# Medics in Afghanistan on frontline



## Armymedic

News article about two medics I usd to work with.

http://cnews.canoe.ca/CNEWS/Canada/2007/01/01/pf-3116034.html

January 1, 2007 

Medics in Afghanistan on frontline

By BILL GRAVELAND

HOWZ-E MADAD, Afghanistan (CP) - The 45 kilometres from where Canadian troops sit here to the Role 3 hospital at Kandahar Airfield might as well be 1,000 kilometres if there's a medical emergency. But the goal is the same for medics here at the front line and those back at the base: finding a way to keep Canadian troops alive. 

Last year was a bloody one in southern Afghanistan, with 36 Canadian soldiers dying. That made 2006 Canada's worst year on the battlefield since the Korean War. Since 2002, 44 soldiers have died in Afghanistan. 

While soldiers fight the Taliban in day-to-day skirmishes or in major offensives like the Canadian-led Operation Medusa in September, it is the medics who are responsible for providing the initial care once someone is hurt. 

"I've seen more trauma out here than I've ever wanted to see in my entire life," said Master Cpl. Brent Schriner, 41, a senior medic with the 2nd Battalion, Princess Patricia's Canadian Light Infantry based in Shilo, Man. 

"It literally is an eyeopener for medics. Back home you're within five or 10 minutes of definitive care where out here it can be 40 minutes," he explained. 

Medics like Schriner must rely on soldiers doing buddy first aid while they take care of the more serious cases. The first minutes of care can mean the difference between life and death. Schriner, called "Doc" as a sign of respect from his patrol mates, joins them on foot patrols, carrying everything he needs in one large backpack. If there is a battle, he is there providing initial care. It's a job that's not for everyone. 

"I'm out with the guys, out in the field where I feel a medic should be. Not everybody wants to be out in the field but we have a need for everyone right through the chain of care," Schriner said while on a foot patrol near the village of Howz-e Madad. 

The Role 3 hospital back at Kandahar Airfield deals with the more serious cases after initial battlefield first aid is administered. Often wounded soldiers are airlifted in for emergency surgery. 

"Priority 1 is immediate and life-threatening, Priority 2 seriously wounded but can wait for surgery and 3 is the walking wounded," said Master Seaman Eric Thiboutot, 39, a medical technician from 5 Field Ambulance, from Val Cartier, at the Role 3 Medical Inspection Room. 

"There's a Priority 4 but that means there's nothing we can do," he finished. "We put them aside." 

Thiboutot is on his fifth tour with the Canadian forces, having served in Croatia, Bosnia and Kabul. 

"The reason I joined the military was I wanted to go on missions, to live the adventure. Back at home everything is routine and I feel I am really doing my job when I am out doing missions," said Thiboutot, who will return home in February. 

But this current mission has been different. Dealing with a rising number of Canadian casualties dating back to August takes it toll on the caregivers as well. 

"Each person has their own coping mechanism. There is mental health and if we have problems we can go talk to them, we talk among ourselves and we each have our own way," he said. 

"But after a while you get used to it, even though it's not normal. As a med tech we are doing our job but we are actually dealing with people that are severely injured." 

Thiboutot has his own way of dealing with the stress of the job. For the first time in his life he started writing every day in a journal. 

"I maybe write it because the story has to be told at some point. For me it's like talking to myself and it allows me to vent out," he added. 

"We are very proud of what we do mission-wise because we help the soldiers get home."


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## PQLUR

http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20070101/frontline_afghanistan_070101?s_name=&no_ads=


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## Gunner98

PQLUR

And your comment and area of expertise are?  This article has little to offer than a few troops appearing in print media.

From Article:
"The 45 km from where Canadian troops sit here to the Role 3 hospital at Kandahar Airfield might as well be 1,000 km if there's a medical emergency..."It literally is an eyeopener for medics. Back home you're within five or 10 minutes of definitive care where out here it can be 40 minutes," he said." 

