Tactical Medicine classes

[BruceLeroy]

Quick question... Do all these Combat Casualty Care Courses getting taught by "XYZ" Tactical instructors have medical directors or are they covered with waivers/liability forms.

I know that the C3 course is the standard from the Army/military but does it require oversight by a doc?

[Gutshot John]

Quick question... Do all these Combat Casualty Care Courses getting taught by "XYZ" Tactical instructors have medical directors or are they covered with waivers/liability forms.

I know that the C3 course is the standard from the Army/military but does it require oversight by a doc?

First TCCC isn't generally meant for medics and in the civilian world the medical techniques covered go beyond the scope of practice of most paramedics/EMTs.

Second outside of tourniquet and combat gauze application, the advanced techniques require a certain amount of anatomical knowledge and the ability to maintain a perishable skill.

Third, TCCC is only peripherally about medicine, it's more about mindset and evacuation.

That said are you an EMT or Paramedic? If you are it wouldn't be their medical director that covers your liability, it would be your command doc. So while they have medical directors, the curriculum is such that if you aren't an EMT, there isn't much in the way of liability protection and you're better off with a standard civilian first-aid class.

Military medicine is a unique animal since the practitioners can't be sued for negligence, they get court-martialed.

There are plenty of good civilian classes out there, and the mark of a good one is a dedicated medical director that has approved their curriculum. Another one is probably (but not necessarily) the absence of the word "tactical" in the title.

[BruceLeroy]

Thanks for your view on it. I see some "classes" preaching the concepts but I wasnt sure how they are covered in terms of liability. The more I dig and begin to get replies from some of these places I see that they really are only scratching the surface in terms of treatment and really focus on parts of our training. That is, supress enemy fire (bad guy), stop the bleeding, stabilize and evac ASAP. I understand that much of what I do does not and will not apply to the civillian side but I was just wondering how they operated.

Thanks.

[chuckman]

There are plenty of good civilian classes out there, and the mark of a good one is a dedicated medical director that has approved their curriculum. Another one is probably (but not necessarily) the absence of the word "tactical" in the title.

Couldn't agree more. I know a group of guys who are less than ethical, held a first responder course, added CQ and tourniquets and a couple "I'm up they see me I'm down" drills and slapped the word 'tactical' on it and added $250 to the price of the course. I really loathe the deligitimacy of good courses/curricula for the sake of a buck.

[malignantbum]

Instead of investing a couple hundred in a class such as that, take the EMT-B course from a community college. One would be better off.

[Gutshot John]

Instead of investing a couple hundred in a class such as that, take the EMT-B course from a community college. One would be better off.

As a paramedic I disagree with this unless you are already in the health care field or planning on going that route. If you want to volunteer to serve your community public safety, the Red Cross or actually get into it as a career, it's an excellent suggestion. If you're looking just to take a class and move on with your life there are simply more efficient ways to do it.

It's not to say that you won't learn good skills, you certainly will, but it's simply not appropriate for most people just trying to learn first aid.

The amount of time investment involved with getting certified (class time, clinicals etc.) not to mention sustaining that certification through CME makes it problematic and requires a lot of dedication. Add in the fact that many of these skills are perishable and require a goodly amount of time running calls on the street make it impractical for most.

From a liability perspective you will also be held to a higher standard when you use the skills in question and if you mess up because you've not practiced/maintained the skillset, let your CMEs lapse or otherwise not performed up to the standard. You have far greater good samaritan protection with a civilian focused first-aid curriculum.

[malignantbum]

If 80 hrs of classroom work and 120 CEU hrs over a 4 year period is "too much effort" then just take the class and do not seek licensure. Retake it once q 4 years. Funny how folks spend all sorts of cash on gear yet won't invest any time in this aspect.

[Gutshot John]

If 80 hrs of classroom work and 120 CEU hrs over a 4 year period is "too much effort" then just take the class and do not seek licensure. Retake it once q 4 years. Funny how folks spend all sorts of cash on gear yet won't invest any time in this aspect.

