Medic

[MedicForce]

Hello CAP members. I have a question which I have not been able to find out. For the medic badge and being a squadron medic, is it possible for a cadet to do it? Where is the regulation that talks about that?

[lordmonar]

Ruben,

If you complete an EMT course you can wear the EMT badge.

We do not have a squadron medic, CAP regulations don't allow us to have a squadron medic in the sense you are using the word.

Having said that.....we will always encourage our cadets and SM to increase their skills in the event that we should ever need them.

Talk Lt Torrez on Tuesday about where you can get some good training.

[MedicForce]

Ok. Thank you sir. I was REALLY confused about that at NESA.

[JayT]

Hello CAP members. I have a question which I have not been able to find out. For the medic badge and being a squadron medic, is it possible for a cadet to do it? Where is the regulation that talks about that?

You have to be a certified EMT-B, EMT-I (or whatever your states version is), or EMT-P to wear the EMT badge.

[ffemt99]

will CAP honor any training I have already taken in which they require (fire and medical certs)? im not a cap member but am considering joining.

[Hawk200]

will CAP honor any training I have already taken in which they require (fire and medical certs)? im not a cap member but am considering joining.

We don't have any need for fire certifications. As to medical, the training needs to be completed EMT training in order to qualify for the badge.

[SABRE17]

GT FIREFIGHTER SQTR...

or

FL CRASH FIRE RESCUE SQTR

haha

[Eclipse]

will CAP honor any training I have already taken in which they require (fire and medical certs)? im not a cap member but am considering joining.

We don't have any need for fire certifications. As to medical, the training needs to be completed EMT training in order to qualify for the badge.

You also need to be certified and licensed in your state as per the local regulations.

[tsrup]

will CAP honor any training I have already taken in which they require (fire and medical certs)? im not a cap member but am considering joining.

The only thing that would transfer over would be your ICS courses (if you have taken any).  Hopefully you kept your certificates..

[Eclipse]

Don't take these responses the wrong way - the mentality of urgency and professionalism found in the fire service is definitely needed, we just don't specifically put out fires or provide medical care.

[tsrup]

Don't take these responses the wrong way - the mentality of urgency and professionalism found in the fire service is definitely needed, we just don't specifically put out fires or provide medical care.

Truth, Many firemen and EMT's have found a home and a niche in CAP.  Quite possibly the greatest and largest benefit these members bring to the program is bringing their respective organizations closer to ours.  If all you ever end up doing in the program is help spread the word of CAP to your agency, then that is a huge win for us. 

[SARTAC Medic]

As a 15 year cap member, and also paid paramedic I just wanted to make  distinction here about the word "medic"

PARAMEDIC refers to someone who is trained to the level of the US DOT standard for training in Pre-Hospital Medicine. 

MEDIC is a slang term for anyone who RENDERS AID to the sick or injured in an out of hospital setting.     


While I do not personally take offense to the word MEDIC while referring to CAP members who are "TEAM MEDICS", "SQUADRON MEDIC", or any similar term, I know people who would.

Perhaps it is better to describe the person who is first aid qualified or higher, who is not CERTIFIED as a PARAMEDIC or EMT through the state to be called "First Aider" or something similar

With the Current climate of CAP using the NIMS system for ICS there may be a conflict with CAP members responding for a CERT mission or to assist with some disaster someplace and have their members mistaken for paramedics or emts because of the internal terms we are using to describe the person on our ground teams who render aid.


Everything said, I will continue to call CAP members who are the person to render aid on the team the "Team Medic" but spend a few minutes letting the person and the other members involved know that  outside of CAP it might be considered inappropriate to refer to their training as medic to offset the confusion it might bring about their qualifications. 

[Hawk200]

Maybe we should start encouraging First Responder courses, and just use that term. Most people know what it means.

Personally, I don't really consider someone that's been through a First Aid course a "medic". If I yell "Medic!", I'm not looking for someone that's capable of just putting on a Bandaid, I'm looking for someone that knows what a nose hose is or can give me an IV.

Nothing against First Aid qualified people, but I don't think the term "medic" really applies in the manner that most people think it to be.

[RiverAux]

Maybe we should start encouraging First Responder courses, and just use that term. Most people know what it means.

Except it is going away.  "Emergency Medical Responder" is the new thing since "First Responder" has basically become a generic term for many types of emergency personnel rather than to those with a specific type of training. 

[davidsinn]

Maybe we should start encouraging First Responder courses, and just use that term. Most people know what it means.

Except it is going away.  "Emergency Medical Responder" is the new thing since "First Responder" has basically become a generic term for many types of emergency personnel rather than to those with a specific type of training.

That and a first responder course is going to set you back hundreds of dollars so it's stupid to replace the first aid requirement with it.

[RiverAux]

"Emergency Medical Responder" IS "First Responder".  They just changed the name. 

Not sure where you're getting your prices from though.  Last time RC did one locally it was like $40. 

[EMT-83]

There's always these folks...

http://www.pawingcap.com/hawk/the_medics.htm

[davidsinn]

"Emergency Medical Responder" IS "First Responder".  They just changed the name. 

Not sure where you're getting your prices from though.  Last time RC did one locally it was like $40.

My wife took it in college to the tune of $700. A local unit does it through ARC using a CAP member as instructor for a deep discount at a price of $100. In IN it's the step right below EMT-B. My volunteer fire company is about 50% first responders and they get there to do initial stabilization before the bus with EMTs arrives. My county does not currently have any paramedics.

[JayT]

"Emergency Medical Responder" IS "First Responder".  They just changed the name. 

Not sure where you're getting your prices from though.  Last time RC did one locally it was like $40.

My wife took it in college to the tune of $700. A local unit does it through ARC using a CAP member as instructor for a deep discount at a price of $100. In IN it's the step right below EMT-B. My volunteer fire company is about 50% first responders and they get there to do initial stabilization before the bus with EMTs arrives. My county does not currently have any paramedics.

Your entire county doesn't have a single active medic? Wow. We're spoiled out here!

[Eclipse]

"Emergency Medical Responder" IS "First Responder".  They just changed the name. 

Not sure where you're getting your prices from though.  Last time RC did one locally it was like $40.

Not necessarily - a lot of members around me have taken classes called "first responder" which is basically first aid + CERT, etc.,
offered by local agencies for about $40.