5 or 10 minutes after an ambulance arrives on civie street and then the wait begins at the hospital.

15-20 minutes after the Blackhawk arrives and little to no waiting at the Role 3 at KAF.   I would take 40 minutes from point of injury to a Role 3 with a CT Scanner any day, at least you know the care providers at KAF are there to Promote, Protect, and most importantly Heal.

What does definitive care mean to the average civilian reading a newspaper?  They could wait hours or days for the type of surgery and diagnostics that the Role 3 can provide.


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## PQLUR

Posted this article as an FYI only . . . I have "no" comment (just happened to run across the article on the CTV. ca website). 

As for my area of expertise . . . 22 yrs and counting as a Reg F Med Tech.


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## lostrover

Gunner98,

Well I have been trying to type a reply for almost an hour thus far, but have taken the opportunity to read and re-read my views.  At present all I can say is, your views regarding the average civilian, and the meaning of defenitative care.  Imagine a small town town in Canada with all the medical toys, a hospital, and more staff (ie medics and soldiers trained in FA/CLS/BTLS etc.......) all within a population of 2200 pers...........but oh wait how many coalition forces are at the same local as the Role 3??.  Soldiers with a cold won't gripe about there wait times when a fellow soldier arrives at the hospital being a priority casualty, whereas many civilians will, for the sole fact that they were there first.


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## Gunner98

PQLUR:
"As for my area of expertise . . . 22 yrs and counting as a Reg F Med Tech."
Congrats on your CD w/ clasp, just got mine, too.  A little more info in your profile will help others correlate the level of experience and knowledge involved in your posts.  Do you really think that it is an 'eyeopener for Med Techs'?

Lost Rover - "Imagine".  

I don't have to as I coordinate the trg for all Role 3 pers going into theatre.  I think a trip to the KAF Role 3 MMU is (or would be) an 'eyeopener' for Role 1 Med Techs and everyone else as well.


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## PQLUR

I found this article on the CTV.ca website and the heading was *"War in Afghanistan an 'eyeopener' for medics"* this heading caught my attention just like your patronizing comments as quoted below". 



			
				Gunner98 said:
			
		

> PQLUR:
> "As for my area of expertise . . . 22 yrs and counting as a Reg F Med Tech."
> Congrats on your CD w/ clasp, just got mine, too.  A little more info in your profile will help others correlate the level of experience and knowledge involved in your posts.  Do you really think that it is an 'eyeopener for Med Techs'?
> 
> Lost Rover - "Imagine".
> 
> I don't have to as I coordinate the trg for all Role 3 pers going into theatre.  I think a trip to the KAF Role 3 MMU is (or would be) an 'eyeopener' for Role 1 Med Techs and everyone else as well.


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## lostrover

Sir, (Gunner98),

Do you feel that the article as printed was positive or negative in the overall perspective of the CF, and most notably the CFMS?  Myself as a former soldier, and one whom has been in the care of CFMS pers, I believe the article can help to provide insight to the general public as to the level of care that is afforded to our service personnel.  I have worked at CFMSS on TQ3-5's (whatever they are called now), and truly believe that the injuries being dealt with currently on operations are much greater than would be experienced in garrision or in the field within our borders, thus for many in they are partaking in there ultimate PO and as the Infantry/Engineers  et al.... .  At this point I am truly at a loss as to your direction with your statements.


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## Bruce Monkhouse

Moved this here from Radio Chatter as I think it has potential.

Lets forget the rocky start and see where it goes.....


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## old medic

Merged too.


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## Southern Boy

A good read. I worked with Eric Thiboutot in Petawawa. I wonder if he is still as crazy as ever?


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## GO!!!

I'd say it's just a classic example of "narrow arcs" reporting.

I the reporter did a good job of interviewing the men in question, but a poor one of putting their experiences in context. Had he provided the numbers of injured, the many instances of lifesaving aid by TCCC/Pl and Coy Medics/Role 3 in KAF, and the unique circumstances surrounding medevacs, the article might have had a bit more punch.

