PRE-DEPLOYMENT Medic Training

Medic! Medic!" the wounded soldier calls. Chaos, darkness and smoke add confusion to the battlefield scene. There is only one medically trained individual present to render emergency care: the soldier-medic. How do you prepare a 20-year-old combat medic for the intensity and chaos of war? The U.S. Army has a soldier-medic training program that works to do just that, with the ultimate goal of saving the lives of American soldiers in combat.

     Since many medics in the National Guard and Army Reserve don't work as medics in their civilian jobs, the Army developed a program to provide necessary medical training prior to these medics' deployment for duty in Iraq and Afghanistan. This course was designed to provide intensive medic training, refresh and update skills, and reorient the focus of soldier-medics from civilian prehospital care to lifesaving battlefield skills. This was a large undertaking. The Army and Army Medical Department Center and School developed a plan to mobilize Army Reserve nurses, medics and other medical personnel with teaching experience to take on the task of providing pre-deployment medic training.

     The Pre-Deployment Training (PDT) course is a concentrated 21-day program that begins with a 12-day EMT-Basic course and refresher. Army medics have previously completed medic training, and many hold certifications as NREMT-Bs. The Army now requires all medics to transition to a minimum of NREMT-Basic status. The PDT course provides an opportunity for the noncertified medic to sit for the National Registry exam and meet this transition requirement. This certification not only provides a basic knowledge of emergency medical care, but also leaves the soldier-medic with a marketable civilian skill once he or she leaves the Army.

     The next five days of the PDT course are dedicated to Combat Medic Advanced Skills Training (C-MAST). It is during this course that the soldier-medics alter their focus from civilian prehospital emergency medical training to combat medical skills that save lives on the battlefield. The final three days of the course consist of "lanes" training under simulated battlefield conditions that allow the medics to utilize skills learned in the classroom. This training combines all the assessment and treatment skills learned during the previous 18 days and requires the medic to make instant decisions regarding triage and treatment under increasingly difficult conditions.

A WORLD of DIFFERENCES
     Emergency medical care on the battlefield differs from civilian care in several distinct ways. Three differences are resources, time and environment. On the battlefield, the only supplies available to medics and soldiers are those that can be carried on their backs. This often means the medic not only has to triage his patients, but must also triage his supplies to do the most good for the most people. The time involved in receiving or transferring the injured to additional medical care is variable, and medical evacuation assets must often be summoned. When there are multiple casualties during combat, the medic must triage and treat the injured soldiers immediately and correctly with only the assistance of other soldiers who have been taught basic first aid concepts like "self aid" or "buddy aid" or soldiers who have "combat lifesaver" training. Lastly, the medic and injured soldiers may be involved in ongoing fighting, which makes provision of medical care challenging as well.

     In contrast, civilian medical emergencies have the benefit of fully stocked ambulances and life flights that are typically on their way to scenes in a matter of minutes, and then systematically transfer the injured to definitive care. Civilian medicine also has the advantage of quickly increasing resources when there are multiple casualties, such as summoning more ambulances to a scene. And most notably, when civilian EMTs face a medical emergency, they do not approach the injured until the scene is safe. The combat medic is taught that he is a soldier first and a medic second. This reinforces that his firepower may be the best treatment for the injured soldier.