Ehhhh...no. That's got nothing to do with anything. First of all I never said "too much effort", you did so I'm not sure why you're putting it in quotes. I simply said it was "impractical." Second who said anything about cash? Tuition is only part of the cost involved. Time is also money. Third, some training beats no training and I'd rather people get some training that requires less-effort and is focused more on their realistic needs than on a program that not only requires significantly greater investment of time but is also mostly irrelevant to their situation.

Depending on your state it's quite a bit more than 80 hours of classroom work (NAEMT has 120 hours, that's 12, 10 hour days - that's more than most people's alloted vacation time per year or 30, 4 hour evening classes which takes months to finish) and also requires clinical (ambulance/ER) time over and above that which isn't realistic for people with jobs, families and a life especially for someone who isn't going to do it for a living. Never mind the fact that the average civilian is not going to have access to backboards, ambulances, jump bags, O2 bottles, BVMs and the myriad of gear that is covered in an EMT curriculum so most of that training isn't even going to be applicable. The training necessary to use gauze, a tourniquet and a hemostat can be accomplished in a fraction of the time.

A typical first aid class is a lot more appropriate for most people who might be put off by the time requirement of a full-on EMT. Some training is better than nothing. If someone takes a FA/FR class and decide they really want to be an EMT, hey great/awesome but you also have to spend some time on the street putting those skills to use in order to become fully proficient. So let's not put forth the notion that it's either opportunity-cost-free or a simple fix.

[malignantbum]

I think we shall just agree to disagree on this.

[Hmac]

If we're talking about emergency medical care at the EMT-B level as a hobby, and a given person can justify to themselves the time commitment to learn a perishable skill on the highly unlikely chance they'll ever be called upon to use it, then they should have at it.

To answer the OP's question on civilian Tactical EMS courses...yes there is often some MD sponsorship of many of them, but I wouldn't call it a major component. Most of civilian Tactical EMS is technique and concept beyond the training and experience of most EMS Medical Directors.

Not sure what your liability question is. AFAIK, there is no liability that would be offset by having a doctor involved in the teaching curriculum.

I have taken some of these courses, taught at some of them, and been the "Medical Director" at some of them. They're designed to build on EMT skills already acquired, utilizing that knowledge and skill in a specialized environment under circumstances that aren't part of the usual EMT training.

[Mitchell, Esq.]

Sig Saur has a First Aid for Range Officers class which was a 1 day, 8 hour basic intro to trauma care which was very good.

The instructor discussed the basic types of injuries on the range, penetrating trauma, eye injuries, catastrophic blood loss and broken bones.

They went into tension pneumothorax, but stayed away from needle decompressions as outside the scope of the class. They wanted the chest injury sealed and went into how to do it, but with the expectation you would be handing off the patient to EMS in short order.

I got the impression they weren’t comfortable with the idea of doing a needle decompression in a basic range first responder class.

Tourniquets, hemostatic agents were covered as were Israeli bandages and improvised seals for sucking chest wounds.

It wasn't Combat Casulaty Care - it was how to deal with a range accident, but applicable to post fight trauma care for the most part.

This is a med kit for the range for people going shooting suggested by Dave Bruce (the instructor) in his 1st aid for Range Officers class:

Battle Dressings
Israeli Bandages
Tourniquets
Quick Clot
SAM Splints
Dish Washing Gloves
Ace Wraps
Triangle Bandages
Pocket CPR Mask
Asherman Seal/Bolin Chest seal
Trauma Sheers
Medical Tape
Eye Wash

Sig sells the http://www.resq-pak.com/products.php kits, but if you want a lower cost prepackaged kit to stash in your bag/coat/briefcase...Adventure Medical Kits http://www.adventuremedicalkits.com/product.php?catname=Sportsman&prodname=Trauma%20Pak%20with%20QuikClot%C2%AE&product=247

If you are looking for a full up combat medical class, John Farnam & Magpul each do classes with their own companies on this subject, and Tactical Response does a 2 day Immediate Action Medical class, and a 5 day contractor class.

Sig's class was good for someone who wants to learn how to handle trauma injuries during the injury to EMS interval.

It was well presented, easily retained, and a very good skill addition for the non-soldier/LE person who deals with firearms in training, and wants to know self aid in the event they get injured in a use of force situation.