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Combat medics and EMTs: do they really have the same training?

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hedgehog Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 12:11 PM
Original message
Combat medics and EMTs: do they really have the same training?
I'm an Obama supporter, but I have to question his frequent suggestion that combat medics be allowed to return to civilian life and work as EMTs without having to go through further training.

Now - combat medics do an amazing job and are responsible for saving thousands of lives. My guess is they are trained to handle wounds from bullets and explosives, chiefly with young adults in good physical condition. My further guess is that EMTs see a much broader range of situations: the middle-aged man with a heart attack, the diabetic in coma, stroke victims, automobile accidents, drowning victims,etc. Without denigrating people in either field for the excellent work they do, are the job functions sufficiently different that medics would need additional training before being certified as an EMT?
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TwilightGardener Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 12:12 PM
Response to Original message
1. They would almost certainly have to get certified in their states to become
Edited on Sun Sep-04-11 12:14 PM by TwilightGardener
an EMT-P (assuming they are at that level). They would have to take the exam and prove competency.
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hedgehog Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 12:18 PM
Response to Reply #1
2. Apparently, that's the controversy - that combat medics have to
take training and/or an exam before working as an EMT. I think both groups have excellent training and experience, I'm just wondering how much overlap there is. It may well be possible that a combat medic is missing training in certain functions that are routine for an EMT, simply because one is trained for a battle field and the other handles civilian crises.
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TwilightGardener Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 12:23 PM
Response to Reply #2
4. I've been EMT-B certified, and my guess is that they get taught the same
stuff, but with a different emphasis, and they probably end up with different work-related experience. But the basics don't change--Airway, breathing, circulation, etc. I'm sure they would do fine.
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Book Lover Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 12:22 PM
Response to Original message
3. I don't know, but would like to bring up another group
you didn't list - mentally disturbed and disabled people. I can't imagine Army medics need training on how to handle, say, people on the autism spectrum.
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polly7 Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 12:24 PM
Response to Original message
5. I would think combat medics would have already been taught all
Edited on Sun Sep-04-11 12:32 PM by polly7
of the above, as MI's, strokes, diabetic emergencies happen to old and young alike everywhere, drowning or near-drowning is one of the most basic, first things taught and automobile accidents and the extraction and treatments would be very similar to what they see in the war-field. jmo. It would probably just be a simple re-cert and maybe a few weekend labs to get their EMT-P certificate. Probably the one thing they might have to brush up on are the symptoms and diseases of the elderly, and basically, still all you can do is follow protocol, possibly get them fluids and allowed medication, and get them to the hospital. Again, jmo. (I'm an EMT-P in Canada, so things may be completely different there).
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nadinbrzezinski Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 12:31 PM
Response to Reply #5
7. I worked side by side with a few, unoficially
so yes, they are... It would be a 20 hour course for the do's and don'ts...
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nadinbrzezinski Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 12:27 PM
Response to Original message
6. Combat medics actually have a wider skill set
that set, in their first training round they are EMT- Basic, like any of their counterpart in civilian life. When they join combat units on patrol they are what you would call intermediate EMTS, aka they can start IVs and use SOME MEDS to fully fledged EMT-P... a few, like Corpsmen attached to subs, are actually well beyond an EMT-P. They are actually certified Physician Assistants, which is well beyond an EMT-P training wise.

What they would need when they come home is a 20 hour course to set what are the local standards and procedures and the state test. Suffice it to say Combat Medics are also certified through the national registry, NAEMT... but the registry is not always recognized by the states.

Realize that on base, combat medics also staff them ambulances that respond to emergencies in military housing. that includes all those other civilian maladies like diabetes, heat strokes, strokes, heart attacks et al. And even young people in good shape get them as well.

Unofficially we used to take american military medics out on calls... and their skill set were just as good as mine, and fully equivalent. Moreover, an urban EMT working for your local fire department... can handle as much trauma as a combat medic, why the military has combat medics and combat surgeons train in what is colloquially known as the gun and knife club... aka the inner city in major cities, and your local trauma center. Now your local EMT-B working for your private Ambulance company... might get a "hot call" once a year... if they are "lucky." Most of the time their skills degrade since they spend most of their shift doing soft transports.

