Doc D

Fort Sam Houston is pretty gay now. Atleast when i went through Charlie Co. 232 medical Battalion....we got smoked every day, they tossed our bays every day, we got mass punished for everything, we got dephased 3 times throughout the cycle, no weekend passes, super fast paced, low passing rate, lots of people fail out, less sleep then basic training, in most cases less then 1 hour personal time. It was a shitty 18 weeks, i would have just done basic training twice instead of going back there for a fresh 18;.

LOL i get -2 rep for talking about how the 232 medical battalion is, LOL.

But yeah too many females got raped so they took our overnight passes and whatnot. Did you know 68w(medic) and 11B(Infantry) are the only people living in bays for AIT? Every other MOS gets 2 to 4 man rooms for AIT. Lol.

Doc D, just reminding you that in some firefights, there can be no discernable "Front Line" for female members of the US Military to not be at.

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Again your not understanding me. I know females get into fire fights and whatnot, but i am assigned to an infantry platoon of all males. I go out with them. No females in the infantry. Im not saying females dont fight, but i dont treat females because of the type of unit i am in. I go one patrols and missions and whatnot with the infantry. I am a line medic. The females are in support battalions and HHC companies, which have their own medics. Im not saying i NEVER will treat a female, but i am in infantry. Support and HHC have their own missions and their own medics.

I am an EMT-B i know BSI is before everything as an EMT, but as a combat medic in the US Army its not too big of a deal. I know it sounds terrible to you guys because its drilled into you as an EMT. Its really different here. I wear gloves in garrison, dont get me wrong. But down there, you dont always have the time todo so. BSI is always good, dont get me wrong. My life and welfare is precious to me, but as a combat medic BSI is preffered but its accepted you wont always have time to get it on. Even in my civilian clothes i always have a pair of gloves in my pocket...but its just different here in the Army. I know its tough and it sounds outrageos to you all i can tell...but its about another persons life, not mine. Someone mentioned just wearing gloves when going into combat........i cant do that. Gloves let the enemy know i am a medic and they will shoot at me first. There arent enough combat medics in the army. I appreciate what all of you guys do. I am a different kind of EMS

Fort Sam Houston is pretty gay now. Atleast when i went through Charlie Co. 232 medical Battalion....we got smoked every day, they tossed our bays every day, we got mass punished for everything, we got dephased 3 times throughout the cycle, no weekend passes, super fast paced, low passing rate, lots of people fail out, less sleep then basic training, in most cases less then 1 hour personal time. It was a shitty 18 weeks, i would have just done basic training twice instead of going back there for a fresh 18;.

Way to disrespect the SISTERS AND MOTHERS AND DAUGHTERS who are fighting just as hard as you are. I dig that there's no chicks in the Airborne, and there's not as many women on the front... but there are women in intelligence and support and medical who are just as vital to the operation of the military as you are. One of my acquaintances just graduated boot and is on contract to be in an aeromedical drop unit. Your first phrase, "it's about a soldier's life" is absolutely spot on. The rest is realllly narrow thinking. Get your head out of your ass. Just because your unit is a bunch of hopped up male adrenaline plane-jumpers doesn't mean that you wholly represent the entirety of the armed forces.

Im a line medic in an infantry unit. All infantry is males. All combat jobs, Infantry, Cavalry Scout, Tanker, Artillary, Forward Observers are males. I work with males. Sure females work all the POG jobs, Females are vital to the Army. I dont work with them, they dont go on the front in most cases. Therefore I dont send sisters mothers and daughters anywhere, aside from out of my room in the morning.(Thats a joke).

Also, BSI is cool and all if your giving your drunk battle buddies IV's, but in the battle field if someone is bleeding arterially, or has other life threatening injuries im not going to waste my time putting gloves on, every second counts. I also know thaat soldiers cant deploy with viral STD's, HIV, Hepatitis and whatnot.

I spent the first 12 years of my career with several uunits in the 29th ID(L). I have since been working at various positions at the Army NAtional Guard Readiness Center. I am technically assigned to HQ Company US Army at Ft Myer, VA. IT is the largest Company in the Army with over 1,000 Soldiers assigned. I was 11B and am now a 32A, being trying to get a reclass to 68W, but there are few slots available where I work so I am SOL.

