For you TacMed people

[Dustdevil]

Arlington National Cemetary is full of guys who felt "secure."

[Michael]

I would be so happy if someone would post a thread for people to submit their favorite christmas cookie recipe

Click here, then (I live for making people happy :lol:/ ).

[somedic]

In2bate: You must have never been in combat before. No one in their right mind would feel secure without fire superiority. Get rid of that false sense of security about your local Swat team as well. Ive seen many "bad ass supercops" soil themselves and become ineffective. Its great that you train together but dont get your self killed over a false sense of security.

Dust: What else could be said about your last post? Nothing.

Somedic

[Asysin2leads]

NREMT, what I'm saying is that when we have the riot shields and shotguns and sniper rifles out, a paramedics training is not really much of a help. The evidence of 12 leads on people suffering from gunshot wounds is dubious at best. In a hot zone, with bullets flying and bad people doing bad things, any life saving treatment that could be provided by an ALS provider would be tantamount to suicide if they actually attempted it. First of all, as all you charming EMT superheroes like to remind me, there is very little paramedics can do for trauma, really only airway maintenance, fluid therapy, some medications, and chest decompression. Making a mad dash, running in, grabbing the wounded guy, and dragging him to safety would be far smarter than trying to do any of that in a hot zone. You really expect to perform RSI with people shooting at you? Maybe you can ask them to stop shooting while you calculate the Lidocaine dosage? Sure, I'd like to give the wounded officer some pain medication, so why don't we get someone big and strong and fast to run in, grab him, and drag him someplace safe so I can do a proper assessment and treat him?

Heck, I could even make an arguement that doing BLS care while being shot at is kinda silly. Splinting is really not a high priority in the midst of automatic gunfire. The active bleed that can be controlled with direct pressure and means the difference between life and death by holding that pressure is really kind of a myth, I mean, its really pretty hard to bleed out from an extremity injury and anything that is internal you can't control anyway, so, yeaaaah.

[NREMT-Basic]

Asysin- Ill be snookered if I can ever figure out which side of the fence you are on. I like ya, but I cant figure you out. If you read my post very very very carefully, you would see that while i discussed various configurations of tactical medicine, I also said that it is a rare beast indeed. Those qualified to teach it are few and far between and those qualified to practice non-military tacitcal medicine are practically non existant. I said that both EMS and Tactical operations would have to be severly overhauled if not completely scrapped and rebuilt to have what could be truly called tactical ems. While I feel I am a well trained basic emt and also well trained in the bare bones basics of live fire real time tactical operations, I would never be so bold as to say put me in coach I am dumb enough and feel lucky enough today to take my tactical shotgun and my ballistic shield/drag stretcher and run between the bullets to bring back that wounded SWAT Captain. I know that I dont need to explain to you the education that basics recieve in terms of their scope or that basic tactical civilians (aka me) are taught the tactical use of a sidearm, shotgun, long rifle, move and shoot maneuvers, defensive and offensive driving, etc. I dont know what your tactical background is. I was once told when I asked someone why so many medics in the city have the little special ops cartoon next to their names that i would be shocked to know how many medics who post here at the city also operate "in the dark." I am still holding my sides to keep them from bursting with laughter. And as I said...i think the best way for tactical and ems to meet is staged a hundred feet apart. I think for most of the people that think of themselves as warrior medics, the notion is truly something like peeing your pants in a dark colored suit, it gives you a nice warm feeling and nobody else actually knows the difference. Oh by the way, at what rate and quantity is blood lost by an open midshaft femur fracture where the femoral arterty is compromised? I think that broken limb could sometimes be fairly significant. Thats it. I had my fun poking my nose into the world of those who practice paramedicine "in the dark." Im going to go play somewhere else now. Oh and do try to refrain from lumping all of us "charming emts" together. I do not share their opinion about what a medic can do to manage a trauma.

[somedic]

Medical /Legal consulting sure sounds like the right job to be in to enlighten us in your wisdom on tactical operations. Thank you for all your help here.

What kind of "bare bones, live fire, real time, tactical training" did you get? Are you a veteran?

