Well I just got the confirmation that I will be attending the Basic Tactical Operational Medical Support Course.
This International, 81 hour, 6 day total immersion course in tactical operational medical support is open to the EMT Basic and above to prepare and train them to operate within a tactical law enforcement environment. This course is medicine based and doesn't perform any live fire exercises. It is an excellent course for current practicing tactical medics to use as a refresher and continue education course.
This course is accredited by the Continuing Education Coordinating Board for Emergency Medical Services (CECBEMS).
The course includes Tactical Combat Casualty Care Certification (TC3) curriculum which is a 2 year certification through NAEMT.
P.O.S.T.- 81 CE Hours
EMS - 81 CE Hours
Course Topics:
Administrative Issues
Operator Wellnes and Fit Assessments
Tactical Combas Casualty Certifiction Curriculum
MTA, Site Survey, and Documentation
Extended Operations/Expanded Scope of Practice
Asset and Resource Management
Remote Assessment Methodology/Sensory Deprivation
Tactical Assessment /Triage/ Movement
Emergency Dental Medicine
Veterinary Medicine for the LE K-9
Land Navigation - Day and Night
Response to Active Shooter
Officer/Operator Rescues and Ballistic Shields use in tactical medicine
Chemical Agents in SWAT/CBRNE / WMD / Clandestine Drug Labs
Distraction Devices and Blast Injuries
Medicine Across the Barricade
Tactical Airways
Less Lethal Weaponary - TASER and Specialty Impact Munitions and Associated Injuries
Searching/Weapons/Handcuffing
Crime Scene Evidence Preservation
Force on Force Scenario Based Training Exercises
I'm excited. Didn't plan on taking the class but it was strongly suggested since I am willing to go overseas if that's what it takes to find a good job.
Not thrilled about being Tazered and Pepper Sprayed again. Getting Tear Gassed will be a completely new experience for me.
Any and all advice is always welcome.
Hizzie
I know about a couple dozen schools that offer this with that title. Which one specifically? Is it the Cyprus Creek course?
The foundational knowledge is pretty basic and pretty much runs the gamut through most of these courses, except for the land nav.
I wouldn't worry too much about being gassed. In my opinion it is MUCH better than OC spray or the taser.
Did you go yet?
I'm curous what you thought of it.
DesertDweller
05-28-12, 01:47
I was a combat lifesaver in the Army but this is more intense.
Last week I attended the Basic Tactical Operational Medical Support course offered by Cypress Creek EMS in co-operation with the Strategic Skills Training Institute.
First my background. I am a current EMT-B and former Police Officer with 12yrs exp. The last 5 of those years were spent in the housing projects. I served most of those 5 in a specialized unit as a FTO and was involved in numerous search warrants and warrant sweeps. My backgound also includes:
Martial Arts
Shooting Competition
TDI Police Knife Defense
Ballistic Shield Operator
IPMBA Police Cyclist
Evidence Identification and Collecting
Some other shit I am probably forgetting
Course description:
This International, 81 hour, 6 day total immersion course in tactical operational medical support is open to the EMT Basic and above to prepare and train them to operate within a tactical law enforcement environment. This course is medicine based and doesn't perform any live fire exercises. It is an excellent course for current practicing tactical medics to use as a refresher and continue education course.
This course is accredited by the Continuing Education Coordinating Board for Emergency Medical Services (CECBEMS).
The course includes Tactical Combat Casualty Care Certification (TC3) curriculum which is a 2 year certification through NAEMT.
P.O.S.T.- 81 CE Hours
EMS - 81 CE Hours
Course Topics:
Administrative Issues
Operator Wellnes and Fit Assessments
Tactical Combas Casualty Certifiction Curriculum
MTA, Site Survey, and Documentation
Extended Operations/Expanded Scope of Practice
Asset and Resource Management
Remote Assessment Methodology/Sensory Deprivation
Tactical Assessment /Triage/ Movement
Emergency Dental Medicine
Veterinary Medicine for the LE K-9
Land Navigation - Day and Night
Response to Active Shooter
Officer/Operator Rescues and Ballistic Shields use in tactical medicine
Chemical Agents in SWAT/CBRNE / WMD / Clandestine Drug Labs
Distraction Devices and Blast Injuries
Medicine Across the Barricade
Tactical Airways
Less Lethal Weaponary - TASER and Specialty Impact Munitions and Associated Injuries
Searching/Weapons/Handcuffing
Crime Scene Evidence Preservation
Force on Force Scenario Based Training Exercises
__________________________________________________________________________________________________
TD 0.5
The first day was registration, administrative BS, Intro to Tactical Emergency Medical Support, introductions and team assignments. Student and Instructor backgrounds varied greatly. My team, Team Charlie, consisted of:
TL - Paramedic, no other background
ATL - Paramedic/Medical Student, lots of other "emergency/disaster" type trainning and likely member of MENSA
Nurse/Paramedic, Intructor
Paramedic, former Ranger/Combat Medic/Contractor/Instructor
Paramedic/FireFighter, former Army
Paramedic/FireFighter, gun guy
EMT-I, no other background
EMT-B, former Police Officer, meathead (me)
Team Charlie - All Bleeding Stops Eventually
*Two things became clear on the first day. Not all of the Instructors were on the same page and giving myself a Foley Catheter would be helpfull since pee breaks were scarce.