I will probably hang up the uniform in a few years. I am currently working on my Masters in Emergency and Disaster Management so I can move into a civilian job when the time comes.

I have been a civilian EMT for about 5 years. I love it. During my divorce I spent about 8 months living in the station which lead to running a lot of calls and giving me a lot of experience!

I am also from the DC area, but in NOVA. Living in Arlington, I volunteer in Carles County, MD where I was living prior to divorce.

Take care and good luck.

SSG G

Your gonna hate fort sam houston seargent......its like not a military base. More officers then enlisted personell there. Tons of butter bars straight out of OCS. Its really funny when you walk by and salute them and they freeze up and dont know what to do.

DOC D, I almost 18 years in uniform, so I think I know of what I speak. I would same some Soldiers dip, chew,or smoke. "Most" implies a majority and in my experience the number was never a majority and is shinking day by day.

I cant speak for the whole Army, but i can speak for the 101st Airborne. We lead the military in Suicides and AWOLS. Nothing to be proud of, but the Department of the Army has the whole division deploying back to back at all times. We all smoke or chew, i have actually never in my life seen as many tobacco users since coming to Ft.Campbell. Dont get me wrong, there are millions of movies and stuff about us, and we fight hard. Death before dismount, we get the job done...but there are consequences of it also.

Have you been back to Gernmantown recently? You'd be amazed at how much it has grown... they have a new station too, 22 that's brand spankin new and really nice at 118 and Clopper Road.

I was there last christmas, but i was chilling at my spots, Around Seneca Valley (i went there), Fox Chapel, Rolling Hills, the neighborhoods around Reburto Clemente etc.. etc.. Theres the New Shady Grove mini ER by Crystal Rock and stuff. But some things never change, Montgomery County Police are still assholes and will beat your ass for no reason. They tried to arrest me, what for i dont know....but my military ID got them to fuck off.

Oh btw. I have an EMT-B, but i am not an EMT. Dont call me one. EMT's only come out with BSI and when the scene is safe. We run out with bullets flying, and dont give a fuck about BSI.Its about a soldiers life, sending a father home to his children, sending a husband home to his wife, sending a son back to his parents. We conserve the fighting forces of this country. We supress enemy fire, its our first priority. Its insulting to call a combat medic an EMT. Thats an insult senior medics will use to call younger medics at times. Please dont call me an EMT. I appreciate all of you for what you do, its a tough job. Long hours, legalities, protocols, etc... but we are very different. We are a seperate breed of EMS.

Damn, CH, I am jealous!!!! I never in my 18 years of M-day and AGR had oportunities like those!!!!

Doc D. Welcome to the city.......

AM 571 here...... I have 14 in with 10 of those AD. 4 tours to the sand box. I know Taji and Sadr better than my own neighborhood.

To be honest, I just put in to go back to AD. Anywho....

Be cool, stay safe, and remember to duck!

SSG K.

Seargents, what unit are yall apart of? (standing at parade rest lol)

I dont dip during the job. Not allowed, nor need to. I dont spit in cups either, i spit in the grass. I dont put raw tobacco in my mouth either. I use pouches. Please remember i am not an EMT. I am a soldier, I am a combat medic. Most male soldiers dip tobacco. Its a bad habit, but its very acceptable here.

Big ups to my MOCO (Montgomery County) paramedics, i grew up there. Germantown, i appreciate what you guys do.

Anyone here Dip?

Thats cool, i noticed nowdays the NG doesnt fund their medics too well with medical supplies. I still see some NG medics walking around with old school powdered quick clot in their bags...lol

I want to preface this post by saying that yes I have worked in both Afghanistan and Iraq; however, I would never compare these experiences to that of a soldier.

Doc D, I do understand your point; however, you must understand there is a big world beyond the four months or so you spent in San Antonio. I appreciate your energy and willingness to discuss your point of view with us; however, as you continue in your medical career and education, you will find that the one way you have been told does not always apply. I hope you would at least take my points into consideration. Again, I do not oppose tourniquet use; however, like any modality at our disposal, we must be careful and thoughtful when considering the use of the said modality. Again, I believe it is appropriate to consider using a pressure dressing trial before transitioning to a tourniquet in many cases. Clearly, the situation may dictate immediate tourniquet use however.

