Pre-Deployment Medical Classes

[MainePA]

For those of you who have deployed, what are the the best military pre-deployment medical classes to attend as a PA and any recommendations for my medics?

 

I've looked at ATRRS but would like to rank these so we can prioritize the funding.

 

3GeronimoPA--any words of wisdom from your recent return? Any resources you favor?

[beattie228]

MainePA,

 

Before my last deployment, my unit's medics and PA went through an EMT-T (Emergency Medical Technician-Tactical) course through a civilian agency that trained the area's SWAT medics. Our PA got the course approved for funding, and the training was an intense week of classroom and mock simulated training exercises. Great refresher for the medics who had deployed previously, and a tremendous opportunity for the new medics coming right out of AIT (Advanced Individual Training in case you're not Army). Hope that helps, and thanks for your service!

[uscbigdawg]

Being at Bragg, before my last deployment, we did a ton of work with the SF medics (I was MEDEVAC).

 

As for options? If I had all the extraneous stuff that I'd want to teach a pre-deployment ground medic and air medic course I would offer to do so.

 

Another great bit of training we did was going to JRTC pre-deployment. It really helped educated the battle commanders on the proper use of MEDEVAC and their sometimes hesitation to launch aircraft in a timely fashion. As you might imagine, there are ground training components to that as well. I'd contact your command group about training at JRTC and the NTC.

 

Rich

[Will352ns]

Before my guys and I go down range, I refresh them on TCCC in house then we will usually push most guys through the Tier 1 Group (T1G) for more intensive training using better models. T1G is civilian owned, but has contracts with the DOD; mostly SOF. I think they open their training to all DOD components, but it isn't cheap. Great training though.

 

There is Deployment Medicine International (DMI). These are the original OEMS guys. I went through years ago and it was fantastic training. I think it is a little bit difficult to get into now due to restrictions on "models". OEMS is the infamous course where guys first start putting FAST-1's into each other (yes, I did it). Dr Hagmann had us doing a lot of procedures on each other and it actually helped our skills....unfortunately, this is one of the reasons many units felt that his approach was "too much".

 

Both these courses have good web sites. Have a look.

[MainePA]

Great ideas everyone, I appreciate the feedback. I haven't run across the T1G that was mentioned---took a look at the website and seems to be a very well thought out program. Keep you posted on what gets approved/denied.

 

Thanks!

[uscbigdawg]

T1G is a good group of guys. I've worked and trained with them in the past and they do a good job. Like others have said, you can get accomplished at the unit level if you get a little creative with your resources. We (DUSTOFF) did a lot of work with our ground teams to get them geared/trained for medical treatments and MEDEVAC operations.

 

Best part is that it's free to do that too!

 

Rich

[3GeronimoPA]

MainePA, hands down TCMC (Tactical Combat Medical Course) in San Antonio is the best course you can get yourself and your senior medic into. Get your GMO/Bn Surgeon in there as well so he can get a dose of reality. It is a remote medicine styled course which will get you familiarity with your sets, kits, and outfits. It'll show you a ton of the field craft that has been acquired over the years. They are constantly improving the course because there are PAs and Docs who are coming back from Afghanistan who are adding lessons learned. They send you out of the door with tons of info, equipment NSNs, and training ideas for medics as well. Some people will suggest going out to Camp Bullis for the LevelII/III facility based courses which have ATLS included. I will tell you that is no where near as applicable to what TCMC is offering for the Battalion Aid Station providers. The only criticism I have is that Doc's and PA's from the civilian world feel they have a good grasp on the trauma and all they want to do when they hit their aid stations down range is set up blood banks and RSI kits. A blood bank will do you no good if you haven't done your due diligence stopping bleeding and an RSI kit is the last thing you put together after everything else is perfect. With King-LTDs and Crics, RSI isn't unimportant, it's just not the priority it used to be. I walked into one of my aid stations which was being ran by a guest provider (new GMO), dude had blood donor citrate bags and ET tubes under each bed and tourniquets/crics/chest seals were on the shelves on the other side of the trauma bay (I made my medics empty everything and set it up piece by piece since they violated the standard).... My point is, really "Smart" people will often walk out of there wanting to do "smart" stuff and forget what saves lives. We run a M.A.R.C.H. program in my battalion. Massive Hemorrhage, Airway, Respirations, Circulation, and Hypothermia. That's how our aid stations were organized and that's what we targeted with what we had under our trauma beds. I did set up a blood bank and I did have an RSI kit but only after everything else in the aid station was zeroed in. That's my recommendation with the providers and your senior medic.