Full-on EMR classes run $700-900+.

[RiverAux]

This was the official Red Cross First Responder course (about 40 hours).  No CERT stuff.  Same FR class as the firefighters take in my state if they go to the fire academy. 

[davidsinn]

"Emergency Medical Responder" IS "First Responder".  They just changed the name. 

Not sure where you're getting your prices from though.  Last time RC did one locally it was like $40.

My wife took it in college to the tune of $700. A local unit does it through ARC using a CAP member as instructor for a deep discount at a price of $100. In IN it's the step right below EMT-B. My volunteer fire company is about 50% first responders and they get there to do initial stabilization before the bus with EMTs arrives. My county does not currently have any paramedics.

Your entire county doesn't have a single active medic? Wow. We're spoiled out here!

True story. We currently have three ambulances with two EMTs per rig on duty 24/7. They are looking at hiring some paramedics so that one is on duty in the center of the county 24/7 and would drive an SUV and meet the rig at the victim or en route to the hospital. We don't have any professional fire fighters either.

[SJFedor]

"Emergency Medical Responder" IS "First Responder".  They just changed the name. 

Not sure where you're getting your prices from though.  Last time RC did one locally it was like $40.

My wife took it in college to the tune of $700. A local unit does it through ARC using a CAP member as instructor for a deep discount at a price of $100. In IN it's the step right below EMT-B. My volunteer fire company is about 50% first responders and they get there to do initial stabilization before the bus with EMTs arrives. My county does not currently have any paramedics.

Your entire county doesn't have a single active medic? Wow. We're spoiled out here!

True story. We currently have three ambulances with two EMTs per rig on duty 24/7. They are looking at hiring some paramedics so that one is on duty in the center of the county 24/7 and would drive an SUV and meet the rig at the victim or en route to the hospital. We don't have any professional fire fighters either.

Pretty common out here. I work in a large urban 911 service and we still have some trucks that are BLS staffed for 911 response. Granted, theres so many hospitals in metro that they can just load and go and be to the nearest facility in 10-15 min. And we tend to have them in the middle of ALS resources, so any direction they run, we can intercept or dual response.

However, Indiana does have an EMT-Basic Advanced course, which a lot of counties who are short on medics use. It's essentially EMT-Basic plus IV initiation w/ fluids and basic cardiology/cardiac monitoring (mainly just recognition of arrhythmias and manual defib, from before the days of AEDs). Plus EMT-B's in Indiana already have some advanced airway toys (combi-tube seems to be prevalent throughout IN). I'm betting most of the techs in your county are AEMT-B's.

And if your wife shelled out $700 for an FR class, sorry to say it, but she got jacked. She coulda done EMT-B for about the same price.

[JayT]

"Emergency Medical Responder" IS "First Responder".  They just changed the name. 

Not sure where you're getting your prices from though.  Last time RC did one locally it was like $40.

Not necessarily - a lot of members around me have taken classes called "first responder" which is basically first aid + CERT, etc.,
offered by local agencies for about $40.

Full-on EMR classes run $700-900+.

The CFR-D/EMR-D whatever NREMT is trying to call it these days is the 50 hour course. Anything less then that is just some advance first aid.

[SJFedor]

"Emergency Medical Responder" IS "First Responder".  They just changed the name. 

Not sure where you're getting your prices from though.  Last time RC did one locally it was like $40.

Not necessarily - a lot of members around me have taken classes called "first responder" which is basically first aid + CERT, etc.,
offered by local agencies for about $40.

Full-on EMR classes run $700-900+.

The CFR-D/EMR-D whatever NREMT is trying to call it these days is the 50 hour course. Anything less then that is just some advance first aid.

Thought I heard EMT-FR once.... more alphabet soup.

[CadetProgramGuy]

"Emergency Medical Responder" IS "First Responder".  They just changed the name. 

Not sure where you're getting your prices from though.  Last time RC did one locally it was like $40.

Not necessarily - a lot of members around me have taken classes called "first responder" which is basically first aid + CERT, etc.,
offered by local agencies for about $40.

Full-on EMR classes run $700-900+.

The CFR-D/EMR-D whatever NREMT is trying to call it these days is the 50 hour course. Anything less then that is just some advance first aid.

Thought I heard EMT-FR once.... more alphabet soup.

There is no National registry for First Responders.

EDIT - Stand Corrected.

And in the near future there will be a name change to EMT's as well

Emergency Medical Responder - First Responders
Emergency Medical Technician - EMT- basics
Advanced Emergency Medical Technician - EMT Intermediates (99 curricula)
Paramedic  - EMT-P

[Spaceman3750]

NREMT registers first responders.

[CadetProgramGuy]

Edited my last, you're right.

[RiverAux]

NREMT registers first responders.

True, but I don't think but a small fraction of folks with the training get registered since it isn't required (anyplace that I know about, that is). 

[JayT]

"Emergency Medical Responder" IS "First Responder".  They just changed the name. 

Not sure where you're getting your prices from though.  Last time RC did one locally it was like $40.

Not necessarily - a lot of members around me have taken classes called "first responder" which is basically first aid + CERT, etc.,
offered by local agencies for about $40.

Full-on EMR classes run $700-900+.

The CFR-D/EMR-D whatever NREMT is trying to call it these days is the 50 hour course. Anything less then that is just some advance first aid.

Thought I heard EMT-FR once.... more alphabet soup.

There is no National registry for First Responders.

EDIT - Stand Corrected.

And in the near future there will be a name change to EMT's as well

Emergency Medical Responder - First Responders
Emergency Medical Technician - EMT- basics
Advanced Emergency Medical Technician - EMT Intermediates (99 curricula)
Paramedic  - EMT-P

Actually, according to the last proprosal I read, the break down would be

CFR=EMR
EMT-B=EMT
EMT-I/85=AEMT
EMT-I/99 and EMT-P= Paramedic

I also read a few things proposing trying to make the CCEMPT/MICUM/APEMTP recognized as a sort of 'super paramedic' grade.

Its kinda a moot point for me, because NY doesn't recognize NR.

