Question for the corpsman...

ThomD

Explorer
sorry to offend nich..... as the great Jeff cooper would say "to ride, shoot straight, and speak the truth."

You're new here, so let me point out that on this forum we do not insult or disrespect each other and then hide behind the "I'm just saying it like it is" defense. You can disagree. You can have a friendly rivalry. You cannot step into a thoughtful, helpful discussion and toss around phrases like

i guess we are just a breed above army standards in regards to learning and expanding on our capabilities

That doesn't encourage participation and does not reflect well on you.

Semper Fi.
 

jh504

Explorer
Ya know what, I am still going to have to disagree. In my three deployments as a medic(two as medical NCOIC for an infantry unit) I have not once used CPR or the skills related to EMT-B/P in combat.

Saving a life in Combat is nothing like it is in the civilian world.
The first thing I tell some one when they boast about being a EMT-B or even P is to "leave it at home" ( I hold a current EMT-P, National and Florida) when they put on the uniform. If soldiers react to a causality as the EMT standards teach to treat a patient both of them would be put into a very bad situation.

Not to be an a@@ but leave the civilian medical training where it belongs... in the civilian world. It has no place on the side of the road at 0200 after an IED blast takes out a truck and you are taking fire from all sides.

Being that you are a civilian paramedic you obviously know that the amount of MEDICAL knowledge required in the civilian EMS world is generally higher than that required by the military. I am talking about pure anatomy and physiology here. I am not talking about medical procedures. Obviously there is a world of difference between civilian medical procedures and combat medical procedures. The anatomy of the human body and the way traumatic injuries effect it will always stay the same. More thorough medical knowledge will not hurt anyone as long as they know the correct protocols to operate under. I understand what you are saying, and agree to an extent, but as long as you keep the patient care protocols separated, the medical knowledge gained in an EMT class will be nothing but beneficial. CPR is only a day and EVERYONE should know CPR. Even though you dont do compressions while under fire.

Thank you for serving, by the way, and I would love to learn some things form you about real care under fire. I am currently in a 205 hour TEMS course and real world experience is always welcome.
 

ruditron

Adventurer
You're new here, so let me point out that on this forum we do not insult or disrespect each other and then hide behind the "I'm just saying it like it is" defense. You can disagree. You can have a friendly rivalry. You cannot step into a thoughtful, helpful discussion and toss around phrases like



That doesn't encourage participation and does not reflect well on you.

Semper Fi.



I agree that got a little to heated, I take back my comment on the army...
 
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Helot

New member
Interesting conversation. I too am new to this board. I've been extremely pleased with the level of discourse and the intelligence and tolerance of the contributing members.

In an earlier life, I served in the Marine Corps and for the last 10 years have worked as a firefighter and as a paramedic.

Obviously, the differences in daily experience between a civilian and military medic are significant, but the training and knowledge of each can only serve to complement and reinforce each other. As a civilian medic, the vast majority of my calls are medical in nature: chest pain, shortness of breath, syncope, seizures, etc. Still, I work in a urban setting known for its share of violence, so I also have quite a bit of experience in trauma from GSWs to ITAs. The nature of all these calls serve to reinforce many characteristics: on scene leadership, delegation, prioritizing patient needs, skills application, etc.

Having said this, I think any individual in the profession of caring for others should take any opportunity to expand and improve his knowledge. I plan on registering for the Wilderness EMT upgrade course this year just to experience EMS from a different perspective and because I'd like to enroll in the week long Overland training course later this year.

So to sum it up, don't ever forget anything you have ever been taught. Rather, expand upon it and add it to your mental rolodex

And to BACA327, look into a PHTLS class. Also, check out these sites:

http://www.phtlspodcast.com/
[ame="http://www.amazon.com/PHTLS-Prehospital-Trauma-Life-Support/dp/0323039863"]Amazon.com: PHTLS Prehospital Trauma Life Support: Military…[/ame]


Semper Fi!
 
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jh504

Explorer
Interesting conversation. I too am new to this board. I've been extremely pleased with the level of discourse and the intelligence and tolerance of the contributing members.

