Medical Technician's and the Combat Arms.

[aesop081]

Do any of you currently believe that there will be a rehashing of the ROE for Medical Tech's and such?

Canada being a signatory to the GCs, we have obligations that you just can't "rehash" because the other guy didn't sign.

 

[medicineman]

Aye, I believe I was reading somewhere that Medic's don't tend to wearr any kind of designation, whether it be the Red cross or what have you on their kit when they're outside the wire. Just gives the Taliban a target, with that said. Do any of you currently believe that there will be a rehashing of the ROE for Medical Tech's and such?

The ROE are no different - a commander can decide whether or not the GC crosses are visible and protected pers are allowed to carry and use small arms for their protection and the protection of their patients.

MM

 

[IronSpike]

Speaking about ROE, I've tried to do as much research as I could but haven't found a definitive answer. When it comes down to CSOR/JTF2 and the medics where do they fall in? As far as I've found the medic plays a supporter role to the operators, but are they right in there with the operators?

 

[MikeL]

Speaking about ROE, I've tried to do as much research as I could but haven't found a definitive answer. When it comes down to CSOR/JTF2 and the medics where do they fall in? As far as I've found the medic plays a supporter role to the operators, but are they right in there with the operators?

Not really sure what you are going for here,  but they are where they need to be to do their job.  Why are you looking for this info anyways?

 

[IronSpike]

Not really sure what you are going for here,  but they are where they need to be to do their job.  Why are you looking for this info anyways?

I've got my application in for Med Tech, and was just curious.

 

[BadgerTrapper]

Hey guys, just an update. I'm about midway through my PCP course as an NCM-SEP. There have been a few questions I've been looking to ask, but since the Detachment I'm based out of doesn't seem to have any Medical Technician's on staff and the school isn't running any AEC courses at the moment. I can't ask them, so here goes for anyone who doesn't mind taking a few minutes of their time.

1.) In terms of medical equipment, what is carried while on a patrol? Part of me highly doubts that a Medical Technician attached to an Infantry unit is carrying an Airway Kit, Med Bag, Trauma Bag and a "First In" bag.

2.) Upon completing my PCP course, I'm off to CFMSS to extend my skill set.  Which skills would I learn that differ from that of a Civilian PCP? I've a third question as well regarding equipment though I've a strong suspicion it'll be answered here.

There it is! If anyone can give me a hand it'd be greatly appreciated! Thanks a lot everyone and happy holidays! 

(Something that might be useful, I'm attending the APA (Medavie Healthed) in Moncton.)

 

[MikeL]

If you have an account for Lightfighter you can see a thread a Canadian Medic did on his CTOMs 1st line pouch and backpack,  lists what he packed, etc

http://lightfighter.net/eve/forums/a/tpc/f/9046084761/m/376104437?r=464104267#464104267

CTOMS 1st line

On the front of the pouch, there is three tournequet pouches that will fit either the SOF-T or the CAT. I've seen them been used to carry sidearm mags or even a pistol. (I personally don't sugest this.)

Above the 3 tournequet pouches, there is a pouch designed for gloves. I was able to fit 6 pairs of XL nitrile gloves and my shears. The shears are attached with a shear retractable lanyard from CTOMS.

The pouch can easily fit enough TFC-Bubble supplies to treat 2 minor casualty or 1 major. I could fit more supplies in there, but I want to reduce the weight I carry.

On the Hemorrhage side, I carry 2x 6" Oales, 1x Pk of QuickClot granules and 1x QuickClot Combat Gauze.

On the Airway/Breathing side, I carry a disposable scalpel, 2x NPA, 2x 14G NARP Needles, a prepackaged cric kit, and some gun tape. Also, behind the MARS pannel, I have 2x Lg Tegaderm.

CTOMS 2nd line

I seperated my kit in 4 modules :

- Hemmorhage
- Airway/Breathing
- Fluid Ressus
- Drugs

All modules are secured in the bag via velcro and can be removed by pulling on the glow in the dark label provide with the bag.

In my Hemmorhage module, I carry equipment to complement my 1st Line Pouch. I used only a Quad Fold for this module.

Content:
- 2x Blast Bandages
- 1x 6" Oales Bandage
- 2x 4" Oales Bandages
- 2x Kerlix
- 2x Combat Gauze
- 1x QuickClot Granules

In my Airway/Breathing module, I carry basic and advanced equipment. I am still waiting to see if the Canadian Forces are going to accept the use of the King LT, if not, I will also put a Combitube in there. I used a MARS Pannel, a Quad Fold and a Book Folder.

Content:
- Premade Cric Kit
- 2x NPA
- 2x OPA
- 2x 14G NARP Needle
- 1x Roll of waterproof tape
- 1x BVM (with NuMask, not shown on pictures)
- 1x Suction (60cc syringe with NPA taped together)
- 1x Acherman Chest Seal

In my Fluid Ressus module I carry enough fluids for 1 major casualty or 2 minor casualty. I used again a MARS Pannel, a Quad Fold and a Book Folder.