[SARTAC Medic]

Joe, all of those advanced medic courses are not functional levels of certification, but rather advanced training for specific needs sort of like how PHTLS, ATLS, PALS, ACLS, (you get the point) are nationally recognized standards of training that folks working in some capacity need to for their job.  I am a state paramedic, but as a paramedic I need to hold certifications in ACLS and PALS for one job, just PALS for another... while someone at, North Shore can take the CCEMTP course to do critical care transports.  The state will never recognize the CCEMTP course for anything as a level, but the job can have people take the course to learn the knowledge and have a cert to prove the completed it.  (hope that was understandable)

Also, as far as cost goes... Red Cross teaches the Emergency Response course which is based on the DOT standard for First Responder.   National Safety Council currently has a First Responder Course which I am molding our "Field Medic" academy around as I am writing the curriculum.   From what I understand, NESA's first responder course was the National Safety Council First Responder course.   Both are similar to the DOT requirements, but each state has their own requirements if they have  CFR type program like New York's. 

Currently practicing instructors can become grandfathered into the NSC as instructors at their current level, and if you are an EMT or higher you may apply to teach the NCS First Responder Course for them.    The total cost for the students to take the First Responder Course is not much higher then taking a First Aid Course, but it VERY time intensive.  The bare minimum for teaching he First Responder Course is 140 hours of class room time.   This is a CRAZY mount of time to expect a CAP cadet or volunteer member to do without pay (IMHO).   We are planning on offering the course as a second step in the process of our field medic course.   Cost wise, the student manual for the First Responder is about $50 dollars for the books and cert card not withstanding the time for the course to be run.   Most places will charge for paying the instructor, paying for coffee/bagels on the day of the class, and other administrative fees.   

As a final thought, I do not see cap needing people certified beyond first aid through CAP since there is a definite policy against cap members performing schedule aid stations, or rending other then life saving first aid.   National wants members to turf the work to the professionals (NON CAP) for anything beyond basic first aid.    If a cadet at a FTX gets injured on day three... they should be turfed home or to the hospital as appropriate if its anything other then small abrasion in my opinion.  While wilderness first aid TEACHES TOURNIQUETS and wound packing techniques to the students for use in the field, there is no need for a cadet who is injured on that level to stay at the activity if there is a way for them to go home and have parents or clinics deal with the problems.   

I could go on and on with my own personal stance on what CAP should and shouldn't be doing as far as medical aid and I will probably make a few enemies here and there, but the FACT IS THAT CAP IS A SELF CARE, FIRST AID ORGANIZATION, WITH THE EXCEPTION OF LIFE THREATS!!.

we do not have a medical director, we do not have protocols, we do not have ability to carry oxygen and other items needed to save lives. 

Would a First Responder Course be useful, yes.  It will teach people how to handle and evaluate situations in order to know what is severe or not.  But bystanders know when someone is hurt without training and they can still call EMS just as readily as a paramedic who is out of his jurisdiction and without equipment.   

[CadetProgramGuy]

"Emergency Medical Responder" IS "First Responder".  They just changed the name. 

Not sure where you're getting your prices from though.  Last time RC did one locally it was like $40.

Not necessarily - a lot of members around me have taken classes called "first responder" which is basically first aid + CERT, etc.,
offered by local agencies for about $40.

Full-on EMR classes run $700-900+.

The CFR-D/EMR-D whatever NREMT is trying to call it these days is the 50 hour course. Anything less then that is just some advance first aid.

Thought I heard EMT-FR once.... more alphabet soup.

There is no National registry for First Responders.

EDIT - Stand Corrected.

And in the near future there will be a name change to EMT's as well

Emergency Medical Responder - First Responders
Emergency Medical Technician - EMT- basics
Advanced Emergency Medical Technician - EMT Intermediates (99 curricula)
Paramedic  - EMT-P

Actually, according to the last proprosal I read, the break down would be

CFR=EMR
EMT-B=EMT
EMT-I/85=AEMT
EMT-I/99 and EMT-P= Paramedic

I also read a few things proposing trying to make the CCEMPT/MICUM/APEMTP recognized as a sort of 'super paramedic' grade.

Its kinda a moot point for me, because NY doesn't recognize NR.

The EMT 83 and EMT 99 folks will get rolled into the AEMT, problem will be in the con ed classes to make them AEMT's

Here in IA, the EMT99 folks will have 3 certification periods (6years) to bridge up to Paramedic, bridge over to an AEMT or bridge down to a basic.

Most of the rural counties of Iowa have teh EMT-I 99 running as "Iowa Paramedics"  Unless they bridge up, most of those counties will lose their Paramedics. 

In Des Moines Fire alone, that require all to be Paramedics, will have 60ish members that have to take classes.

[SJFedor]

KY just recently started recognizing the AEMT cert, and I can only think of 1 or 2 services that use them in the state, and those were the testbeds for the AEMT program.

[JayT]

Joe, all of those advanced medic courses are not functional levels of certification, but rather advanced training for specific needs sort of like how PHTLS, ATLS, PALS, ACLS, (you get the point) are nationally recognized standards of training that folks working in some capacity need to for their job.  I am a state paramedic, but as a paramedic I need to hold certifications in ACLS and PALS for one job, just PALS for another... while someone at, North Shore can take the CCEMTP course to do critical care transports.  The state will never recognize the CCEMTP course for anything as a level, but the job can have people take the course to learn the knowledge and have a cert to prove the completed it.  (hope that was understandable)

Oh, yeah, without a doubt. Like I said, it was just a proposal I saw in some NREMT white paper about pushing for a wider acceptable of any sort of advance practice paramedic.

Good to see you back Dave, as soon as I'm done with Stony Brook I'm getting back in.

[SARDOC]

I thought you guys were just certified "ambulance drivers"     

[SARTAC Medic]

Joe, Glad to be back.. just trying to get my papers in order


And yes, sometimes I feel like a glorified taxi driver, hobo wrangler, and part tim zombie hunter.   

[JayT]

Joe, Glad to be back.. just trying to get my papers in order


And yes, sometimes I feel like a glorified taxi driver, hobo wrangler, and part tim zombie hunter.

If there was ever a zombie attack, we'd be the last to figure it out. Even if the zombies took over the dispatch centers, we wouldn't know the difference.

[fyrfitrmedic]

"Emergency Medical Responder" IS "First Responder".  They just changed the name. 

Not sure where you're getting your prices from though.  Last time RC did one locally it was like $40.

Not necessarily - a lot of members around me have taken classes called "first responder" which is basically first aid + CERT, etc.,
offered by local agencies for about $40.