Take care,

chbare.

I understand. Thanks.

I can't speak for other people, I did attempt to be nice, but based on his posts in other area's all put together it is safe to assume he is brand new. Which is fine, everyone starts somewhere, but with some of the statements he has made, he needs to be made aware of the larger picture.

Some of the statements I have made, are all how the army teaches their combat medics. You work a totally different type of EMS then I do. The whole reputation thing was a joke, i dont really care too much about it. About the flight medics, i cant pull up the protocol on it online for a bunch of reasons. one, the army doesnt release that stuff online, 2 every different Unit has its own protocols. Some cut em', some keep em'. Most cut em' though. Its like how my friends in the 4th ID have to use saline locks for all their IV's, while us here dont even get saline lock kits. We do straight IV's. Its like that.

Sure. I could amputate it too, would also do the trick but it maybe a bit too serious.

Come on now...

It takes 6 hours for a tournakit to do tissue damage, and 8 for it to cause nerve damage

Doc D, I think you missed my point. I am not arguing against tourniquet use, I am saying we need to be careful, thoughtful and use the tourniquet when it's indicated. As I attempted to emphasise, there is a delta between a non-permissive environment and say the "typical" civilian setting. Again, I believe in many cases a properly placed pressure dressing can control external haemorrhage. My point being, not every seriously bleeding wound will require a tourniquet.

Take care,

chbare.

Edit: "wound"

Yes, an arterial bleed from a limb is its indicated use. Then again, you work Civilian EMS where there is protocols, in combat medicine there arent many and our wounds are different then yours

If it's a simple device to remove, then there would be no reason to cut it. If it's loose enough to get a shear blade under, maybe it's not tight enough?

Flight medics cut everything off and throw it away, its their protocol. Wow this thread has really hurt my reputation...lol combat medicine is substantially different then civlian EMS

I dare say that caution with tourniquet application would be the prudent pathway to follow. I would even go so far to say that most injuries can be managed with a pressure dressing. If a tourniquet is needed, so be it; however, it seems many providers treat nearly any wound as a nail that can only be treated with the sledgehammer of a tourniquet.

Well my friend, the tournakit is meant to control arterial bleeds, which are life threatening. If someone tries to use one to control venous or capillary bleed's, so be it. It will do the trick, it maybe a bit too serious for such a simple injury, but it will still do the trick.

Cost. Can't put a price on a life, but you gotta be able to afford equipment, in bulk.

The main issue i see, is wheneever we move on to the higher escheloes of care they CUT the tournakits off with trauma shears instead of just unbuckeling them, thus wasting a 40$ tournakit used once.

Never heard of the 38th infantry division or 1-125th Air Assault...are you national guard?

Improvisitation is the difference between a shitbag medic and a doc (In the Army) 4 sam splints is what we carry in our bag. You can splint a femoral fracture with it then provide traction on the ends to splint a femoral fracture. Its the only splint we got, but when my guys knock on my door and someone broke their arm playing football, i always splint it with a SAM

Goddamn power went out during an electrical storm... three hours ago...

PA is pushing TK and Hemostatic product use now. A lot of new providers think TK use is something that's just being introduced, but it was always taught, just looked down as a thing of the past. I "grew up" in EMS with a lot of really OLD providers, live in a very rural area, and have been trained in Wilderness medical care. I could make a TK out of just about anything that is pliable and can be drawn taut. Before, it would have been, direct pressure till you were out of strength, then a TK as a last resort. In our whole county, we were probably the only units to carry TK's, until about six months ago. However, they were likely from WWII, the old webbing and buckle type. I kept several for kicks. The SOF Tac. TK uses the same design, with a couple additions to make it work better. That's what we carry now. We're to use a hemostatic product, direct pressure. If that fails to work with in a minute, slap on a TK, wait five minutes, loosen the TK, and likely by then, the bleeding should be pretty well stopped. If not, I have some of my own methods that work pretty well. Like a tray of gauze squares, saran wrap, and a roll of elastic wrap. Laugh if you must, but it's worked for me before on a forehead lac. If you really want to get technical, you can "suture" the scalp, in the field, with the patient's hair by tying it together. It works.

