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military medics versus paramedics

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#1 newmee

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Posted 20 December 2007 - 12:12 AM

Putting this one out there for opinions. I am a civilian paramedic as well as a returning combat medic with the US army. In my humble opinion I find the military medics good for trauma only but very limited and poorly trained for medical issues. I saw time and time a again combat medics clueless when dealing with medical issues. I also found time and time again that the combat medics were quick to do skills (IV's mainly) but not so quick or good with the basic stuff of stopping the bleeding. They were often dependent on an IV line over good basic care for the wounded (holding pressure to a wound). Even in medical situations I saw them quick to start a line put on a monitor but looking to others to read the ekg strips. I deployed with a national guard unit and I remember one of my combat medics who was regular army starting a line and putting a patient that arrived with a chest pain on the monitor but had to search and find me to read the ekg and instruct what he needed to do next. As I said in the beginning I feel the combat medics are good in trauma but poor in medical issues. I feel that the army is not doing soldiers any justice putting out half trained medics and even calling them medics. I feel they need to revamp the program even more than they have already.
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#2 chbare

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Posted 20 December 2007 - 01:06 AM

Oh brother... :roll:

First, there are many different levels of medical education in the Army. You have entry level providers, to LPN's, to special operations medics, to 18D's. I would be very careful when shooting out sweeping generalizations regarding all "medics."

Next, do you honestly think a line medic needs to worry about dealing with chest pain following an IED explosion with multiple causalities and an unsecured scene? Many people are coming back home alive due to improved point of wounding trauma care. ( Aggressive hemorrhage control and timely evacuation.) It only makes sense to focus on what saves lives in theater.

In addition, we need to consider the demographics of these line units. Younger and generally more fit than the average Joe US citizen. So, in depth medical issues are not as emphasized. Also, seriously ill or injured people will be evaced to a MTF if the front line provider cannot care for the problem in most cases.

You need to appreciate that there is a delta between the "field" we work in and the "field" that military medics work in. Remember, at the MTF, there will be nurses, docs, and support people that can deal with medical problems.

Finally, I know several medics that are actually quite good with medical subjects. Their ambulatory medicine knowledge is actually top notch.

Please correct my erroneous thinking if I am in fact way off base here.

Take care,
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#3 Dustdevil


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Posted 20 December 2007 - 03:39 AM

I agree that this is a totally out of context discussion. I mean, I notice that most dermatologists suck at obstetrics too. Most wildfire fighters don't know anything about structural tactics either. Duh!

Turning it around, most civilian medics don't know dick about medical emergencies either, beyond EKGs (if they're lucky) and when to administer D50. I recently saw a ten year paramedic treat Shingles as an AMI. How many EMT-Ps do you know that even know where to start when trying to determine the cause of nausea, vomitting, diarrhoea, or abdominal pain? All they know is IV, O2, and transport. Does that mean they are inadequate for their job? Well, okay... you probably could make that argument. :lol: But the point is, that is not what their system deploys them for. Similarly, we don't deploy Whiskeys for practising cardiology on mostly healthy males under 30 years old. That's what battalion surgeons, nurses, and the occasional competent PA are for.

Turning 18 year old field medics into jacks of all trades is no more realistic than turning cardiologists into field medics. It's a preposterous propositon. They would so very rarely use their EKG skills that they would dangerously deteriorate. There just isn't enough call for that in a combat unit.

As for calling them "medics," they were using that name for about fifty years longer than we were in the civilian world. In fact, civilian medics stole that name from them strictly out of laziness, because it is just too much of an inconvenience to say the full word, "paramedic". I have yet to see an NR or state paramedic card that actualy says "medic" on it, so it's a little disingenuous for us to presume to lay claim to that term.

Incidentally, this "problem" you describe is more evident in the Army than elsewhere. I am impressed with the quality of the Navy Corpsmen I work with daily, as well as the Air Force medical specialists. They get a lot more of a clinical focus in their school. But then, you'd probably say they suck because they aren't trauma gods like Army medics.
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#4 Richard B the EMT

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Posted 20 December 2007 - 10:37 PM

Dust, would you agree with my assessment that what the civilian Paramedic does nowadays, is originally based on procedures developed by in-the-battlefield Army Medics and Navy Corpsmen, from at least the First World War, to today?
If I asked this of you before, I apologize for repeating myself.
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#5 Eydawn

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Posted 20 December 2007 - 10:42 PM

I love it! "Wildland firefighters suck at structural tactics and most dermatologists suck at obstetrics... DUH..."

Dust, you always make me laugh!

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