The article brought up the point that this is not the type of mission the CFMS has had in the past, but I don't think it was negative in it's portrayal.


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## Gunner98

The article's view is very narrow indeed.  It does not leave the public with a good idea of how quickly troops receive treatment after evacuation via Blackhawk or other coalition air assets.  Nor does it leave anyone with the impression that their kin are in good health care hands.  If we continue to state that the situation is an eyeopener for anyone, especially our medics, then we leave the media observer/reader with the perception that we have not trained them properly.  It is widely known that the level of trauma and blast injuries cannot be simulated during training or even found in any emergency room in Canada.  The Role 3 staff has consistently stated, with deserved pride, that the facility has saved every possible Canadian that has reached it alive.

My particular concerns are over the statements such as:

"I'm out with the guys, out in the field where I feel a medic should be. *Not everybody wants to be out in the field but we have a need for everyone right through the chain of care*," Schriner said while on a foot patrol near the village of Howz-e Madad.  This leaves the impression that some medics are refusing to leave the camp.

The Role 3 hospital back at Kandahar Airfield deals with the more serious cases after initial battlefield first aid is administered.* Often *wounded soldiers are airlifted in for emergency surgery.  Should say - whenever injuries permit. 

*"There's a Priority 4 but that means there's nothing we can do," he finished. "We put them aside." *  This is only the case in a mass casualty scenario and after initial triage. They are not put aside, they do not receive ongoing intensive medical treatment, but they are not put aside, alone.  Someone stays with them or checks on them regularly and keeps them as comfortable as possible.


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## lostrover

Gunner98
"If we continue to state that the situation is an eyeopener for anyone, especially our medics, then we leave the media observer/reader with the perception that we have not trained them properly.  It is widely known that the level of trauma and blast injuries cannot be simulated during training or even found in any emergency room in Canada."

If the level of trauma and blast injuries are such that cannot be simulated , thus for one it would be surprising or revealing, that is not to say there is a lack of training involved.  Take a soldier fireing on a range at fig. 11 targets, then provide a reactive target to fire upon, for this individual would shooting at a reactive target  prove to be an eyeopener?  I believe it would.

We can all read an article, and walk away with a different view.  Could the article have been better....yes, could it have been worse...yes, there is no happy medium.  This is a forum for open discussion, we all have own own views, and need to respect the views of others at the same time.


Apologizes for posting during your edit, all points raised are valid and I agree with them.


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## Gunner98

Lost Rover - I agree with your comments as well.  The merged article below has more detail and substance the original one posted by PQLUR.  The level of complexity of the injuries, the fact that ambulances leave camp without their Red Crosses displayed, with C-6 MG mounted.  We now train medics who will leave the camp on reflexive firing and rundowns, as well as live-fire C-6.  These concepts are eyeopening as well.  

I guess it is really the devious headline (words not in context) and the first two paragraphs that do not correspond with reality or the medics meaning.  Having work in the print media, I know it is the sensationalism that sells papers but in process sometimes it misleads or misinforms the public.  That is why I much like St. Mike's saw it as exposure for a couple of Medics.


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## GO!!!

Gunner98 said:
			
		

> My particular concerns are over the statements such as:
> 
> "I'm out with the guys, out in the field where I feel a medic should be. *Not everybody wants to be out in the field but we have a need for everyone right through the chain of care*," Schriner said while on a foot patrol near the village of Howz-e Madad.  This leaves the impression that some medics are refusing to leave the camp.


I disagree. He said "_not everybody wants to be in the field_" not "_medics are refusing to do their jobs_"

I've been in a Parachute/Light Infantry Unit for several years now. We have a dearth of medics who are capable of being both a rifleman and a medic, and even fewer who actively seek this out. I doubt you would dispute my position that most medics consider a task as a platoon/company medic highly undesirable, that many prefer the working conditions and schedule of a UMS/Role 3.

This medic is stating an inconvenient fact.


