What have you seen Combat Medics do down range that was out of the scope of practice?

TO ALL THE FNG's and Young Troopers still fighting the fight today reading this...Just ONE real-world, mission essential piece of advice...TAKE CARE OF YOUR MEDIC!, because Doc is Damn Sure gonna take care of you.
Doc don't pull guard, because when you are copping zulus Doc is checking feet and fevers...
Doc dont dig his own hole, he don't need blisters on the hands that will start your IV.
Doc eats FIRST, because he will spend 90% of that chow break making sure your NUGS and Privates are drinking water and eating something besides candy bars (I know this is YOUR JOB there Squad Leader, but Doc does it too, because he fracking cares).
Take care of Doc, Help him carry his load, cause most of his load, is for you and the platoon. One last thing, if your are still reading...Check Doc's feet once in a while, offer him a cookie from home in that box from your little sister, let Doc know he is part of the platoon, and is misassigned to HHC. Invite Doc to your platoon cookouts, and even to Christmas dinner if he is single.
In the fight or in Garrison, Doc is a Grunt's best friend.

As a Physician Assistant in the United States Army, a former combat medic, and a front line provider, I train my medics in everything I possibly can. The idea is to push as much knowledge forward as possible since I certainly cannot be everywhere. I train my medics to do everything as it relates to trauma (tourniquets, airways, crics, NCDs, chest tubes, digita intubation, morphine and ketamine usage, Narcan, and when it comes to noncombat (DNBI), i teach constantly to increase their awareness and ability to treat. Any provider who doesnt is failing his medics, in my opinion, and therefore failing the warfighter. AMEDD has done a poor job adapting its combat medic program with the reality of combat medicine. And as we leave the known combat theater, it will need to get its head wrapped around the idea of sustainment training for all medics, because table 8 BS is worthless and MSTC sites are hit and miss. If we dont support a solid program moving forward we will lose a massive amount of institutional knowledge and return to the medic we went to war with, not the Combat medic we brought home.

A medic's scope of practice is often expanded or contracted based off their relationship with the PA or the BN Surgeon if deployed. In my experience for a "good" medic their scope can be a lot more beyond the STP critical task list. I have personally performed many minor procedures in a field MTF environment as PFC while deployed. This was always proceeded by vetting through the BN Surgeon on every aspect of the of the procedure such as identification/conservative treatments/procedure risks/procedure steps/supervised executions.

From what I've seen, of medics that are coming out of the school house, they are still getting the full run through of combat oriented treatments, but are severely lacking on the general sick call identification, treatment, and documentation (Medical treatment ,organic and area support). I also had some basic field sanitation knowledge coming out of training, but now they seem to have none (Preventive medicine services). Which is a very large issue as the line medic can often serve in the place of the unit field sanitation team. For both of these shortfalls in training, I have not seen new medics come out with any additional training so I have no idea what may have taken its place.

I deployed right out of AIT. My PA at the time was awesome, he taught us emergency chest tubes, suturing, nerve blocks, medication and various other skills. We actually bought a local goat to practice. (no the goat was not alive) but it did make for a great BBQ afterwards. Seeing as I ultimately spent most of my time as a medic in a combat situation, or taking care of the aftermath, the additional skills came in handy. Having training on what to do when "sitting" on a patient would be handy, outside of the basics. I never really had one for long before they were passed on to the next echelon or transported. I spent one week in a sick call after hurting my back, and I found it to be a challenge. Again, my PA was awesome, if I couldn't figure it out on my own, he didn't give me the answer, he gave me his medical books. He would then double check my findings. I have found trauma is easier to deal with, it is in your face and you see what you are dealing with, illness can be a very sneaky un-obvious thing.  Just my input. 

Medics, we had the full spectrum of medics with us in Task Force Spartan (1-36 Indantry) during OIF 05-07 (surge), our medics demonstrated some amazing feats of courage. Our first Silver Star was awarded to a medic (a Specialist) attached with our A co, 1-36 Infantry, his courage under fire was amazing, his action was something you'd expect to see a movie made about.

Our Surgeon saved countless lives throughout the deployment to Hit (between Aramark & Al Asad). Medics were essential to saving the life of one of our company commanders, we broke 5 tourniquets on him while exfilling him to the evac site.

One of our medics was a cutter, he would take a razor blade and cut his upper arm/shoulders....he said it was therapeutic to him. And our PA (at FB5 - across the Euphrates River) started losing it, he would shoot stray dogs and then try to save their lives. Our medics were all over our battle space, multiple Valorous awards were awarded to our medics, they were a huge combat multiplier for us!

