In the past, we've debated the best way to achieve a high standard of medical care under tactical conditions.
We've debated the deltas to be covered from a civilian paramedic to a deployable medical technician, we've covered topics to be taught to bring a cbt arms member up to a Cbt FR level; we've debated fluid resuscitation methodology, techniques and procedures, pre-MTF analgesia, training plans and techniques.
We've discussed reserve HS medic employment, and we've discussed limitation on skills and their maintenance. We've seen several different skill sets presented as "the solution," and progress seems to be proceeding apace at developing a national-level course to give our "sharp end" more ability to look after their wounded prior to contact with HS staff.
In the "CSS Less Deserving" thread, Infanteer summarized four attributes of a combat-ready CSS member: Physical preparedness for the rigors of combat; Mental preparedness for the psychology of combat (will to combat?-Author); Skill at arms (and a willingness to use them-Author); and tactical awareness. I won't dispute Infanteers analysis of this.
These leads me to consider which medical personnel have these attributes, fairly consistently, across a spectrum of the CF units, and are best able to provide medical support. Then it hit me. The pers who best embody these qualities aren't CF medical pers at all. In fact, most that I've encountered are extremely opposed to joining the CFHS. They're the Res Cbt Arms members who are also EMS. As Armymedic pointed out, tactical medicine is best achieved when
"both the shooters and the medics (regardless of the tactical situation) ...know and understand certain protocols that will aid in the rapid treatment of life threatening injuries." http://forums.army.ca/forums/threads/26415.210.html
Currently, these people are being told specifically that, unless employed as a 737, they are not authorized to provide treatment as a 737. This is due to the fact that:
"All medical services and treatments provided to the members of the CF fall under the legal responsibilities of the Surg Gen. Those responsibilities are delegated down thru (sic) the med chain to the lowest level at the MO, PA, NP level. Med Techs are authorized to provide medical services with a specific scope of practice that is allowed thru that chain, but ultimately its the supervising MO, PA or NP who is responsible for maintenance of the standard." Armymedic http://forums.army.ca/forums/threads/26415.135.html
Several posters have pointed out that, not only must we improve the medical skills of our cbt arms mbrs, but we must improve the tactical capabilities of our medics, and equip them with a skill set that embodies Infanteer's Four Points, and gives them the approach to provide only the necessary care required, as dictated by the tenets of TCCC.
Dr King expressed his concerns as to the advanced nature of the skill sets required to intervene in life-threatening battlefield wounds.
"There are some significant interventions taught in TCCC. Too short a course risks producing grads who are simply dangerous. ... Again, it is essential that there be an FTX component. Otherwise, we are simply teaching a medical course. The tactical component is just as important, if not more important to producing competent grads."
Dr Roger King
http://forums.army.ca/forums/threads/26415.150.html
The shooters have shown a remarkable interest in this topic. They want to look after their own, and they want medics who can look after themselves, put rounds on target when required, and provide the care needed without compromising the mission. But, we're handcuffing the people best able to provide this. One of the principle reasons these people are opposed to remustering is the reorganization of the HS and the "calling home" of the medics to the Fd Ambs, which is understandable. In the Res world, loyalty tends to lie with the Regiment, not the trade.
Acknowledging that there is a delta to be crossed to bring any res force member up to a deployable standard, is this delta perhaps not best crossed by someone who's clinically current and tactically aware? By someone who's used to working with both an infantry/ armoured/ eng/ arty unit AND taking care of sick and broken people? We need to embrace these paramedic/infanteers, not tell them they can't take care of their own because the CF won't cover them.
I'm not advocating a return to reserve trained med-a's on their own in UMS, or even to Reg F medics spending years in UMS. WRT the Reservists, they have neither the skills nor the experience to be working as we did in the past (fun as it was), and the Reg F are too few in number to dole out as they were, but these people who hold a civi license can be bridged to a working knowledge of CFHS procedures much more quickly then we can bridge a medic to be a integral member of an LIB, and provide a level of experience you will not see in a typical Reg F med tech.
Obviously there are exceptions. The medics who spent years in 2 Cdo, or was a crewman in the LdSH, or a Diver or Bos'n are clearly going to have a better understanding as to what's what in their old unit's operations.
Sqn Medic, Old Ranger, I'm especially interested in your views on this,
DF