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## Armymedic

Gunner98 said:
			
		

> That is why I much like St. Mike's saw it as exposure for a couple of Medics.



This and as a future reference for people looking to find out what we do when we are deployed.

Anyway, enough with the squabbling...not every medic is superbly suited to every job. Unlike the cbt arms where they have a single mission focus (i.e. to close with and destroy the enemy...), medical services has widely encompassing roles in order to fullfill its mission of preserving manpower. I personally am glad there are medics who would rather work in the sterilization room or the medical/surgical wards while I am out in the unit medical stations. Every role needs to be filled, and its better if those filling them enjoy their job.


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## xo31@711ret

A good read. I worked with Eric Thiboutot in Petawawa. I wonder if he is still as crazy as ever? I also worked with with Eric in Coralichi, Bosnia, ROTO 4,
. I was a masterjack and Eric a cpl of one of the bison amb teams; crazy in a fun way: but one of the best, professional people I had the pleasure of working with....

Eric, I hope you read this: Well done, keep up the good work and come home safe...

Gerry Connors, formally 2RCR UMS back in the day


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## manhole

I doubt that many reporters are able to write a story that we could all agree with the content........I could criticize anything they said regarding artillery while someone else could find fault with what was said about engineering or supply, etc.   All I know about medicine you could put in a thimble.  That being said,   I doubt there is anyone here who doesn't appreciate the excellent job the medics do (whether or not they are in the field or in a hospital).   So.....here's to all medics


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## Southern Boy

I didn't mean to insult Eric by saying he was "crazy", just that, well, the guy is nuts on a motorbike or anything else he does, like downhill skiing, hockey... He is a great guy and he would do anything for anyone. If your going to war, he's the guy you want on your side.  Good work Turbo! :skull:


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## medicineman

GO!!! said:
			
		

> I doubt you would dispute my position that most medics consider a task as a platoon/company medic highly undesirable...



That's a real pity - my favorite times as a medic were at the platoon/company or small unit level.  In fact, I think it's the best job in the Army.  I'm not going to get many (if any) chances as a PA to do that stuff anymore.

My $0.02.

MM


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## xo31@711ret

Agree medicineman; my best times as a 'med a' were as a company and battery medic. maybe it's just me, but I found it an honour  that everyone from the company commander to the new pte refers to you by 'doc' and not by rank. I also enjoyed my time as the snr NCO of a UMS or tmt room, but the best time for me was a company or battery medic.


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## Trinity

I spent 8 years as a medic attached to infantry

Wouldn't have had it any other way.


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## PQLUR

Would that be 8 yrs. as a R711 and attached for some wknd FTX's?, or 8 yrs. full time (just wondering, but I am sincerely glad you enjoyed your time).



			
				Trinity said:
			
		

> I spent 8 years as a medic attached to infantry
> 
> Wouldn't have had it any other way.


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## Trinity

As per my profile... reserve time.

Doesn't lessen the experience IMO.  Beats playing up tent down tent in a Med Coy...


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## xo31@711ret

tent down tent in a Med Coy...LOL LOL; agreed Trinity, spent my first 6 years in the infantry (good times also); "...up pole, pull pole....great coats on, great coats off...get on the bus, get off the bus....hurry up and wait...."  .....seems nothing changes with the passage of time or what trade you are  ;D


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## PQLUR

"The training, everything else, everything just becomes automatic and you almost don't think. It's one step after the other after the other.  And you only stop and think about it once everything's done and he's evacuated," as quoted from the following article:

http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20061223/landmine_afghan_061223/20061225?hub=CTVNewsAt11


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## bisonmedic

I have a response to the comment that Gunner98 made about having the role 1 med-techs having a tour of the role3 mmu and it being an eye opener. As a role 1 patrol medic, I would say that have a role 3 medic take a tour of my AOR. I don't disagree that they do great work over there, but when was the last time they where in a firefight or ambush? We have lost two good medics during our tour( Boomer Roto 1 and Glenn Roto 2) and have had several injured during combat operations. The dismounted medics, the bison crews, the prt patrol medics have all put their asses on the line for the combat troops and keep them alive for the role 3 so they can work their magic. We know the things the role 3 has to deal with because we are the ones that sent them there to get further help, we don't need an eye opener from them. We have had enough from the enemy thank you very much. All we have to help our fellow soldiers is what we carry on our back, and that's it. Nothing fancy, just stuff that works and a little imagination from a field medic.