Full-on EMR classes run $700-900+.

Wow - somebody's being taken to the cleaners with that price; although I guess it depends on where and who's offering the course. EMT classes in this part of the world run $300 or less.

[sarmed1]

The bare minimum for teaching he First Responder Course is 140 hours of class room time.

That hour requirement seems a litte steep to me.  My personal experience is 40 hours (a curiosity check of the interweb shows on average 40-50 hours, some listed as low as 24 and some as high as 80)... but obviously each state often does its own thing (the whole must meet or exceed the DOT/NREMT type standard)

Dave, as far as teaching institutes go I would consider ECSI; they use the AAOS series of texts; offer a Wilderness Advanced First Aid (customizable from 8-36 hours) as well as a First Responder cert.  HMRS used NSC in the past and moved away from them as thier pricing began increasing and increasing to match demand from the OSHA/industrial need.  ECSI offers pretty much the same instructor reciprocities (grandfathering), has no costs required other than purchase of the books and cards.  WFA is about $25 to the teaching center and FR $60 (last time I had to buy books)
HMRS currently uses the 36 hour Wilderness course as thier base certifiation; then adds in CPR and a number of "Hawk" specific blocks covering areas such as field sanitation and hygeine, illness/injury prevention, evacuation etc.  They graduate year 1 with the hope of coming back next yaer to continue on.  This gives them a year to get out there, review and practice thier skills; they have set up 10 approx 1 hour self study con-ed papers for them to keep fresh on during the year.  Year 2 then roles in first responder and additional training (basically a more in depth coverage of some of the first year topics)

They had done a 40 ARC/DOT first responder course in the past, all in year one and found when coupled with the additional wilderness/SAR/prevention topics they were pretty much sitting in a classroom for 9 days.  The WFA course gave them the most bang for the buck and felxabilty in the schedule.  This way they get classroom time (its a long 3 days) plenty of practice time, they then "intern" with an existing medic for the 3 day field problem, then still have study time and test time at the end of the week (plus throw in a few other fun times... ground ambulance familirization, helicopter familirization and a cardio/resp disection lecture) as well as time to work on their standard SAR qualifications.

mk

[ryan.turner]

Here's a question: does CAP consider an EMR an EMT? Some paperwork I've dealt with for my state and nremt licensure have referred to it as EMT-FR... not trying to push the limits, just curious. My assumption is no, but maybe others have dealt with this before.

[N Harmon]

As a final thought, I do not see cap needing people certified beyond first aid through CAP since there is a definite policy against cap members performing schedule aid stations, or rending other then life saving first aid.

Is this true? I am quite sure I read in our MOU with the American Red Cross something about CAP agreeing to provide personnel to man aid stations under ARC supervision.

edit:
According to National Headquarters, "The MOU with the American Red Cross expired 07 May 2002 and has not been replaced. Historically, most if not all mission support for the ARC has been through state and federal missions and existing mechanisms for employment. We expect that will continue into the future. Both organizations hold one another in great esteem and serve America well without an MOU."

[JayT]

Here's a question: does CAP consider an EMR an EMT? Some paperwork I've dealt with for my state and nremt licensure have referred to it as EMT-FR... not trying to push the limits, just curious. My assumption is no, but maybe others have dealt with this before.

It's really not considered an 'EMT' in most states. Depending on the state, the CFR-D/EMR may not even be commonly taught. Around Long Island, the only time they really run the class is before the FDNY Academy class goes in, because it's a requirement upon entry.

[Krapenhoeffer]

Be careful with the ARC Emergency Response class. In my neck of the woods, legally, it's just Super Advanced First Aid (now with BP, Oral and Nasal airways, and packaging!).

There are some things that I've heard of Cadets being taught that just frightens me. From what I understand, AL wing teaches Cadets how to "properly" use a C Collar.

About a day later (this was at NESA), these cadets when faced with the scenario "My plane crashed, and I'm cold and I'm thirsty. Also, I'm pale" they gave the simulated patient something to drink.

IMHO, having Medical First Responders (or above) in CAP serves a good use in CAP. First, they can recruit more EMTs for the local Vollie Bus. And, they can keep the Basic First Aid people from doing incredibly stupid things.

[sarmed1]

From what I understand, AL wing teaches Cadets how to "properly" use a C Collar.

you know its not like it requires a degree in rocket science....

Also, I'm pale" they gave the simulated patient something to drink.

I alsways love this one; can anyone explain to me why its a bad thing.  As a blanket statement to cover the least competant or lowest trained provider I understand.  Sure there are a few instances where you may be compounding the problem:  abdominal injury where stomach contents or intestinal contents may be leaking interanlly; adding increased volume or pressure there could worsen the injury.  Impending surgical intervention you want to avoid something in the stomach that may come back out under ansthesia.
Current military doctrine allows oral rehydration for traumatic injuries if there is a reasonable anticipation of delay to surgical intervention (just as there would likely be in a plane crash scenario).  So to me this is not the absolute no no it once was.... (just like tourniquets, c-spine clearing in the field etc etc)

mk

[SARTAC Medic]

Cap will never be an EMS agency. 

Even if they did, they would need a national level medical director to cover the protocols needed, and there would need to be local medical direction for the field providers.   

Seeing as the country as a whole cannot get their heads out of the ground when it comes to a national level of EMS certification (NREMT aside, which still cannot let you be portable across state lines) I think trying to make CAP members anything other then advanced first aiders is a moot point.

I can see however, having a cap specialty rating as a "field medic" or some other term that will not twist knickers which is essentially a standardized first aid program with some wilderness/remote aspects incorporated.    As far as ground teams goes, this would be compatible with wilderness search and rescue AND some of CAP up coming (in my opinion) disaster relief role as pertains to natural disasters.   There is no reason why a cap ground team cannot be deployed to assist the red cross in an area where a tornado, hurricane, or other natural disaster has hit to do damage assessment and other CERT type missions.   

As far as cervical collars goes.... I see no reason to not include proper training in this.  Even if we are not transporting or moving patients there is no reason we cannot give members training to help limit morbidity of crash victims or other aided cases we may find during cap missions.   A ground team out on a ramp search who comes across a car accident could potentially cause more damage trying to "help" the victims then if they were properly trained to hold stabilization until rescuers respond. 