I am definitely a tourniquet fan. The new stuff they have on the market is just the bee's knee's. Progressive Medical has a nice selection!

SOF-T is alright, but we use CAT Tournakits (Combat Application Tournikits). I dont understand why the hell people are so scared of those things. It takes 6 hours for a tournakit to cause tissue damage and 8 to cause nerve damage. Back when i was on the EMT side of my job, before moving to combat medicine they taught us Direct Pressure, Elevate, Push the arteries or something like that. Improvisint tournakits is pretty easy. A belt can be a semi-effective tournakit, but you can make a good tournakit from cravats and a stick, or cravats and tounge depressors.

Palpating ribs, guess im gonna have get some more practice. the angle trick is pretty interesting also, will look into it. I have another question? What is the effectiveness of a flutter valve on pneumothorax? putting an occlusive dressing on the exit wound in the back, and putting one on the front but leaving the bottom open for air to flow out and sitting the patient up-straight

Hey, I was in the 101st in 1992-95, 326th Combat Engineer and 187th RAKKASANS, then went to MEDDAC to go to paramedic school while working the post EMS.

Im with Bastogne, 1st Brigade BCT. 3rd BCT is already outta here, only the rear detatchment is left. Did you used to live in the 3rd BCT barracks?

I think the best splint out there, is actually the only splint we use here. its the SAM splint that forms to the limb then you ace wrap it. It also easy to improvise it into a traction splint for long bone femoral fractures and whatnot.

Back in my days at Army medic school i wondered what SKED stood for, and my seargent told me Super Kickass EVacuation Device. I know thats not what it stands for but its a good memory. The sked is pretty sweet though. Makes a good sled, and its easier to drag patients rather then lift them in certain cases.

I am a special kind of EMT... a combat medic, US Army. I carry an m-9 pistol and an m-4 carbine rifle w/ M68 CCO.

Are they used often or only with arterial bleeds?

Well thats hard to say. Every combat medic has their own ways. Tournakits are the best and preffered way to control the arterial bleeds in a limb. I guess the etb could be a substitute after packing the wound with kerlix or combat gauze(hemostatic agent). Even if the arterial bleed on a limb is already controlled with a tournakit i will still pack the wound with Kerlix or combat gauze(hemostatic agent) to keept dirt and debree from getting into it. Honestly, i would much rather use an Ace Wrap though, pack it, wrap it up tight with the ace then use like 6 inch medical tape to secure it. Im telling you that plastic knotch for holding the pressure cen break. I dont trust it, and its useless because the higher eschelon of care, in my case the aviation/flight medic is just gonna cut it off and use his own preffered dressing.

Cool! One of my best friends is an army nurse at Ft. Campbell right now...she deploys in September though. Whereabouts in Maryland? I grew up in Bethesda right near DC.

Welcome to the city... it's a pretty neat place to hang out and get some good information

Kate

army nurse deploying in september, she is with the 86th CSH (Combat Support Hospital). I have some friends in that unit. Hanging around their barracks you meet alot of girls (Its a hospital unit with monstly females, its a haven for girls on friday and saturday nights). I grew up in Germantown Maryland. Same county as you.

My best advice for you is to make someone from the unit lay down and count his ribs. You can't be good at it if you don't practice. Further I question your ability to properly perform 12 lead EKG, specifically electrode placement, if you can not properly palpate ribs.

I dont do those other things you listed. The EKG and electrode placement is what EVAC is trained in. I am a front line medic, i work with the supplies in my aid bag. I was just saying because on the training dummies its very easy to find the 2nd intercostal space, but its not so easy on a human being.

Quick question for my paramedics here. I am a medic in the US Army, we wear IBA and IOTV body armor. Thoracic injuries of penetrating trauma dont really occur often. I would always apply the occlusive dressing, but my question is about the NCD. I havent done it on an actual human being because i havent encountered the injury. I know your preforming the NCD on the 2nd intercostal space, which is right above the 3rd rib. I have done it on training dummies all the time, but my question is on a human being it is hard to feel the third rib to know. Does anyone here know an easier way of identifying the 2nd intercostal space without feeling for the third rib?