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## Fraser.g

I believe there would be good value in the trade off going both ways. It is not about who's job is harder or more stressfull but more about the medical staff at the Role 3 getting a better understanding of the environment the casualties come from. Simultaneously, it would be beneficial for the medics in the field to see where the casualties are going so as to better prep them.

It is about the whole evac chain and team work. Each has a job to perform and the better each member of that team understands the job of the other the better the team works.


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## bisonmedic

That's right, the role 3 types don't understand the environment the patient came from or the problems we face as the role 1 medics. The problem is that the hospital medics do not get the same kind of opportunities as the FD AMB medics get. I have nothing against the medics at the MMU, but you have to realize that we do not need a visit to the role 3 for an "eyeopener". We know what they can do, we have seen the results by simply having the patient go home alive or back to the Coy he came from. At the same time you have to realize what the mounted and dismounted medics from role 1 have gone through this tour. We don't need anymore eyeopeners.


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## Gunner98

The Role 3 Med Techs are replacing the Role 1 Med Techs on a regular basis during tours and are filling several of their tasks for the next few deployments (including OMLT). I think the Role 3 Med Techs have a very good understanding of the Role 1 Med Tech role as many/most of them came from the Fd Ambs and are returning to the Fd Ambs as supervisors.

My comment about eye-opening involves the full spectrum of care including beside care for military as well as Afghans.  

I was not suggesting that those on the current tour require an eye-opener, however, Med Techs specifically from Fd Amb in general should be more aware of the bells and whistles at the Role 3.


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## HCA123

Just as a follow up to Gunner98's post - we are telling medics scheduled for 1-08 that in the end they might be placed in the TO&E as role 3 - but expect to be role 1 at some point. There were requests "can I get a role 3 spot on the tour" and they were quickly given a reality check - because anyone going over has to be prepared to do either the role 1 or 3 jobs.


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## Fraser.g

Sorry,

From your responce I get the feeling that you are saying that you can learn nothing from the Role 3 medics but they have tonnes to learn from you.

I disagree, 

Yes, the environment that the Role 1 crew work in is more austere and those who spend their tour at KAF have a more comfortable tour than on the other side of the wire. 
Agreed, you do not need an "eye opener" but spending some time in the other man's shoes is never a bad thing. There are different challenges facing those at the Role 3 than the Role 1 but perhaps you could pick up a few tips and techniques from the Role 3.
There is a reason that the SF crew come in and "help out"

Your call


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## bisonmedic

Well I have yet to see a medic from role 3 out here, maybe they did a convoy task once or twice, but nothing out to where the stuff happens. As for bells and whistles, we have our fair share of high priced machines that go " Bing". In our UMS not only do we provide patrol medics, we do the things you would normally do at the role3. We do it because the role 3 does not want to do it for us. And saying that they have a good understanding of what we do is out of line. As for treating the local population, come down to where we are because we are eyeballs deep with the treatment of locals. Unless you are one of the fd amb medics currently on tour, you don't know anything about our job. We can do both roles thank you very much, without role 3 help. :threat:


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## Fraser.g

I did not say that the role 3 crew understand your job, I am also saying that the reverse is true. 

What I am stating is that rotating through each others position may be beneficial.
I just got back from KAF and so do have some idea what is going on over there.
Check my bio and name, you may then get an understanding of where I am coming from.

Is it so terrible to state that each may have something to learn from the other? If you don't believe so, then thank god it's getting to the end of your time.


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## GO!!!

RN PRN said:
			
		

> What I am stating is that rotating through each others position may be beneficial.