They'd need about a 20 hour course to learn the do's and don'ts. Hell, if I wanted to work in San Diego and moved to Riverside, I'd have to recert fully since medical directors have a slightly different standards on how you do things...

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polly7 Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 12:31 PM
Response to Reply #6
8. Yes, I agree with you. My cousin is a medic in Afghanistan right now,
and received training through the army to become a PA. I bet there are many who have superior training to EMTs already.
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newfie11 Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 02:22 PM
Response to Reply #8
18. I agree, their training is closer to a PA than an EMT
I am married to one that was a navy corpsman, and many PA's I have met were corpsman and went further to be a PA.
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Book Lover Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 12:39 PM
Response to Reply #6
11. I would appreciate your insight
to my point above. Are Army medics also trained regarding mental illnesses and disabilities?
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nadinbrzezinski Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 04:18 PM
Response to Reply #11
23. Yes
PTSD is something that is broached... it is part also of the national curricula
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Book Lover Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 05:14 PM
Response to Reply #23
27. Thanks! (nm)
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jwirr Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 02:45 PM
Response to Reply #6
21. Not to mention continuing education would probably be a requirement
and could fill any holes that were specific to the community. I think this is a good idea.

One issue I would worry about is PTSD - if the combat medic was subject to this then working the emergency route could trigger episodes.
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nadinbrzezinski Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 04:20 PM
Response to Reply #21
25. Medics, civilian or military, can get PTSD
<-------- thank you very much. Mine is much milder, by the way... but it is there.
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jwirr Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 05:28 PM
Response to Reply #25
33. The things you see are often terrible. It is not surprising that this
disease exists in many professions.
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nadinbrzezinski Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 05:34 PM
Response to Reply #33
35. We worked heavily in decompressing my EMT's
I made it a rule that after any major call they could go AWAY from civilians, to tell dirty jokes, talk about it, and generally speaking deal with it. That is how you reduce it.

Oh and trust me, the jokes are NOT for polite company.
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RSillsbee Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 02:47 PM
Response to Reply #6
22. The only certified Physician Assistants in the Navy
are certified Physician Assistants. They are commissioned officers An independant duty corpsman is just that an independant duty corpsman who would be a Rating or a Petty Officer.
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nadinbrzezinski Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 04:19 PM
Response to Reply #22
24. CPO, and the one that went with the boat
on my husband's command WAS a CPO. Realize the rating my husband had on the boat, A-NAV, usually done by a commissioned officer in the surface fleet.
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RSillsbee Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 05:16 PM
Response to Reply #24
28. CPO is senior petty officer but still a PETTY officer
And not a PA
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nadinbrzezinski Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 05:24 PM
Response to Reply #28
31. Problem is he was...
Edited on Sun Sep-04-11 05:26 PM by nadinbrzezinski
and I know exactly what a CHIEF PETTY OFFICER IS. you forget the sub fleet is a whole different animal.

As I said, my husband's rate, is an officer rate in the surface fleet. It is done by a CPO on board a sub. My husband was an A-Nav.. doc was a PA

Why I was very specific in saying SUB SERVICE.
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RSillsbee Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 06:34 PM
Response to Reply #31
37. W/ all due respect
If you are saying that your husband was a certified Physician's Assistant and acting as such as an enlisted member of the United States Navy, you are either gravely mistaken or being disingenuous in the extreme
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nadinbrzezinski Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 09:47 PM
Response to Reply #37
40. No I am saying the doc on the boat was
my husband was an assistant navigator. Both are filled by officers in the surface fleet, Why I was very specific to what part of the service. we were talking about.
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RSillsbee Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Sep-05-11 08:04 PM
Response to Reply #40
41. Again w/ all due respect
You are being less than completely truthful or someone is telling you sea stories.