In an earlier life, I served in the Marine Corps and for the last 10 years have worked as a firefighter and as a paramedic.

Obviously, the differences in daily experience between a civilian and military medic are significant, but the training and knowledge of each can only serve to complement and reinforce each other. As a civilian medic, the vast majority of my calls are medical in nature: chest pain, shortness of breath, syncope, seizures, etc. Still, I work in a urban setting known for its share of violence, so I also have quite a bit of experience in trauma from GSWs to ITAs. The nature of all these calls serve to reinforce many characteristics: on scene leadership, delegation, prioritizing patient needs, skills application, etc.

Having said this, I think any individual in the profession of caring for others should take any opportunity to expand and improve his knowledge. I plan on registering for the Wilderness EMT upgrade course this year just to experience EMS from a different perspective and because I'd like to enroll in the week long Overland training course later this year.

So to sum it up, don't ever forget anything you have ever been taught. Rather, expand upon it and add it to your mental rolodex

And to BACA327, look into a PHTLS class. Also, check out these sites:

http://www.phtlspodcast.com/
Amazon.com: PHTLS Prehospital Trauma Life Support: Military…


Semper Fi!

Great advice. PHTLS is an excellent course. I follow the PHTLS standard everytime we are dispatched to a trauma.
 

yaknowthatguy

New member
in my days I've been around a bit and seen a few things. Most of the time I work in an excessively remote portion of Alaska with limited resources and weather related travel restrictions frequently; the rest of the time I work in a 50 bed ER near Denver. In Alaska - which is not combat related of course - the vast majority of what I see is not traumatic, it's medical. chest pain, belly pain, difficulty breathing, etc., and there are times I may have to sit on a critical patient for two days before they can be flown out. More medicine also holds true for the ER in Denver, but we see more trauma there, mostly due to population size, some due to behavior (eg, drug crime, car accidents, etc).

While so much of civilian medical training and EMT training is focused on trauma, I think it's too finite - you're much more likely to experience medical issues than trauma. In some ways, the primary significant traumatic things that tend to kill people (hypovolemia, pneumothorax, airway compromise, etc) are "relatively" easy to deal with (with the right training). When I was a paramedic I actually become somewhat bored of trauma - because it's so similar in so many ways, you do the same stuff all the time. Medicine is much more varied, challenging, and rewarding - at least to me.

One of the best programs I've seen is run through Harbor View Hospital in Seattle for mariners in the northern pacific and Alaska. while they do have some training, the captain has a box of a variety of drugs and a small handbook. Someone sick or hurt, the crew can call Harbor View, get some guidance for what is happening, and use meds they have on board. Buys time until they can get to port, but doesn't require the use of the Coast Guard most of the time.

The point of all of this is that trauma (outside combat duty) is less likely than bad medical things. As such, expanding one's medical knowledge as far as you can is a good thing. While medicine isn't everyone's passion/career/calling, more knowledge never hurts. Take classes. go through the Wilderness First Responder/EMS courses if you can (takes EMT basic cert first...so a commitment).

If you are a dedicated traveler/overlander, and have phone communications, maybe you can work something out with your doc if you have a good relationship - get them to write you Rx for certain meds, bring them along, and contact him/her if needed. Not everyone will do it, but it's worth a shot.

one other thing - I have to agree with the military folks about the use of CPR. When bullets are flying, buildings are burning down around you, or in some other way the SHTF, the application of CPR has limited worth. The START triage algorithm that is the standard for EMS doesn't even mention CPR if you have several patients and not enough resources - because it dedicates time/resource to one patient that is probably not salvageable when it should be dedicated to others you can save. It's cold, it's callous - and it's reality. Also, CPR by itself has dismal statistics for bringing someone back - without defibrillation and the right drugs within 4 minutes your odds approach <1% extremely fast. It can be a valuable tool - but it is not a panacea, and like every tool it has its application.

Going into the wilderness prepared for medical issues is, IMO, just as important as recovery gear, fuel and spare parts. It's what gets you home. Si vis pacem, para bellum.
 
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