Beneficial to whom?

It takes weeks to get a patrol medic up to speed with the unit they will be working with in the light infantry context, and it takes that medic a few tries to get their distribution of kit, personal gear and weapons to where they need to be - just like the rest of us.

It is hard enough to find fit, aggressive field - minded medics to accompany Light Infantry Platoons and Companies - now you want to rotate them in and out so that some percieved "well rounded" benefit will occur? 

How about corporate knowledge, knowing the men in your unit, esprit de corps, skill at arms and cohesion? Are these secondary to "having a more comfortable tour"?


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## Gunner98

bisonmedic said:
			
		

> Well I have yet to see a medic from role 3 out here, maybe they did a convoy task once or twice, but nothing out to where the stuff happens. As for bells and whistles, we have our fair share of high priced machines that go " Bing". In our UMS not only do we provide patrol medics, we do the things you would normally do at the role3. We do it because the role 3 does not want to do it for us. And saying that they have a good understanding of what we do is out of line. As for treating the local population, come down to where we are because we are eyeballs deep with the treatment of locals. *Unless you are one of the fd amb medics currently on tour, you don't know anything about our job*. We can do both roles thank you very much, without role 3 help. :threat:



I guess it is a good thing that you can't tell one Med Tech from another out at the front. The Role 3 guys don't have a big sign on them that say they are Role 3.  They have been for several Rotos, are now and will continue to be employed out at the front lines.  I guess the point lost on you is that a Med Tech that has served at both Fd Amb and Role 3 has a broader skill set than one who has not been posted to both.  The Role 3 Med Techs are also backfilling for the patrol Medics at their chain of command's request and for HLTA.  If you wish to PM I can give you more specific info.  Keep up the good work, all of you.


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## bisonmedic

Like I said before, we do both jobs not only here, but in garrison as well. If the role 3 types have been on the front line, why then don't we have more of them out here ? As for rotating medics during a tour, by all means, the problem is well stated by GO!!!. The medics we have now have been with combat arms units for a fair amount of time and have a good skill set thanks to the unit that they serve. To take a medic from outside causes headaches for that group. Learning how to survive the battlefield does not happen in weeks, it takes more time than they can afford while deployed, especially here.


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## Gunner98

Truth is that there aren't as many Reg Force Role 3 or Role 1 Med Techs as you might wish for left for next few deployment.  There is only one Role 3 unit with less than 80 Med Techs, there are 3 Fd Ambs to draw from for Role 1.  Many Med Techs have deployed or are deploying for a second or third time to A'stan.  

On many Bases like Pet (as of 12 Jan 07) and Edmonton CDUs are now the norm.  The Fd Ambs and Med Techs belong to the HSGs, so that integration is getting even harder.

I agree with your ideals, however, reality is and always will be somewhat different.


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## bisonmedic

The only saving grace for the medics at both the fd amb and the field hospital is the pending merger of medics. From what I hear, the 1CFH will be closed. C-Med will watch over the kit, and 2FD Amb will grow from 300 to 600 pers, making it a med support regt. In a way this can solve manpower issues depending on how they do it. If it happens, I hope to heck they do it right. We all need more people for the current ops and whatever happens down the road.


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## Gunner98

For a Medic so involved on the front lines, you seem to have time to post here.  Isn't it  great to stay informed in the electronic age.


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## old medic

bisonmedic said:
			
		

> The only saving grace for the medics at both the fd amb and the field hospital is the pending merger of medics. From what I hear, the 1CFH will be closed. C-Med will watch over the kit, and 2FD Amb will grow from 300 to 600 pers, making it a med support regt. In a way this can solve manpower issues depending on how they do it. If it happens, I hope to heck they do it right. We all need more people for the current ops and whatever happens down the road.



When has the CF cut and merged anything and not wound up with something smaller than the sum?  
I expect we'll loose more gear, and wind up with an even smaller 2 Fd Amb.

