned up and dealt with it. If you have a broken leg, what good are you anyway?

I dunno, you clearly see the need but I don't.

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.

 

[Vetitas86]

Dunno how I feel about the primary care bit. Oversteps scope of practice to me.

But that's how I see it. Tac teams should be trained in at least some level of medical care, but having a medic there could improve survival rate if something went south, as well as providing emergent care to casualties beyond the range of first aid/BLS.

Sure, not every operation goes south, but not every ambulance call is a "true" emergency. Just because its not common doesn't mean it isn't helpful or necessary.

As far as cross training, I do believe medics should be armed and trained at least in personal defense, and have at least a working knowledge of law enforcement procedure to be able to function as a member of a tac team.

 

[zmedic]

One way of looking at it is that if a tactical team isn't full time, training a medic in the SWAT part isn't that expensive. Many of them want to do it and would do it as a volunteer, or their ambulance service pays their hours with SWAT as part of the contract with PD. Contrast that with the expense of taking a police officer and spending lots of money putting them through a paramedic course. Futhermore, if you want someone who will provide good medical care in stressful situations there are advantages to those who are full time medics as they run calls every day.

I've heard from those who are MDs and work with SWAT that much of what they are doing is basically sports medicine, helping the team with nutrition plans and dealing with injuries like strains and tendonitis from training.

 

[DPM]

Realistically, does you tactical provider need the full training / scope of a paramedic? In the tactical situation. Dealing with bleeding and life threats and maybe hanging an IV... would they need ACLS? Would they need to push any drugs? Medical Aid in a tactical situation is very limited. Deal with / stabilize the ABC's and then evac the casualty. You aren't definitive care, and neither is the Ambulance. This guy needs a hospital, there's not a lot any of us can do, let alone in the tactical environment.

 

[EpiEMS]

Deal with / stabilize the ABC's and then evac the casualty. You aren't definitive care, and neither is the Ambulance. This guy needs a hospital, there's not a lot any of us can do, let alone in the tactical environment.

Makes sense. And it fits with TCCC guidelines — they're essentially

1. Deal with major hemorrhage
2. ABCs come after — when you're not getting shot at

Source:
http://www.naemt.org/Libraries/PHTLS TCCC/TCCC Guidelines 101101.sflb

 

[DPM]

Makes sense. And it fits with TCCC guidelines — they're essentially

1. Deal with major hemorrhage
2. ABCs come after — when you're not getting shot at

Source:
http://www.naemt.org/Libraries/PHTLS TCCC/TCCC Guidelines 101101.sflb

This makes sense to me, and I don't think it unreasonable to expect your SWAT etc to be able to do this.

It's the broken leg / tooth ache stuff that I don't understand.

 

[DrankTheKoolaid]

re

Follow me on this one.

So your a Tactical Paramedic assigned with the local marijuana eradication task force for example. You and the team just spent 3 hours hiking through the forest high in the mountains with not a single dwelling within 40 miles in any direction on a rainy day. (Read, no air support). One of the team members just (insert injury/illness here). The mission has to be completed and with a little outside of the standard 911 box ALS treatment has been applied it can, unless obviously it is a life threatening injury or illness then plans will change. And if it is life threatening and there is a 3 hour hike back to the nearest vehicle who do you want in the team, A EMT with basic first aid training, or MD/Paramedic with an expanded scope of practice for Tactical Operations to take care of whatever it is.

You have to think outside of the little box you seem to have Tactical Medicine closed into. Not all Tactical Medicine is urban and in my neck of the woods that scenario above would be the rule and NOT the exception.

And remember TCCC is not Tactical Medicine, It's just a very small component of it and established their own minimum requirements