A certified Physician's Assistant (who must work under a Physician's license BTW)is an officer billet period. An independent duty corpsman does not have a license to practice medicine. (neither does a PA BTW). There are no enlisted PA's anywhere in the United States Military.
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hedgehog Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 12:35 PM
Response to Original message
9. Thank you all for the clarification.
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Lisa0825 Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 12:36 PM
Response to Original message
10. I recruit for some medical positions, and we consider medical corpsman as equivalent to EMT. nt
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newfie11 Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 02:27 PM
Response to Reply #10
19. There are rwo classes of EMT,or used to be
EMT Basic and Paramedic. I am not sure what the difference is.
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nadinbrzezinski Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 04:24 PM
Response to Reply #19
26. There are more than two
but the EMT- B does BASIC life support, can transport a pt with an IV at To Keep Vein Open... and can't administer any med save oxygen. The time in training is average 120 hours.

EMT-P can administer a slew of meds, is certified in Advanced Life Support, pediatric Life Support, Advanced trauma, and has an average of 1200 hours of training.

What exactly an EMT-P and EMT-B can do in any specific county depends on their medical director... which used to drive us nuts. My EMT's were EMT Intermediate, which meant they could start IVs and run them, as well as oh five really basic meds... they had 200 hours of training.

And as paramedics I could administer about 10 more drugs than my counterparts in San Diego... which led to a few issues. I also was allowed to do a couple more procedures.

(Yes that was in Mexico, but we used Seattle's protocols for the longest of time)
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Lisa0825 Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 05:23 PM
Response to Reply #26
30. EMT-B (Basic), I (Intermediate), and A (Advanced) = Paramedic.
For the positions requiring any EMT level, medical corpsman qualifies for all titles. I do not have any positions requiring Intermediate, but it is a plus. I have one title that requires advanced, and I would just need evidence that the corpsman's training included the advanced topics required, such as interpreting EKGs (as opposed to just setting up/ running them). That class is part of Paramedic training, but not basic training.
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nadinbrzezinski Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 05:25 PM
Response to Reply #30
32. Absolutely, and interpreting them can be all kinds of fun
Edited on Sun Sep-04-11 05:26 PM by nadinbrzezinski
:-)

Realize that we used to have EMT A. EMT B. EMT Intermediate I, Intermediate II and P at one time.


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saras Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 12:44 PM
Response to Original message
12. I would expect EMTs to have a lot more concern for the patient's experience than combat medics...
...but I'm not sure that this is a training issue, so much as a hiring the right people independent of skills issue.

In actual medical emergencies, combat medics may have more training and more experience, but that isn't the only, or even the only important, part of an EMT's job.
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polly7 Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 12:52 PM
Response to Reply #12
14. That's part of what I meant when I said a few weekend labs and hours
Edited on Sun Sep-04-11 12:57 PM by polly7
in class. Because pt. history is so important (if you have the time and are fortunate enough to have a conscious pt. or family members around) - it may be the medical assessment they may have to brush up on, as well as what Nadine said, the protocols and legalities involved per region. I'm sure they know all of it, possibly some have never had the chance to use some of their early, most basic training.
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Nuclear Unicorn Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 12:49 PM
Response to Original message
13. Soldier Medics have to obtain a EMT-Basic through the National Registry
Converting that to a state EMT certification varies but where hubby and I live its just a matter of registering with the state.

They do get civilian training. Hubby had his Advanced Cardiac Life Support certification as well. And there is also "sick call" if I remember the term correctly. Lots of day-to-day medical stuff there from what I've been told. Although I would imagine in some municipalities a little combat training never hurts and from what I've heard there are plenty of vehicle and training accidents both in the military and things they happen upon when deployed. Not to mention civilian outreach where they go into an area and provide medical services for the locals. It was one part of his service hubby was VERY proud of.