 

With the rest of your medics you have two decent options though neither of them will replace time spent with their PA. That is BCT3 (Brigade Combat Team Trauma Trainer) and the MSTC (Medical Simulation Training Centers). The BCT3 is a traveling training team which will offer scenario based labs and classes. It's the "medic version" of TCMC which is put on by a San Antonio based Army Crew. They did good things for my battalion. The MSTC has regional responsibilities and your nearest installation medical center should have information on how that is ran in the area. This is good because it addresses all of the TC 8-800 training requirements for the medics and meets the CEU requirements for their EMT certs. You can do this yourself but there is some training benefit to a crew that has all of the simulators etc.

 

Short of it all

-Providers, Nurses, and E-7 medics (may be able to sneak in a SSG Platoon Sgt) TCMC. They have a website on AKO which will give you instructions for getting funding etc.

-BCT3 and/or MSTC for the medics. BCT3 may have an AKO page, I'm unsure because this was coordinated at BDE level for us. We had 100% participation with this. MSTC is a regional deal. I'm in Anchorage, ours is in Fairbanks. I barely got any of my medics into MSTC but I don't think the program is bad.

 

-For ALL, train together and set up unit standards. Set up a mock trauma bed example before you deploy. We had Airway and Bleeding ziplock kits up under the beds, hypothermia blankets already laid out, fluids and lines hanging (but still unconnected for sterility) with an IV tourniquet holding the alcohol needle and line. We had 3" tape dog-eared and hooked on the sides of the beds, tourniquets extended out one per limb on the side of the bed, O2 hooked up, BVM under the head of the bed, suction hooked up etc. to streamline everything. If you message me an email address I'll forward you pics with explanations of how and why we did what we did. My way is "a way" and it worked. What I did was I set it up to what I thought was best and then I brought in EVERYONE 10 level and up and said, "Shoot holes in it and tell me if you have a better idea". Medics offered their advice. We timed drills to see if their ideas offered benefit to the patient and we made changes as appropriate. I put my pride aside and the patient benefited. After you have a "Trauma Bed Standard" for your unit set up a PCC/PCI checklist with your PSG and distro it out once you are deployed. I had daily checks and weekly checks which involved inventories, cleaning, and function checks. Anything that was plugged into a wall was turned on daily. Everything was cleaned and inventoried daily, and weekly expiration dates were checked. Tedious it was, but whatever. Aid station medics sit on their butts anyways when they aren't training or doing trauma so they can pay their dues and due some scut work. You can set up your own PCCs and PCIs like narcs checks, RSI box inventory(once you set it up), blood bank kit inventory, ACLS kit inventory and weekly algorithm reviews. Set up a weekly class for yourself to give that lasts a couple hours and then work your NCOs and make them teach classes. When they teach a sucky class, teach them how to teach a class, when they teach two sucky classes, start making them reteach classes and counsel as appropriate. You can be a one man show but if your NCOs can teach it, they can run trauma bed 2, 3, or 4 while you are working on your worst patient. Run outside scenario drills. Get casualty cards from your units WIA and make every medic learn from it. If a truckload of dudes got blown up and all had low extremity trauma, that's 8-10 tourniquets. Put your medic on a truck with some joes and make him find 8 tourniquets and apply them. If he has to dig into truck bags is he doing anyone favors? After that class, my medics made it SOP to have 10 tourniquets between their kit and aid bag before they went outside the wire. They come to their own conclusions once you make them run through real world scenarios. I could type all day and just scratch the surface not to mention that their are PAs out there that could knock my socks off with their knowledge on this stuff.

 

Hit those classes if you can. Check your pride at the door, you can learn something from anyone if you are open to it. Whatever is best for the patient is best regardless of what anyone else says. Fight for your patients. Put time into your medics. If you don't put PCCs and PCI schedules on paper and have documentation that they were done, they will not be done. Every wounded Soldier in your unit is an opportunity to teach a lesson that none of your medics will forget because it is as real as it can get. Things will be done wrong in the heat of things. These are times to learn without embarrassment. Everyone can make mistakes. Things will be done wrong out of sheer neglect, or an "I know better than the SOP or TCCC" (like one of my attached Engineer medics who didn't manage hypothermia because he's been deployed before and hypothermia "isn't a concern at 80*F"). These are opportunities to monkey stomp the living hell out of arrogance and teach an entire battalion in once *** chewing that you are the wrong officer to piss off. Good luck. Message me an email address. I'll send you pics, share lessons learned, talk to you about how to force your will on medical higher. What risks almost got my *** in a sling and what risks I got away with.

 

Nate sends

[68W2PA]

I am a medic and hope to be going to IPAP soon. I have to say that was one of the best posts I have read.

Thank you.