Being pale, does not alone indicate being in a state of profound hypo-perfussion.     The only reason we are trying to limit oral intake on a "shock" patient is so they do not aspirate their gastric contents if they vomit, and to allow them to be rushed into surgery if needed.   With that said, if someone in a crash is compensating decently with their low level hypo-perfussion, why let them die of dehydration awaiting rescue 4 hours away.   

I know this is a hot button issue with all the EMS and fire people out there, so Im going to not get on a soap box here (or step down if I have stepped up).

[N Harmon]

Cap will never be an EMS agency. 

Never? Ever? Not in a thousand years? That's a mighty definitive statement you're making.

I think it is safer to say we will not be an EMS agency for the foreseeable future, barring any major nation-wide changes to our mission and/or structure.

[SARTAC Medic]

Im going to stick by my "never ever" policy.

But i will conceid that CAP may eventually have some sort of standardized field medic program. 

The main obstacle i forsee is a lack of standardization nationwide in the current EMS system.  Its not like cap could say "OK Folks, If you are a certified EMT outside of CAP you can apply to be an EMT for CAP." There simply isnt a homogeneous system in place for EMT training. 

Also, anyone in EMS knows that even BLS providers operate under a medical director.  I also cannot forsee CAP getting a medical director who will allow sooooo many EMT's to operate at large without a massive nation wide academy for EMT's.  This is why I think that CAP may choose to have a standardized First Aid Program based on some of the already nationally recognized First Aid Program.  The one problem with this is that in some areas of the country it is difficult, if not impossible to find one of the "alphabet" oranizations.   American Red Cross (ARC), American Heart (AHA), National Safety Council (NSC), etc....  We would need a mass instructor train the trainer course so each wing would have instructor trainers, who then would have instructors trained at the local level, who woudl finally train the local members to be providers.   CAP could become a national training organization for any of the groups, much like NOLS has nation wide centers.   

Another option i forsee is a splintered program where national recognized the need for BLS (maybe) and allows members who are doctors to sign a crap load of forms to be local medical directors and then authorize their local members to operated under that medical director with a specific set of BLS protocols (maybe a national set, which can only be used if there is a medical director)   I think that these protocols would be simple... Bleeding control, splinting, spinal immobalization, stuff along those lines.     

ALS protocols are waaaaaaay down the road if this were to even come to fruition.   There are loads more considerations what i dont think will ever never ever never, allow cap to be an ALS program...

[Major Lord]

From what I understand, AL wing teaches Cadets how to "properly" use a C Collar.

you know its not like it requires a degree in rocket science....

Also, I'm pale" they gave the simulated patient something to drink.

I alsways love this one; can anyone explain to me why its a bad thing.  As a blanket statement to cover the least competant or lowest trained provider I understand.  Sure there are a few instances where you may be compounding the problem:  abdominal injury where stomach contents or intestinal contents may be leaking interanlly; adding increased volume or pressure there could worsen the injury.  Impending surgical intervention you want to avoid something in the stomach that may come back out under ansthesia.
Current military doctrine allows oral rehydration for traumatic injuries if there is a reasonable anticipation of delay to surgical intervention (just as there would likely be in a plane crash scenario).  So to me this is not the absolute no no it once was.... (just like tourniquets, c-spine clearing in the field etc etc)

mk

In many ways, its misleading to compare military protocols to civilian protocols. Civilian EMS is married to the "Golden Hour" where timely  Pre-Hospital care and rapid transport is known to result in significantly higher shock/trauma survival rates. I think that the idea of keeping trauma patients NPO stems from the old days, when adding water to your guts just made the the fluids migrate even more efficiently through the peritoneum. This resulted in a blanket order for nothing by mouth the only sensible thing to do in penetrating peritoneal or thoracic injuries ( typical war wounds) To give water (beer, whiskey, gatorade or anything else) to a patient with a hole in their trunk is just an awful idea.

So now the question of why not give a drink to a person who in the described scenario gave a text-book signs and symptoms description of shock? Partially, for the reasons above, i.e, transporting fluids around and reducing the survivability of the patient due to peritonitis. The nature of a high impact event like a plane crash ( the Mechanism of presumed injury) suggests a high likelihood of internal injury, so shock protocols are prudent. (especially since your patient was kind enough to read you their triage tag for the exercise) Secondly, giving shocky patients anything by mouth will almost certainly result in vomiting, especially when they have a gut injury. Naturally, this will also happen as their level of consciousness declines, so you will now be left with a patient who will almost certainly aspirate their vomitus. ( your water plus stomach contents, blood, other icky fluids) This leaves you with a patient who will require airway management, taking one EMS provider out of the game and unable to deal with other patients.

In the military pre-hospital care environment, treatment may be delayed past the point of a rational expectation of survival. If so, I suggest you euthanize your patient with morphine or a pistol rather than drowning them with your canteen. Giving water to a patient who is in shock, will probably require surgical intervention, or require advanced airway management is just a bad idea. That is why you learn to start IV's. Making a judgment call in the field  to give water by mouth is one that is unlikely to help the patient, and will be one you will have to live down if things go wrong, and defend even if everything goes right.

Major Lord

[Eclipse]

Cap will never be an EMS agency. 

Never? Ever? Not in a thousand years? That's a mighty definitive statement you're making.

Never.  Ever.  Never.

[Larry Mangum]

Another side tracked topic.  A cadet asked a question concering the wearing of a badge and about a position that does not exist. NESA does not have a medic couse, it simply offered a wilderness first aide course.

[Krapenhoeffer]

Honestly, the "golden hour" will still apply to any patient we likely stumble across.

I don't know about where you live, but where I live, the Flying Bus is only half an hour away (at max) at any given point in the State, and they carry heavy rescue equipment on-board...

I can say for certain that CAP will never ever be a ALS provider... I mean, you can't provide ALS to civilian standards without a rig. However, I wouldn't mind seeing individual wings certified to the EMR-FR level, provided that those First Responders have their own insurance...

[Eclipse]

Honestly, the "golden hour" will still apply to any patient we likely stumble across.

How do you figure?  We don't even deploy within the golden hour.

It starts when you get injured, not when the ES resources are called, and in most of our searches, ground or air,
it takes longer than that just to decide CAP will be involved.  Even during SARSAT days it was usually at least two passes
before AFRCC would start waking people up.  That's 2-4 hours, easy.