As Gunner98 pointed out, there are only 80 Med Tech positions at the Field Hospital.  Divide by three
and the math says your only going to free up 26 people.  A gain that the recruiting system could
easily cover.

Hardly worth another loss of capability.


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## medaid

Another thing... some of the Role 3 guys, don't want to be Role 3 guys, and they're just slotted there, because, well the luck of the draw. A fellow member of this unit, to whom I have high regards for, is fit, aggressive AND field-oriented, *surprise* and got a role 3 job. So... are you saying he's less then qualified to be a Role 1 pers? Ya... I don't think so.


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## Gunner98

Perhaps some of the Role 3 positions have to be filled by Role 1 pers because the Role 3 resource pool is now near empty because they have had to backfill Role 1 positions on recent Rotos.


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## Fraser.g

Frankly it does not matter which unit you belong to when it comes to deployment. If 1 Fd Amb is tasked with a Roto then those pers will fill both the role 1 and 3 positions.
As Gunner said, its luck of the draw. Honestly, those in from the Fd Hosp had as much to learn about Role 3 work as those from the Fd Ambs.

Remember, this is the first time we have staffed a Role 3 Fac except on Ex since Korea.

GF


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## Bruce Monkhouse

Would  it be an imposition or a security breach to explain what the "roles" mean/are?
Its obviously a passionate topic but...... ???


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## Gunner98

RN PRN said:
			
		

> Remember, this is the first time we have staffed a Role 3 Fac except on Ex since Korea.
> GF



RN PRN

As I have said this is the second go round for many of the pers from/in the Multi-national Role 3.

Bruce:

Role 1 - At Point of Injury, Casualty Collection Point/Station - initial treatment -  Unit Medical Station, in FOB or with vehicle or foot patrols - battlefield advanced first aid and initial life-saving treatment care - Medical Officer and Physician Assistant available

Role 2 - Brigade Medical Station (Field Ambulance) - road evac, limited holding capacity 72 hours or less - first level with dedicated Medical Officers - not normally seen on current operations

Role 3 - Advanced surgical centre or field hospital, currently first level with surgical (orthopaedic and general), internal medicine and diagnostic capability - Lab, X-ray (Diagnostic Imagery including CT/CAT scan), Social work, mental health, dentist with dental section, oralmaxofacial surgeon, physiotheraphy, Formation Medical Equipment Depot (Pharmacy), support services and supply section, most importantly - stabilization for Air Evacuation to Role 4.  Normally max 7-10 days, longer if there is a chance of returning to action.  Capable of diagnosis of disease and fairly complex reconstructive surgery.  Holding capacity is approx. 24 beds.

Role 4 - Convalescent hospital normally out of theatre - Landstuhl, Koblenz, Canada

The point that has been lost in this discussion is that the guys at the front do outstanding work to keep the front line soldiers where they belong at the front lines and alive.  If they require any invasive or diagnostic procedures - the assets exist at Role 3.

At KAF - there is a multi-national field hospital with approx. 180 staff of which Canada provides approx. 90 HSS/CSS personnel.  The list above for Role 3 is the current capability of the multinational medical unit (MMU).

Being able to work along side these specialists and with the superior diagnostic equipment is amazing.  Having all of same the tools and skill sets available in a civilian hospital on stand-by at KAF is "eye-opening."

Having outstanding Med Techs at the front lines is life-saving.


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## bisonmedic

Well said


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## Sawbones

Insert Quote
Quote from: RN PRN on Yesterday at 20:44:20
Remember, this is the first time we have staffed a Role 3 Fac except on Ex since Korea.
GF 


RN PRN

Whoa, easy with the history there, some of us are attached to our surgical past... 

Actually we did Role 3 care in Saudi Arabia 1991 during the first Gulf War, including surgery for about two dozen Iraqi, UK and US combat wounded.  Two ASCs from the field hospital were colocated with a UK Field Hospital at Al-qaysumah near Hafr-Al-Batin.  Yeah, we got real black rain and real wounded there.  

