Do we adequately train medics to treat the most common injuries seen in the military? Where is the gap?

SFC Private RallyPoint Member — Tue, 13 Jul 2021 04:57:28 -0400

According to the articles below, The primary cause of death in the military is not from combat but lies in the realm of DNBI. There are significant efforts aimed at training medics to be proficient in trauma medicine while observing tactical awareness using the phases of care under TCCC. What happens when the ASM, CLS, or medic come across a scenario like a heart attack during PT, vehicle vs. pedestrian, or a rollover in the training area when they don't expect it and may not have their aid bag handy? Working at the JBLM MSTC and in cooperation with the Madigan Emergency Department, we found that in a training environment standards went out the window and commonly there was no medic at POI or handoff to the ambulance, and no casualty documentation created or passed to the receiving MEDEVAC crew or MTF.

Where is the breakdown? Are medics not being trained as medics and lacking the knowledge of trauma skills usage in a training area and that DD 1380s are still fully applicable in a training environment? Is there a training gap that exists from the institutional standpoint that fails to cover how to react to a medical scenario or trauma scenario in a tactically safe environment? Respond with your thought and how we can make this better. Follow and comment on the thread here as well https://www.milsuite.mil/book/message/948063.

Trends in Active-Duty Military Deaths Since 2006
https://fas.org/sgp/crs/natsec/IF10899.pdf
"Summary of Deaths. Between 2006 and 2021, a total of 18,571 active-duty personnel have died while serving in the U.S. Armed Forces. (Throughout this In Focus, the designation “active duty” refers to all active duty troops, including mobilized Reserve and Guard components.) Of those that died, 25% were killed while serving in OCO operations—primarily within the territory of Iraq and Afghanistan. The remaining 75% died during operations classified in this In Focus as Non-Overseas Contingency Operations, or Non-OCO".

Since 9/11, military suicides dwarf the number of soldiers killed in combat
https://www.nbcnews.com/news/military/9-11-military-suicides-dwarf-number-soldiers-killed-combat-n1271346
"Since 9/11, four times as many U.S. service members and veterans have died by suicide than have been killed in combat, according to a new report".

A year without combat deaths: This Memorial Day, military fatalities overseas were the fewest since 9/11
https://www.militarytimes.com/news/your-military/2021/05/31/a-year-without-combat-deaths-this-memorial-day-military-fatalities-overseas-were-the-fewest-since-911/
"In the year since Memorial Day, 2020, 18 U.S. service members have died while supporting overseas operations, including Operation Enduring Freedom, Operation Freedom’s Sentinel, Operation Inherent Resolve, and NATO’s Kosovo Force. In 2001, 11 servicemembers died, but by 2003, numbers had soared to more than 500 deaths. The death toll peaked in 2007 at 1,020. And, as of May 27, there have been three deaths in 2021.None of the deaths were caused by hostile forces, and most were attributable to vehicle accidents. A U.S. servicemember has not been killed in action since March 11, 2020, when a rocket attack on Camp Taji in Iraq killed Army Spc. Juan Covarrubias and Air Force Staff Sgt. Marshal Roberts".

A 12-Year Analysis of Nonbattle Injury Among US Service Members Deployed to Iraq and Afghanistan
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6583884/?report=printable
"In this study, approximately one-third of injuries during the Iraq and Afghanistan wars resulted from NBI, and the proportion of NBIs was steady for 12 years. Understanding the possible causes of NBI during military operations may be useful to target protective measures and safety interventions, thereby conserving fighting strength on the battlefield".

Deaths due to injury in the military
https://pubmed.ncbi.nlm.nih.gov/10736538/
"Results: From 1980 to 1992, injuries (unintentional injuries, suicides, and homicides combined) accounted for 81% of all non-hostile deaths among active duty personnel in the Armed Services. The overall death rate due to unintentional injuries was 62.3 per 100,000 person-years. The suicide rate was 12.5, the homicide rate 5.0, and the death rate due to illness 18.4. From 1980 to 1992 mortality from unintentional injuries declined about 4% per year. The rates for suicide and homicide were stable. Men in the services die from unintentional injuries at about 2.5 times the rate of women and from suicides at about twice the rate of women. Women in the military, however, have a slightly higher homicide rate than men".