Content:
- 4x 18G IV Needles
- 1x Saline Lock
- 1x 3M Transpore Tape
- 1x IV Tournequet
- ETOH Swabs
- Sm Tegaderm
- 1x 500cc NS Bag
- 2x 250cc HSD (RescueFlow)
- 2x 100cc NS Bag
- 2x 10 drops Basic Drip Set
- 2x Secondary Drip Set
- 1x Roll Coban
- 1x Medication Added Label

My Drug module is built with a MARS Pannel, a Quad Fold and a Book Folder. I carry my meds in a prototype MedBox by CTOMS.

Content:
- Syringes (different sizes)
- Needles (different sizes)
- DrugBox
- Sharp Container
- Glucometer
- BP Cuff
- Salbutamol, Ipratropium Bromide and NTG
- ETOH Swabs

 

[BadgerTrapper]

Thanks, Skeletor. Great link, milpoints inbound. All of that looks relatively familiar aside from the HSD which I've had no dealings with whatsoever. Not all that familiar with administration of Hypertonic solutions at this point in time, I'm assuming that's one of the things I'll be taught at CFMSS? As well as the extra medications. Ipratropium Bromide from my understanding is a COPD treatment drug correct, is this the CF application or is there another desired effect? (I know I'm kind of going over my courses head at the moment, but I like to have a decent knowledge of this kind of thing.) Thanks! - BadgerTrapper 

 

[Armymedic]

As well as the extra medications. Ipratropium Bromide from my understanding is a COPD treatment drug correct, is this the CF application or is there another desired effect?

In his Afghan centric trauma oriented bag, I do not know why he is carrying Sabutamol, Atrovent and Nitro. Perhaps he was told it was a good idea by the someone. It is, after all, just an advertisement for CTOMS.

My best hypothesis is that it is for reactive airways as a result of dry heat and dust in the ATO. As for the angina meds; I can't even provide a best guess.

Realistically, as an infantry medic you'd carry items that fit into the MARCHE pneumonic:

Massive Bleeds:
Tourniquets
Dressings: Oales or ER
Packing: QC  or HK gauze

Airway:
NPA
OPA
Whichever blind insertion device youre comfortable with
Cric set (once your qualified to do it)
BVM with mask

Resp:
Halo seals
14 gu angio caths

Circ:
Steth and BP cuff
Pulse Ox
IV initiation set, Saline lock
IV Tubing
2x 500 ml bags of crystaloid
1x bag colloid
Oral rehydration packets

Head/hypothermia:
ENT set (oto & othaloscope set)
Hypothermia kit

Everything else:
Triangular bandages
Tensor bandages
boo-boo kit (band aids, antibiotic cream)
SAM splint
safety pins
suture/staple/skin glue kit
blister kit
Drug kit (based on your scope and AOR)
casualty cards and markers.

Don't get sucked into a company's cool kit and niche of Afghan vets; Not everywhere we go has a helicopter on 30 mins NTM and a level 1 trauma center just a quick radio call away.

 

[BadgerTrapper]

Cric set (once your qualified to do it)

You mean it's not as easy as sticking a Bic Pen in the Cricothyroid Membrane? 

Also, the Salbutamol I can understand if employed to counter possible Asthmatic problems while in the field?

Much appreciated, Rider Pride. That pretty much clears up all my questions in terms of equipment! I assume that is on top of the Combat load and such as well?

Anything in regards to the skill set? BadgerTrapper 

 

[Armymedic]

You mean it's not as easy as sticking a Bic Pen in the Cricothyroid Membrane? 

When you know what you are doing, and have done a few proper ones before, it can be that easy.

:bowing:

 

[medicineman]

Weird - got those puffers in there but no aerochamber to deliver them with...

BT - the salbutamol and ipratropium are often used synergistically to deal with bronchospasm and airway secretions for asthma attacks.

As Rider mentioned, you need to be able to tailor to needs, mission and lcoation relative to higher medical assistance.  You'd be surprised what you can get into some of the various off the shelf med bags that are out there and how easily they can grow or shrink to purpose (or lack of proper planning in the case of growing).  Experience will teach you how much of what you take and where it should go in your kit...not to mention what you're actually allowed and trained to use.  I remember looking at one of our MO's on the coast one time that was going on a sail, had limited space for gear, and wanted a small hospital with more drugs than a local ER simply because something happened one time and he spent too much time treating instead of evacuating...I just looked at him and asked if he'd ever lived out of his ruck before - he hadn't.  "Sir, you only really need this, this and that...if they're that sick, someone can come get them or you can take them ashore in short order".  There is always temptation to take everything when it really isn't needed.

:2c:

MM

 

[ArmyGuy99]

Every time I get tasked somewhere, I read the OP/Admin Orders, do MY map recce of the AOR and find out if any air assets are available, and then I think about what I will need to bring.  Then I pack my bag.  Then I realize how heavy it is. (We tend to try and pack everything).  So I lighten it.  Regardless of how I pack, my bags are usually 35-45lbs, with water.  I use a Camelback BFM with the Med Insert.