[Krapenhoeffer]

Precisely.

Any patient we have will likely be part of our own teams.

A plane crash victim is either 1) walking wounded or 2) deceased by the time we reach them.

Second: The Golden Hour, isn't. Basically, it's a phrase that sounds cool (and is misunderstood by everyone), that means "shortest amount of time possible."

[Eclipse]

For some of our pilots, the golden hour refers to how long they can fly before they have to go potty...

[Krapenhoeffer]

... Which is why the Jumbo Mega Coffee (with extra Caffeine) is to be drank at least 45 minutes prior to wheels up. Gives the aircrew PLENTY of time to take care of biological needs...

[SARTAC Medic]

I dont know how to quote posts yet, so Im not going to.


There is no way that you can say that any victims that CAP stumbles across will be within the golden hour.  I mean honestly.  There are plenty of times where in the response system where I work that  we don't get to real 911 calling patients within the golden hour.... AND I OUR AVERAGE RESPONsE TIME IS 6 MINUTES!!

If i were planning a CAP field medic course... (BTW, Im teaching the last class room session of my Field Medic Course today in about 2 hours) It would most certainly be centered around the idea of self and team aid.   Giving the students the correct information about shock, head injury, spinal trauma, joint and bone injuries, cold and heat emergencies, and GI distress is the back bone of the course.  It also gives them some ORM to deal with wilderness trips, and some more indepth hands on then the standard first aid class.   The most important aspect of this program is dispelling the idea that there is always an ambulance 10 minutes away, and that some of the old wisdom "old wives tale" and folk remedies (butter on a burn) are worthless.  My students may not be qualified EMT's but we are working to make then compitent first aiders who can assess the need to make a slow or fast evacuation and have the proper information gathered for rescuers.   Its alot more about critical thinking and the thought process then it is about treating individual wounds.   

Ill beat this pony till the apocalypse,  CAP WILL NEVER EVER NEVER be an EMS agency and as soon as we accept that and stated to train accordingly we will have a good program.   

I was never involved with the NESA field medic program or the hawk program, but my co-author of the LIGSAR field medic program was.   He said that NESA was a pretty decent program as far as information provided and that hawk was about similar. 

Training to the level of first responder, which encompasses a wilderness/remote and delayed help block would be appropriate.   It would give people the know how to start to mitigate emergencies, minimize life threats, and recognize when there needs to be someone more trained to deal with the problems.   

[Krapenhoeffer]

And that's what I like about the ARC Emergency Response course. Legally, it's just Not-So-Basic First Aid (at least where I live), and with the exception of oral and nasal airways, nothing in the curriculum would make Lawyers get angry.

But what I really like about the First Responder curriculum is that it has two big things: Patient assessment, and treatment of life threats. Not to mention that it goes into the "why?"

Back in my high school days, when I was just Basic First Aid man, my instructor didn't bother telling us why we do things, they just said do it. And when my High School offered the ARC Emergency Response class, my big thing was that they explained, in detail, why Chest Compressions are a good thing for unconscious choking patients, why giving oral fluids to a shock patient is a bad idea: Things like that.

Buddy Care is important, as it makes up at least 90% of any medical situation we come across, but occasionally, we do get distress finds.

Ideally, we like to find our patients alive, and being able to speak the language, and get patient assessments done before the Flying Helicopter Bus arrives is important.

The stethoscope isn't a bad thing, when wielded by persons who know when and how to use it. Granted, if I see a cadet wearing one around their neck, I'll tell them why it is a stupid idea away from a clinical environment, and why they should be kept in their nice storage case.

[JohnKachenmeister]

Small SIPS of water to relieve the discomfort of dehydration... OK.

Drinking the whole canteen... Bad.

CAP will never, ever be an EMS agency.  Never.  Niemand. No Way.  Not Gonna Happen.

Our "Medics" exist to provide aid to our own guys who might get hurt.  When we find a civilian in need of medical care, we call a civilian EMS agency.

In the police academy, after the extensive first aid instruction, the instructor asked "How do you treat a stab wound victim with multiple stabs in  his abdomen and who has lost a lot of blood?  The correct answer (after a few of the suck-ups described a whole medical treatment regimen) was:

1.  Press the microphone button on your radio.

2.  Say:  "Dispatcher, send me medical here."

3.  Release the microphone button, and continue to do YOUR job. 

[SARDOC]

Bringing this back to the original uniform thread as it was intended....Does anyone know why Vanguard sells the EMT Badges with the Senior and Master ratings although there is nothing in the regs that allows it?  Do they know something that we don't...are there pending changes to the reg?

[Eclipse]

If they do it has been double-secret.

Most likely this, like the HSO badges, was/is in anticipation of a published spec that has yet to be decided (and may never).

[Hawk200]

If they do it has been double-secret.

Most likely this, like the HSO badges, was/is in anticipation of a published spec that has yet to be decided (and may never).

So pick them up now for collectible purposes. In ten years or so, they'll probably be worth what you paid for them.

[arajca]

They were authorized a couple years ago at an NB meeting. I don't have the details in front of me now...

[SARTAC Medic]

CAP Emt Badges are approved IAAW Cap Regulation 39-1.  The Specific section escapes me at the moment.  Requirements (outside of the normal approval required to OFFICIALLY wear the badge) are as such;

Basic EMT - Completion of state EMT training which meets federal Department of Transportation standards for EMT training.

Senior EMT- Completion of state EMT training at or above the level defined by the Department of Transportation standards for EMT training at the Level of EMT Intermediate (yes, i know that there are two NREMT standards  either one is fine)

Master EMT - Completion of state EMT Training at the Level of Paramedic as defined by the Department of Transportation


Some states (such as New York for Example) have more then the three levels of training.   For instance new york has emt, emt- intermediate, emt-critical care, and paramedic. 

the critical care level AND the intermediate level in NY Both meet the minumum of the department of transportation standards for EMT- intermediate and there for at BOTH qualified for the senior emt badge. 

Since there are many states ( last time i checked, 50 of them) there are many individual state levels of training.  Non the less each state has to compare their standards to that of the department of transportation.

For those who are only national registry qualified, i think, that the same standards apply.  If I am wrong about that part, I am sorry...

[arajca]

If you are NREMT certified, but your state does not accept NREMT, you can't wear the badge since you won't be state certified.