Okay, to me this is a broad subject. A medic will excell has they see fit. During OIF 6 I had 4 NCOs that had no hands on medical trauma prior to deployment. It was up to me the FAS NCOIC to get them up to par. You always start with the basics ie bleeding airway.. Blah blah. But being that we were in a secluded place we had to go further. They learned the dynamics of what was in the MES sets and what every medication and very single piece of class viii was used for. Between the PA and I they were taught the basics along with the advanced. What I'm saying by advanced is RSI , intubation , chest tubes knowing the basics of ACLS amongst others. It was a daily learning experience. By the end of our deployment my Soldiers were treating children with the Broslow bag, intubating on their own. Was the PA there, yes, but not over there shoulders.  As a add on... I believe addition training should focus on medication medication medication. Especially now since the Army is going back to the ADTMC system. Since the war is coming to the end, more focus needs to be on sick call procedures. You would be surprised how many medics can't do a basic HEENT exam... And I'm tired of hearing this Motorpool medic also... just my two cents

Combat medics should be granted national civilian paramedic certification. These highly skilled clinicians should be able to transfer their skill and experience into the civilian world without the current hassle. Loosing just one would be a tragedy.

Well I was not a medic but I am proud to say my son is a combat medic station at Ft Lewis

i've been out longer then most of you have been in, but in Vietnam, most Medics, Army and Navy, participated in medical missions in the villages when not on operations. I did some Swift Boat stuff while assigned to a PsyWar type of unit, and we always had a Navy Medic (not a Marine) administering to the villages on remote Islands north of Nha Trang. It was amazing what a little bit of kindness did (at least for me). These villages were in insecure areas and never was there a problem. Great experience.

To save a life or limb, in combat there are no rules. you mentioned in your topic intubating, I was a Paramedic 30 years ago and we were intubating on the street back then, or would you rather see a fighting man die because he can't breath. thumbs up to the medics that try any knowledge they have to save a life in combat. and to intubate you need an laryngoscope, you sure you know what intubation is ? and a PA or Dr don't have to be looking over your shoulder when you are trying a procedure , if you been trained to do something , you do it.

I stiched a guys dick back together. FYI that falls into plastic surgery SOP. He lived and his dick still works.

As a a Combat Medic myself with two deployments, I'll tell you that almost all the other ones I worked with did things outside of our SoP. We are trained as an EMT-B (Civilian) and Combat Medic (Army). I won't run down everything we do just from that.
I've given tons of IV's, shots, dressed bandages, bagged patients with breathing difficulty, treated wounded under fire, stabilized I don't know how many people, etc. Here's the 'fun' part. I've held a man's brains in his head, while intubating him with help from another medic. I've had to assist packing a gunshot would on an Iraqi prison who shot himself: fit 2 unrolled Kerlix rolls into him to help stop the bleeding. I've ventilated 3 children all under 7; 2 of whom we lost. Cut dead skin off a woman's foot with diabetes so I could bleed and she would hopefully keep her foot.
Gave an IV inside a moving military ambulance; which is NOT easy. This guy along with 3 other patients at the same time. Applied tourniquets to those that needed and bagged the worst one while trying to close a severe head wound. I learned Advanced Airway and Advanced Trauma procedures roughly a month after I got to my first duty station.
Our PL (who is also a PA) decided who got the additional training. I got to carry Morphine and Narcan which we usually aren't allowed to carry unless the PA feels we are efficient in it's use. EMT's and Medics aren't about treatment so much as "Pack and Go" or stabilize and transport. With Medic training being 4 1/2 weeks there is no way be can become efficient in our knowledge and skills above basic level.

I was a grunt for 13 years and have nothing but respect and admiration for all DOC's. Feel free to disagree, but if one provides first hand stories of medic performing procedures beyond their allowed skills, then do they not open themselves up to liability/military discipline? I'm just looking out for the medics who have done what needed to be done to save life or mitigate serious injury.

A medics scope of practice is a relative concept down range. Practically, medics don't have a scope of practice so long as they have proven they know what they are doing, and this also varies medic by medic, unit by unit. I'm well aware that this is legally not condoned, but as I said this is in practice how it works. <br><br>Short of a medic performing open heart surgery in the field, so long as a medic can justify what they've done and are not incompetent then most PAs by my experience will back them up. <br>

Work demeaning civilians jobs because skills are not a respected transfer. Many more qualified than Doctor. God bless EMTs.

My providers gave us a pretty broad blanket. We ran the role 2, triaged, highlighted the things we felt needed their attention, got a lot of things started before they even got there. They gave us a pretty wide scope to use a lot of meds we don’t necessarily have access to back home, so they definitely upped my pharmacology game and primary care skills.

confused because of the pressure and was about to start an IV with a 14 ga.And the worst part was his BS was very low including his respiration.I only wish we could have Administrated morphine at that time but he would never made it.

I honestly don't care to talk about it but I saw a lot. We had a combat medic on our truck and he did awesome and amazing things. That's really all I want to say. No offense

Told and occasional video. Respect.