As you can see below, in the last 2.5 years I've had very different taskings.  You will learn through experience, both yours and others.

as for the other part of the discussion.  While in Afghanistan, I did air sentry all the time.  Had no choice, due to manning.  And honestly, I loved it.  And yes our Bisons and then 113 Ambs were armed with C6's, the 113's had the RWS. 

A portion of our mandate as medical pers is preventative medicine.  If I can kill the rat for no good reason other than it MIGHT have fleas or MIGHT bring poisonous snakes around.  Then why can't I start shooting at 200m??  <- Just for arguments sake.

Snapshot:

Ex Trillium Response 12: 90 + min North of Hearst, Ontario.  In the middle of a Provincial Park.  Totally dismounted.  Assigned as the Coy Medic for 56 pers, with 6 plt medics and an LSVW AMB at the entrance to the park about 30-45min away.  Evac to the Hospital in Hearst was more than 90 Min by land.  No Helo extract available.

In Afghanistan 2010 : We pretty much had a chopper Not more then 30 min away and my bag was packed for trauma and hydration.  I was all by myself either with the OMLT or RCD Recce usually not more then 8 to 14 pers.  So I was mounted which allowed me to bring more in a 3rd line bag that stayed in the TLAV/LAV, as we were usually out for weeks at a time.  Also did convoy duty for NSE Force Protection.

In Ft Irwin, California During Work Up 2010: I was again mounted with a Bison AMB as the GIB, got tasked out all over, usually on convoy duty or at the coy level. (ex was a gong show, if you were there you know).  We had Airevac at about 20 min after the 9 liner.

 

[Hunter]

Circ:
Steth and BP cuff
Pulse Ox
IV initiation set, Saline lock
IV Tubing
2x 500 ml bags of crystaloid
1x bag colloid
Oral rehydration packets

What colloid solution is in current use in dismount med bags?

 

[ArmyGuy99]

Currently, nothing.

While overseas in 2010 we trialed using HSD, which meant we also carried NaCl.  Yes we carried 4 500cc bags of IV fluid.  On long patrols I'd pack 6 (an extra 2 saline).

The final study came out last spring I believe (it's at work hanging on the board and I'm on Block Leave like the rest of the CF).  The result was that there was absolutely no difference in using saline over HSD when it came to long term survival rates.  The only benefit was to the medic on the ground, as we need to carry less HSD then Saline.

As far as I know the HSD was only a trial and hasn't been implemented as a protocol as of yet.  Although I could be wrong on that by now.

 

[Armymedic]

As of last summer, the issued colloid is Voluvent.

It's made with a synthetic starch in normal saline.

Apparently it has a reduced harmful effect of coagulation and does not harm the kidneys as severely as previously issued large molecule colloids.

I believe it is still a Surg Gen controlled item, so it's unlikely you will see it here at home much.

 

[Hunter]

Currently, nothing.

While overseas in 2010 we trialed using HSD, which meant we also carried NaCl.  Yes we carried 4 500cc bags of IV fluid.  On long patrols I'd pack 6 (an extra 2 saline).

The final study came out last spring I believe (it's at work hanging on the board and I'm on Block Leave like the rest of the CF).  The result was that there was absolutely no difference in using saline over HSD when it came to long term survival rates.  The only benefit was to the medic on the ground, as we need to carry less HSD then Saline.

As far as I know the HSD was only a trial and hasn't been implemented as a protocol as of yet.  Although I could be wrong on that by now.

Really? Seems odd that in 2010 they would be trialling something that was in widespread use on ROTO 6 (2008-2009). 

 

[ArmyGuy99]

I could be wrong and ROTO 6 data was in there and I only remember roto 09 cause that was my roto.  I will check on the 7th when I get back to the clinic and will scan a pdf of the study or find the very obscure link to it.

MTF on this Wait Out....

 

[BadgerTrapper]

Thanks so much for the information, greatly appreciated. Gave me some things to research over the break. How do you tend carry the gear itself? Different pack? etc. It's pretty snowy down here in NB, so just consider this as me stirring the pot a bit before I head back out to shovel for the 6th time today. Whoever said "Do a job right the first time and you won't have to do it again" obviously never shoveled a Canadian driveway. - BadgerTrapper 

 

[ArmyGuy99]

Ok,

Here is the link to the official document:

http://pubs.drdc-rddc.gc.ca/BASIS/pcandid/www/engpub/DDW?W%3Dadddate+ge+'20111001'+sort+by+adddate+descend%26M%3D25%26K%3D535477%26R%3DN%26U%3D1

and I will attach a .pdf of the Executive Summary,

Turns out, I was mistaken.  The dataset is for 2006-2009 and publised in 2010.  Not sure why we were told to carry both sets, if the study was completed.  Interesting results though.