[Майор Хаткевич]

As someone not with an EMT background, can someone explain why we have a NREMT if it's not "recognized" everywhere? Or why it's not recognized in some/most places?

[Hawk200]

CAP Emt Badges are approved IAAW Cap Regulation 39-1. 

There is no CAP Regulation 39-1. CAP Manual 39-1 shows only a single EMT/Paramedic badge (Figure 6-17, page 119).

If these badges have been authorized, then the award criteria is in another communication.

[JayT]

As someone not with an EMT background, can someone explain why we have a NREMT if it's not "recognized" everywhere? Or why it's not recognized in some/most places?

The NREMT (just went over it today in Paramedic school) was set up to help ensure a uniform standard for training and testing across the country, as well as set up a system of reciprocity. All but a dozen or so states 'recognize' an NREMT certification.

In New York for example (someone correct me if I'm off base with other states), you take the New York State Emergency Medical Technician B/I/CC/P Exam at the end of your test, and become state certified. I/CC/P then also have to meet the county Medical Advisory Committee testing or what not standards to operate under that areas Control.

New York doesn't 'recognize' the NREMT. So if you want to transfer to a New York agency, you need to have a card from a state that New York has a reciprocity agreement with. 

[SARTAC Medic]

CAP Emt Badges are approved IAAW Cap Regulation 39-1. 

There is no CAP Regulation 39-1. CAP Manual 39-1 shows only a single EMT/Paramedic badge (Figure 6-17, page 119).

If these badges have been authorized, then the award criteria is in another communication.

Way to miss the forest because you are looking at the tree's....

Bust my chops because i referred to a manual as a regulation, really?  I am sure while I think I had a fair handle on the award requirements for the emt badges, i am sure there was some falt there... did you really have to pick apart that little tid bit?   

Why not make this constructive rather then go on the attack for my mis label of a MANUAL. 

[ßτε]

EMT/Paramedic badge and patch
    Question
     If I am certified by a State agency as an EMT, can I wear the EMT badge and patch?
     Answer
     

Yes, you must be a licensed EMT to wear the EMT badge.  Upon satisfactory completion of a US DOT EMT/Paramedic Training Course or approved equivalent and licensing, members may wear the EMT badge or patch meeting the requirements in CAPM 39-1 CAP Uniform Manual 23 Mar 2005.  Provide a copy of your completion certificate to your professional development officer for entry in your records.  Note: Vanguard lists a senior and master Paramedic/EMT badge but CAP currently has not established criteria for these levels.

(Emphasis added)

[Hawk200]

CAP Emt Badges are approved IAAW Cap Regulation 39-1. 

There is no CAP Regulation 39-1. CAP Manual 39-1 shows only a single EMT/Paramedic badge (Figure 6-17, page 119).

If these badges have been authorized, then the award criteria is in another communication.

Way to miss the forest because you are looking at the tree's....

Bust my chops because i referred to a manual as a regulation, really?  I am sure while I think I had a fair handle on the award requirements for the emt badges, i am sure there was some falt there... did you really have to pick apart that little tid bit?   

Why not make this constructive rather then go on the attack for my mis label of a MANUAL.

Then I'll take another tact: the basic badge is illustrated in 39-1, but there is no award criteria in that publication for any level of EMT/paramedic badge whatsoever.

I gave you the benefit of the doubt, and pointed out the fact that your post was inaccurate.

[RiverAux]

So, NHQ knows Vanguard is selling EMT badges to CAP members that they aren't actually allowed to wear? 
Now, Vanguard can certainly sell anything they want, but I think CAP should have at least a little bit of influence on what items they list in the CAP section and should ask for those others to be taken out. 

[SARDOC]

As someone not with an EMT background, can someone explain why we have a NREMT if it's not "recognized" everywhere? Or why it's not recognized in some/most places?

The NREMT (just went over it today in Paramedic school) was set up to help ensure a uniform standard for training and testing across the country, as well as set up a system of reciprocity. All but a dozen or so states 'recognize' an NREMT certification.

In New York for example (someone correct me if I'm off base with other states), you take the New York State Emergency Medical Technician B/I/CC/P Exam at the end of your test, and become state certified. I/CC/P then also have to meet the county Medical Advisory Committee testing or what not standards to operate under that areas Control.

New York doesn't 'recognize' the NREMT. So if you want to transfer to a New York agency, you need to have a card from a state that New York has a reciprocity agreement with.

States have the right to license or certify all healthcare providers within their state.  The United States Department of Transportation sets minimum standards for Emergency Medical Technicians at all levels.  If the State wants to compete for USDOT highway funding the state has to meet or exceed the level set forth by the DOT.  The National Registry of Emergency Medical Technicians is a private organization that verifies training competencies to the MINIMUM DOT levels.  Some States however change their requirements usually exceeding the minimum standard and therefore do not accept the Minimum established standards for reciprocity to practice within their state.  National Registry just verifies you've met basic minimum training...that is not an authorization to practice medicine at that level.  You must be certified or licensed by the state in which you practice.

[SARTAC Medic]

While I should have done the research before sticking my neck out, i did find a CAP released Reference to the three levels of the EMT badge. 

Released in 2005 from the National Board Meeting was a slide show entitled something like "Looking Sharp In Uniform"  it was a slide show that had, amoungs other things the NEW senior and master EMT badges.   

I have looked and there is no regulation or manual which lists award criteria for the badge. 

[Hawk200]

While I should have done the research before sticking my neck out, i did find a CAP released Reference to the three levels of the EMT badge. 

Released in 2005 from the National Board Meeting was a slide show entitled something like "Looking Sharp In Uniform"  it was a slide show that had, amoungs other things the NEW senior and master EMT badges.   

I have looked and there is no regulation or manual which lists award criteria for the badge.

That's one of the problems with using National Board minutes as regulatory. Sometimes (or more accurately a lot of times) what's discussed at NB doesn't end up in the pubs.

The criteria you listed seem fair, but we're all still waiting for the pubs to catch up.

[SARTAC Medic]

Considering that there have been a few uniforms changed between 2005 and now, and there hasnt been a revision of the CAPM 39-1 since then, we might be waiting a long time before we see it published...

[Hawk200]

Considering that there have been a few uniforms changed between 2005 and now, and there hasnt been a revision of the CAPM 39-1 since then, we might be waiting a long time before we see it published...