This is one of the president's more insightful ideas. Hubby wouldn't do it because when he got out he wanted a break from it all but I imagine there are thousands of young people just like him with skills and experience that could translate quickly into helping our local neighborhoods and cities.
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cally Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 01:11 PM
Response to Original message
15. A relative took an emt course with a combat medic
and basically he knew everything and had to do no stu.dying. He had to borrow about 3,000 dollars to take courses and get certified so he could continue doing what he already had been doing in the military. He had basically served as a paramedic for 5 years but was unable to get a job unless he enrolled in some private course and paid high fees. My relative, who roomed with him during the training, felt it was unfair and that he knew more than she did even after the training.
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hedgehog Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 01:42 PM
Response to Reply #15
17. "He had to borrow about 3,000 dollars to take courses"
I think we just found 3000 reasons medics have to be retrained to be certified as civilian EMTs!
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Davis_X_Machina Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 01:28 PM
Response to Original message
16. Reminds me of the early 80's...
...when in the absence of any domestic shooting wars, the Army was rotating selected medics through Grady Memorial's trauma unit in Atlanta for some experience.
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RSillsbee Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 02:41 PM
Response to Original message
20. All US Army Medical Specialists (91B)
Go through the EMT basic course at Ft. Sam Houston in San Antonio during AIT and graduate as NREMT-Bs

A 91C is a licensed LPN

An 18D ( Special Forces medical Sgt.) has training equivalent to a PA
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dionysus Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 05:18 PM
Response to Original message
29. people bust their ass in many ways in a combat theatre that don't involve bombs or bullets.
i'd say there's a much higher injury rate than in the general populace here.
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hedgehog Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 05:30 PM
Response to Reply #29
34. Well, again, a healthy person who is injured is different from a
person with a chronic illness (diabetes, asthma, COPD, heart disease) who goes into crisis. The age range is probably tipped to older people in civilian life. However, others have indicated that the training and experience medics get is a reasonable match for that EMTs get.
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nadinbrzezinski Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 05:38 PM
Response to Reply #34
36. I will be more specific
it really depends on the area of town you work... no serious.

When I worked downtown... towards Second Avenue... that was our gun and knife club during Saturday Night. I knew most of my calls would involve stabbings, gun shot wounds ,knifings, blunt trauma and other lovely things. The same went for a few of the colonias where most of the drug dealers were involved. Since most of the drug labs were there as well, well that included burns, explosion injuries and hazmat.

Now if I worked the more middle class neighborhood, or the more sedate working class colonies... my calls trended more to the medical.

We used to switch medics and crews every so often, so they'd get to practice their skills. You can see the same in the military more or less.

Medics working in front line units, or front line hospitals are going to see a lot more trauma. Those working stateside in a base will get more medical.
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RSillsbee Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 06:42 PM
Response to Reply #34
38. Most US Army Medics
do a tour (or two) in either an Army Community Hospital or an Army Medical Center where they act in the capacity of a Certified/ Registered Medical Assisitant in the clinics or an E.R. tech in the E.R.

They see almost the same cross section of the population as they would in a civilian hospital.

When I was assigned to Evans ACH at Ft. Carson about half of our jr. enlisted had civilian side jobs in dental offices, emergicares, radiology clinics and other civilian medical practices. They had no problem getting civilian jobs. A couple of our docs were on call at local civilian hospitals too
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RSillsbee Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Sep-04-11 06:45 PM
Response to Original message
39. To answer your question very specifically, yes.
Every 91B ( Medical Specialist) that goes through the Academy of Health Sciences has to graduate from EMT school to graduate AIT. They are trained as civilian EMTS
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Drew Richards Donating Member (507 posts) Send PM | Profile | Ignore Mon Sep-05-11 08:53 PM
Response to Original message
42. I am assuming that you don't know any combat medics?

MY best friend was a combat medic.

He had more certifications than any EMT1 in the state of WV.

He chose to finish nursing school and is a critical care nurse and respected by all in the hospital.
So much so they are pushing him to go back to school to become a doctor for the WVU health system.

Just so you know, combat medics ARE certified EMT2's not EMT1's

EMT1's are trained in basic emergency medical care and may not perform invasive life saving procedures or administer any medicinal intervention without prior doctors approval.

EMT2's ARE critical care specialists and may perform lifesaving invasive procedures and administer medicinal intervention without a doctors approval due to their advanced medical training.

So combat medics know a heck of a lot more than just bullet wounds, they are trained and certified in everything from geriatric medicinal concerns to primary and secondary degenerative disease. From performing a simple bolus drip to cranial drilling in the field...

I would take a combat medic over any standard civilian EMT1 that I have ever met.

ANYDAY and twice on Sundays.

That is just my opinion of course :)
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