Its good that you actually do recognize the inherent stupidity of "tactical medics" in the civilian arena. Asys has the same belief as I do (not to speak for him) Good medicine is needed in bad places but without all the stupidity that becomes dangerous for amatuers when bad guys shoot back!

Somedic

[Asysin2leads]

NREMT, to answer your question, I have a good amount of tactical training but its not in the way you might think. My training includes pretty much recognition of dangers and eventualities that could be encountered on the scene and how to best mitigate the situation with minimum casualties. In other words, I am trained to place safety of the operators at the highest priority as a part of my responsibility as a medical officer on scene. I haven't done live fire exercises, but I have done many drills involving tactical elements. As I said before this usually involves recognition of the danger (armed perpetrator, violent EDP, hazardous chemicals, explosive device, etc) and mitigation, which to be honest, usually involves evacuating the area as soon as possible.

I'm not saying there is not a place for EMS in a tactical situation, or that there is no need for specialized training, I'm saying most tactical training involves doing things that if you tried them in real life would make you very dead and has a very poor understanding of the requirements to provide good quality ALS care. If you want to utilize a paramedic, put him where he will be useful. Instead of sending the paramedic in through the hail of gunfire, have him sit back in the ambulance with his meds stocked, airway kit and suction and fluids ready to go, perhaps with a video and voice link up to the first responder trained SWAT officers and a direct line to telemetry at the nearest trauma center. If someone goes down during the operation, the paramedic will be able to use his skills and really be able to do some good.

[NREMT-Basic]

Excellant point, well made and taken. Thanks. I think this is alot of what I was trying to say in my earlier posts. I have taken a few courses in tacatical ems and quite frankly at the basic ems level in which i currently operate, I have no business any closer to a tactical situtation than in an ambulance drivers seat waiting to hear "GO GO GO!" I have no delusions of myself as a tactical medical operator and honestly the only way I ended up taking tact med "courses" was becaues during training and employment with a private security company which provides everything from military base security to personal protection of dignitaries, someone came to me and said, hey, you wanna go take a one week course in tact med. And I said sure, if youre buyin'. Its great fun to imagine myself particpating in a move and shoot tact med scenario with a real outcome rather than a scenario where the safety officer says, ok, you got clear, the bleeding is moderately controlled on thta swat officers open midshaft femur but there are still two officers down. Thats an adrenaline rush. But I aint putting myself on that scene anytime soon in the real world. . If I ever go back to armed work again, I am perfectly happy to stand post outside an office door while some stuffed shirt has a meeting and then driving him home again. I mean when even in drill scenarios, you can hear the screaming over the gun fire...well...i dont need much more than that to make me know I will stick to my ambulance based work. Cheers mate.

[Bulldogmedic]

I don't get it what do you all have against a medic being on a swat team? I am a member of a new medical team that is part of the swat team for you pd. We are new and will be going to cleet (police school) and also contoms. The officers are very confident in our skills as we are all paramedics. As far as the warrior medic thinking there is more to being a medic for a team then just to be there in the hot zone. We are responsible for all details of medical care for the team. We do things like monitor for changes in officers from heat and cold. We also do little things like treat headaches and sprains but we are there and will go into the hot zone if we are needed. So before you all keep bashing us medics then I suggest you do a little research so you have a clue what you are talking about.

[somedic]

Bulldog: Im very qualified to answer your post by virtue of military and civilian paramedic experience and I serve as the coordinator for tactical medics in our department.

I stand behind any statements Ive made. No one here has said that there is not a place for specialized medics in a tactical situation.

There are however, a lot of "tactical medic" schools out there that will teach you how to get killed. My own department was a victim of one of theses programs. I was away on a deployment when my Chief hired a company called "Mission First" to come and teach "tactical medic operator course". I came back home in time to attend some of the training.

I found out rapidly that the instructors were not the war vets they claimed to be and the icing on the cake came when an instructor told me he is an "operator" in the very same unit Im in!!

CONTOMS is NOT one of them. The fact your department is sending you to that course indicates that they are serious about tactical medicine.

Tactical medicine is a fad. It gives people a chance to be something except be ambulance drivers.

My feeling with you is that once you do have a major contact and blood is shed, you will back out of this fad. Either way, best of luck to you.

Somedic