Yeah, that bothers me too. They can post the notes and things approved from a board meeting that happened ten minutes ago, but it takes years to update a pub? Not staying on top of updating them is a problem. The uniforms alone have what, about a half dozen ICLs since '05?

The one thing that people first see of us seems to be considered the last priority. I'm not saying it should be first (safety or ops should be, my opinion), but it needs to be somewhere near the top.

[Eclipse]

The one thing that people first see of us seems to be considered the last priority. I'm not saying it should be first (safety or ops should be, my opinion), but it needs to be somewhere near the top.

It needs to be a baseline "given" with little need or room for interpretation.

Make the choices, write it down, accept the wailing and gnashing of teeth and never have the conversation again.

[ltdaubach]

I'm finding a common theme with all of these threads on this site.  Everyone likes to argue about everything.  To answer the question that was first asked. you must be a EMT-B; EMT-I; EMT-P to wear the EMT badge.  This means that you must be NREMT registered.  As being a field or squadron medic.  There is really no such thing.  At big activities there are "Medical Officers" that treat CAP members when they become injured.  But when EMTs go on Ground Teams and come up on a injured person, you have a duty to act.  You are trained to help persons in medical need while waiting to get them to hospital care.  You are able to help within your training.  All things that you will learn when you go through EMT school.

[arajca]

I'm finding a common theme with all of these threads on this site.  Everyone likes to argue about everything.  To answer the question that was first asked. you must be a EMT-B; EMT-I; EMT-P to wear the EMT badge.  This means that you must be NREMT registered.  As being a field or squadron medic.  There is really no such thing.  At big activities there are "Medical Officers" that treat CAP members when they become injured.  But when EMTs go on Ground Teams and come up on a injured person, you have a duty to act.  You are trained to help persons in medical need while waiting to get them to hospital care.  You are able to help within your training.  All things that you will learn when you go through EMT school.

You do not have to NREMT registered. I am not, but I certified in CO (where I live). The requirement is to be certified in your state. Some states do not recognize NREMT so having that doesn't work in those states. Some states have a dual track - state cert & NREMT (CO is one). Some only recognize NREMT.

Check with your wing HSO to determine the Duty to Act limitations. CAP is not a medical service. Some states have a blanket duty-to-act requirement, some don't. For some, it depends on your medical control/system.

This broad range of issues is a major reason why CAP is not medical service provider. Having a consistant policy nationwide is not possible for a civilian organization. Money is the other major reason - providing liability coverage would cost more than CAP has .

[RogueLeader]

Can we be CLS (Combat Life Saver) Trainingfor Seniors?  Its a 40hr class that has the Blood-borne patogens, 1st aid, with some really cool training with giving IVs and nose hoses.  I learned it all in the RM.  That way we could be more "high speed- low drag".


JK btw

[SARDOC]

Can we be CLS (Combat Life Saver) Trainingfor Seniors?  Its a 40hr class that has the Blood-borne patogens, 1st aid, with some really cool training with giving IVs and nose hoses.  I learned it all in the RM.  That way we could be more "high speed- low drag".


JK btw

CLS has been updated to what is called TCCC (Tactical Combat Casualty Care) and it includes all that plus Chest Decompressions.  Great class.

[RogueLeader]

^ last I heard also is that they took out the needle stick. . .
<shudder>

[SARDOC]

I'm finding a common theme with all of these threads on this site.  Everyone likes to argue about everything.  To answer the question that was first asked. you must be a EMT-B; EMT-I; EMT-P to wear the EMT badge.  This means that you must be NREMT registered.  As being a field or squadron medic.  There is really no such thing.  At big activities there are "Medical Officers" that treat CAP members when they become injured.  But when EMTs go on Ground Teams and come up on a injured person, you have a duty to act.  You are trained to help persons in medical need while waiting to get them to hospital care.  You are able to help within your training.  All things that you will learn when you go through EMT school.

NREMT is a Private Organization that just verifies training and education through a certification process, Some states require this credentialing process, Some States May accept it, and Some states don't.  There is absolutely no requirement in my state to even know what national registry is until you get to the Paramedic Level.  My State does not offer a State Paramedic exam, so you must go through the National Registry exam to get certified through reciprocity.  Once you are certified you are no longer required to maintain your membership in this professional club.

As a Member of Civil Air Patrol, I do not have a DUTY TO ACT.  My duty to act only extends to my Emergency Medical Services Agency paid employer or any EMS volunteer employer where I am required to be on call.  First, CAP is not an authorized EMS agency therefore I can not provide EMS level care under their auspices.  When Volunteering with CAP I may serve in multiple different possible roles none of which is Paramedic, therefore no duty to act or duty to respond.  This is a Medical Legal issue that most people don't understand.  They often confuse duty to act with a self ethical responsibility to do something.  That being said under the umbrella of CAP, I am bound my CAP policy regarding this.  Anything I do outside of policy is done so at my own peril, I will not be covered by CAP's insurance carrier if I do something wrong.  I am not covered by my employers insurance carrier because I do not have a duty to Act. That would make me personally responsible for my actions that clearly violated policy making me liable, placing my livelihood and my family's well being at risk and that is my first and foremost ethical responsibility.

While in CAP, if an emergency medical situation arises, I will provide immediate care authorized by CAP (read: CPR and First Aid) and believe me when I say, I can call 911 with the best of 'em.

[SARDOC]

^ last I heard also is that they took out the needle stick. . .
<shudder>

They did...people in the fog of war were getting too hung up on starting the IV rather than placing a tourniquet stopping serious bleeding.  They were starting great IV's in guys that were perfectly dead.

[RiverAux]

NREMT is a Private Organization that just verifies training and education through a certification process,

Really no different than NASAR self-appointing themselves as the be-all and end-all of SAR certification.  Heck CAP could start certifying SAR quals for non-CAP members and it would be just as official and formal as NASAR. 

[SARDOC]

NREMT is a Private Organization that just verifies training and education through a certification process,

Really no different than NASAR self-appointing themselves as the be-all and end-all of SAR certification.  Heck CAP could start certifying SAR quals for non-CAP members and it would be just as official and formal as NASAR.

Pretty Close, except NREMT Meets Basic US Department of Transportation Guidelines for EMT's at all levels, where correct me if I'm wrong NASAR just uses Industry accepted standards...but Yes, Ultimately the same point