TD1
Lectures started off with the usual house keeping issues. Next up was Operator Wellness. Topics included discussion on health, exercise and nutrition. Funny since most of the meals we were fed were rather greasy. We did the Fit Test outdoors that included pushups-no time limit, situps in 1min, chinups in 1min and a 0.5mile obstacle course with dummy drag and pushup stations. O Course was timed as individual but a Team effort. Rather confusing as students were all in various fitness levels.
After lunch we discussed Extended Operations and what was involved in keeping a Team running and healthy for 12hrs+. Food, water, hygiene, rest periods, booboo's, sniffles and related logistics. Basically how to be a "mommy" and make sure everyone is able to perform when needed.
Pharmacology and medicines were discussed as related to Tactical EMS as opposed to regular EMS.
Remote Assessments were discussed and how to evaluate a patient you cannot get to and maybe only see through binoculars/scope and/or talk to over a radio. Also how to assess a patient you can touch but not see was discussed. Skills for both were practiced in a realistic format and situational stress introduced. The importance of keeping your own ass safe hammered home.
TD2
The day started off with morning PT for "team building" purposes. The Tactical Casualty Combat Care was introduced. Care Under Fire and the importance of tourniquets/Healing with Steel were discussed. The recommended extraction methods (fireman carry is a NO-NO now) and tourniquet application discussed. Skills for both were practiced with and without situational stress.
Chemical Agents, Distraction Devices & related injuries, and Handcuffing & related injuries were discussed. Handcuffing skills were taught/practiced. *I will go on record to say that I do not agree with the taught handcuffing technique. I was shown in the past and tried for myself in the field. I did not use it for a reason. We also practiced the use of the King Tube LT airway.
TD3
More TCCC and Tactical Field Care. Basic and advanced airways, tension pneumothorax and hemorrage control were discussed.
Note: According to TCCC, QuickClot Combat Guaze is the ONLY recommended hemostatic agent.
We practiced skills for chest needle decompression, cricothyrotomy and wound packing without situation stress. This time.
After lunch we continued the TCCC lectures and discussed IV/IO/Fluids. Skills utilizing the Pyng FAST IO device and Ranger IV were practiced. *Being BLS the only time I have even touched an IV catheter was to put 1 into a sharps container. I informed the Instructor of this. The limit of teaching IV skills was "Insert IV.." and then onto the next step. Without 2 of the Paramedics on Team Charlie I would have been SOL.
A written TCCC test and TCCC "Trauma Lane" skills testing were completed. The Trauma Lane was full of PT, physical stress, emotion stress, low level light and screaming Instructors. A visit by one of Mr. Murphy's relatives liberated my Ranger IV kit while on another patient. Started to lose my cool but recovered. Remember to breath!
A mock Medical Threat Assessment was completed for a fake warrant. We had to utilize any source available to determine any/all health hazards to the Team and/or K9 Unit if involved. Enviromental conditions, local flora/fauna and any chemical hazards that might be encountered needed to be identified and What If's accounted for. Logistical support had to be arranged for each possible outcome JIC.
TD4
Lectures began with Active Shooter Incidents and HAZMAT Decontamination Proceedures. K9 Emergencies were discussed and skills for Handler Down (not shooting the dog) and K9 Emergency Medicine were practiced. Lots of good info provided by a local Vet that works with all the local K9 Teams. K9 Meds, IV's, Heat Emergencies, CPR and SubQ fluids were taught.
Clandestine Drug Labs, WMD's/Chem/Bio Weapons were discussed. Crime Scenes and Preservation of Evidence was discussed using several well known and not well known incidents. Medicine Across the Barricade was discussed. Skills for PPE/Decon were practiced using SCBA, HAZMAT suits and a mobile decon facility we had to set up. Medicine Across the Barricade was practiced with the help of a local Hostage Negotiation Team and role players.
TD5
Class was reloacted to a training facility owned jointy between a federal agency and local PD. SIM Less Lethal Weapons/Munitions and related injuries were discussed in detail. ALWAYS be able to account for every bean bag, baton and rubber ball fired. When in doubt CT Scan. The Tazer was discussed and willing victims exposed via alligator clips. Fool me once shame on you. Fool me twice shame on me. I did not take another ride. Next up was a trip down the O Course to prepare us for CS exposure in the gas house.