American War and Military Operations Casualties: Lists and Statistics
https://fas.org/sgp/crs/natsec/RL32492.pdf
"This report provides U.S. war casualty statistics. It includes data tables containing the number of casualties among American military personnel who served in principal wars and combat operations from 1775 to the present. It also includes data on those wounded in action and information such as race and ethnicity, gender, branch of service, and cause of death. The tables are compiled from various Department of Defense (DOD) sources".

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Response by SFC Private RallyPoint Member made Jul 13 at 2021 9:56 AM

SFC Private RallyPoint Member — Tue, 13 Jul 2021 09:56:48 -0400

I agree with your statement and the answer I keep getting from the schoolhouses is that its TRADOC and they can't make the AIT longer due to $$

Response by SMSgt Bob Wilson made Jul 13 at 2021 11:24 AM

SMSgt Bob Wilson — Tue, 13 Jul 2021 11:24:44 -0400

This issue isn't going to be resolve on this site. It brings up many questions: Here are a few: When does the Medic stop being a Medic and begins to "practice medicine"? In a combat situation, the Medic's job is what? [Stabilize the injured party and prep for transport.] What function does the "Helo" crew have? [Can the on-board Medic start IVs, administer drugs, etc]. "...no casualty documentation created or passed to the receiving MEDEVAC crew or MTF..." What paperwork is needed? In a combat situation, the Medic is going to take time to fill out DD Form 600a in four copies [on for the Medic, one for the victim, one for the air crew, and one for the MTF]; I don't think so. [Maybe a 3x5 card stating issue, meds given, and time the tourniquet was applied.} The Medic could be trained to a Paramedic level. REMEMBER: The military does not always get the Recruit they desire. It sounds like you are advocating for a Combat Nurse and not a Medic.

Response by MAJ Byron Oyler made Jul 13 at 2021 5:33 PM

MAJ Byron Oyler — Tue, 13 Jul 2021 17:33:06 -0400

It is not a training problem, it is a utilization problem. Active duty units need to stop seeing their medics as motor pool jockeys, parade formations, CQ, and all of the other non-medical tasks they do during peacetime. Once that stops, get them out in the field and in peacetime, that is not the Army. Here in El Paso we have Life Ambulance running 911 calls in the country, at least three volunteer fire departments, and AMR an hour away with the city and county 911 contract. I am dual licensed and for the past six years doing both RN for the Army and paramedic to keep my skills and was a 91B in 1993. It is a win win situation for any Army community, your medics get out in the community helping the community (great PR) and the medics see real live shit. You can find a 911 service close to every military post and 75% of the fire service is volunteer. I just retired and my last unit just filled FB with picts of putting the hospital up and doing fake patients. A culture change needs to come from big Army and until that happens in my opinion, our peacetime medics will not get better. Even with active duty medics, unless you were at something like Mogadishu or Fallujah One or Two or the Mosul mess hall bombing, or Keating, etc you really have not seen much. As things stand now, a seasoned medic has seen a lot of buddies get hurt and that experience is not worth the cost in PTSD. We have the civilians around our posts that get hurt, get sick, and taking care of them does not mess with your head as much as the infantry guy you used to go on long walks with...

Response by SPC Christopher Perrien made Jul 14 at 2021 2:27 PM

SPC Christopher Perrien — Wed, 14 Jul 2021 14:27:41 -0400

Whether or not they have morphine out in the field, during training excersizes. This was an issue that goes way back. I saw/heard in happening , going back to the late 1980's- early 1990's. Higher-up obstruction create such a PITA or didn't allow it , becuase of the schedule nature of the drug.

But it dam would have been needed in cases of traumatic injuries. Burned my ass ,everytime I heard our Medics in the field didn't have morphine because of the BS zero tolerance and top-down control measures crap that infested the Mil leadership about it.