This was my first ever CS exposure. Based on the videos I've seen and students reactions that went ahead of Team Charlie I expected to burn, snot and cough a lung up. I did not expect what would actually occur. We were marched into the gas house and kept moving using flashlight to see. My skin burned and eventually burned so bad it felt cold. No problems. I can get hit my a CVPI doing 35 and get back up so CS shouldn't be shit. My turn to take off my mask came up and I yanked it off and took a real breath. (Instructor warned us that if we tried to hold our breath or any other funny shit we would stay in the house till he felt we were suffiently exposed.) My lungs did not burn. They slammed shut worse than the most severe asthma attack I have ever experienced. The Instructor thought I was trying to hold my breath and asked if I was even exposed. I was unable to move enough air to speak clearly. He let me out and I held the mask out for a handler to take it from me. I forced my eyes open despite the burning so I could decon as I walked. I was unable to breath deeply my chest was so tight. Coughing, hacking and snotting I tried and tried to get full breath. Most every other student was completely deconned and good to go within 10-15 minutes. After 15 min I still had trouble getting to the next skill. 2 hours post exposure my resting HR was 110+ and my respirations were 30+ and shallow despite 4 puffs of albuterol from my inhaler. The Team Charlie ATL was very concerned (so was I) and brought my condition to the attention of the Instructors. They were completely unconcerned. My lungs were not 100% till the following morning. I hate CS.
CS Exposure was followed by the Tower of Pain. An exercise using rapelling harnesses and a caving ladder. Despite having difficulty breathing I completed the exercise and was having fun. I wanted to climb that ****er to the top.
After lunch we discussed Officer Rescues, Tactical Movements, Shield Use and CQB. Skills were practiced but concepts were hard for those without any experience. Hard to distill multiple 40hr classes into two 1hr lectures and two 1hr practice sessions.
TD6
The day started with one of the best lectures of the entire week on Dental Emergencies taught by a local dentist. Temporary fillings and temp crown replacement were discussed and practiced.
We were given a FTX briefing before lunch. After lunch were were completely geared up (I was issued a vest, helmet, holster, handcuffs and airsoft SIG226) and given Safety/PPE Briefing and had our final Team briefings. Were then sent off to our respective scenarios that utilized moulaged actors in simulated high stress enviroments. The scenarios included:
-Active Shooter Incident (Simunition, there was lots of shooting) which fed patients to the FTC
-Field Treatment Center and Technical Decon
-Clandestine Drug Lab
-Hostage Rescue
Lots of Running and PT between scenarios and for punishment. One of the Team Charlie FF/Paramedics shot a hostage.
*There were problems. Being just an EMT-B and former, non-SWAT, street cop my input was dismissed. My medical skills were dismissed by most (not the ATL) of Team Charlie. I did not get to treat many of the patients and was used mostly as muscle. I was Rear Guard on the Active Shooter. My common sense ideas on how to set up the Field Treatment Center were ignored only to have an Instructor advise Team Charlie, after the fact, that my setup was how it should have been.
The day was hot and brutal. 2.5gal of fluids and I still felt dehydrated. I looked like I walked into a shower with my clothes on. My body was wrecked after it was all said and done.
TD 6.5
The final day was breakfast and graduation. After a week of abuse my back and neck began spasming. Everything hurt and I wanted to find a hole to crawl inside but that was too much effort.
Overall Impressions:
Overall this was a good class and I learned a ton of information and skills. Could the class have been run better? Yup. Some people, no matter how skilled or knowledgable, just make poor lecturers. Talking with one of the Instructors the usual class size is 16-20 students. It seeemed as if 29 might have been too many. There were not enough potty breaks. They told us that this class was like drinking from a fire hose due to the volume of info taught. One could not afford to get up from lecture to pee. You just missed too much. I felt there was too much down time wasted. There were times we literally sat in an empty classroom waiting our turn for a scenario. That time could have been spent on skills. I think the PT element was unneccessary. Most students would have been pushed into the black through Insturctors screaming at them without having to be out of breath first. Again more time for skills. While the class was open to EMT-B's on up (we had 2 Dr.'s) skills were not taught down to this level as I mentioned my problems with the Ranger IV instruction. There was a lack of healthy food options. Most, but not all, of our meals were just too greasy for me and eating together was required. My body is a temple and the gods get pissed when I desicrate it with shitty food. Don't get me wrong only one meal sucked taste wise.
While Day/Night Land Navigation is listed as one of the course topics and items related are on the Required Equipment List it was NOT taught. I was told it was dropped for TCCC.
Wow that took forever to type. That is all I got for now. Mind still trying to wrap around just how much good info I learned.
Oh and I signed up for Paramedic School. :D Start in July.
Great AAR - thanks. I always wonder if these would be "worth my time." Sounds like, yes, but I'd need to filter courses before I choose.
Congrats on medic school. It's a bear - I had a friend that got flunked 3 different times. No CS exposure, though :)
Ouroborous
07-06-12, 07:13
Thanks for the AAR Hizzie. If you don't mind me asking, how much was the course and did your dept/company pay for you to go through?
Class was $1600 with hotel and $1200 without hotel. I paid out of my own pocket.
Ouroborous
07-06-12, 19:26
Class was $1600 with hotel and $1200 without hotel. I paid out of my own pocket.
Thanks for the update Hizzie.
I'd like to take a CTOMS/TCCC course myself someday.
Are you using the skills you learned yet?
I am just an EMT-B and do not have my TCLEOSE certification. I learned some of my weaknesses during the class and have set to correcting those deficiencies. I do feel that I am a better EMT having been tested under stress on skills that were well above my normal scope. The training has also set me to thinking more when on scenes.
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