A few of those people are still around and have already worked at the KAF R3MMU.  Many of the specialist MOs have now done 6 to 12 tours and treated wounded in former Yugoslavia too.   The specialist MOs on the surgical teams are not seeing anything really new, just more of it than previous tours.  Of course for the more junior staff this is new work, but not everybody is a tenderfoot.

RN PRN can be forgiven as there is some ambiguity about Role 2+ versus Role 3, one way to look at it is that Role 3 makes casualties ready for out-of-theatre StratEvac.  Also, the NATO and US Role/Level definitions actually don't quite match up at present as the world has changed since those STANAGs were written.  Plus, if there are helicopters and air superiority, then the Role 2 (inc. ground Fd Amb or FST/ASC/FFRS) is redundant if there is a Role 3 within flight range.  

A big problem now is that we are losing our experienced Role 3 specialist MOs as many are in 20-25 years.  We will run out of CF surgeons, orthopedic surgeons, radiologists and internists in rotations at various points this year, hence the announced program to hire civilian Canadian specialists and pay them $3-5K per day to fill the gaps.

Busting up the historic Role 3 capability at 1 Cdn Fd Hosp into smaller bits for HSRs probably is not going to help much either. The pie is pretty small already. 

We are hurting for more good people.

For my 2 cents, Role 1 and Role 3 MedTechs all did a great job while I was there.  Sure, different jobs, but I was very happy with the care our wounded had received before arrival at KAF, and very happy with the job MedTechs did for us on the base too.  I heard no complaints from my colleagues about MedTechs over there either.  

Medical is all about getting our wounded home, lives and limbs intact, and I saw no one doing an "easy" or "less important" medical job anywhere over there.

Sawbones


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## Armymedic

Was not Sipovo BiH a role 3 for a short time?

As for role 1 vs role 3 tasks for the medics....

I say shut your cake hole and do the job you are given, and do it well. We medics all belong to the same org and get paid the same regardless if we are working with a rifle platoon, backseater in a Bison, UMS at KPRT or Medic on the surg ward.

Everyone has a job to do. This petty bullshit has no place in theater.


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## Gunner98

St. Mike's

Role 3 or Role 2+ or Role 3-, ASC(+), ASC(-), it gets fuzzy at times.  As Sawbones stated the distinguishing element to an effective Role 3 is Strat Evac capability (pers and assets).


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## xo31@711ret

Everyone has a job to do. This petty bullshit has no place in theater Well said St. Mikes'. We are (were in my case) Canadian Forces medical Services wearing a Canadian uniform. _This petty bullshit has no place in theater_: or at home. We must learn from each other and pass our experiences / lessons learned / mistakes on to our peers and subordinates.


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## Fraser.g

xo31@711ret said:
			
		

> Everyone has a job to do. This petty bullshit has no place in theater Well said St. Mikes'. We are (were in my case) Canadian Forces medical Services wearing a Canadian uniform. _This petty bullshit has no place in theater_: or at home. We must learn from each other and pass our experiences / lessons learned / mistakes on to our peers and subordinates.



I could have sworn that was the point I was trying to make but perhaps too obtuse about it. I was not trying to get into a "Tastes Great, Less filling" pissing match. More sudjesting that We have stuff we can learn from the role 1 guys and vice versa. 
When I was in theater there was no animosity that I experienced. It was totally Team...as it should be. 

Thank you St Mikes and o31@.

GF Out


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## armyvern

RN PRN said:
			
		

> Remember, this is the first time we have staffed a Role 3 Fac except on Ex since Korea.



Maybe my memory isn't the best here but weren't a component of Cdn Fd Hosp deployed, employed and operational during the first Gulf War? With an Inf Secur Coy if I recall correctly.

Am I confused?


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## Roy Harding

RN PRN said:
			
		

> I could have sworn that was the point I was trying to make but perhaps too obtuse about it. I was not trying to get into a "Tastes Great, Less filling" pissing match. More sudjesting that We have stuff we can learn from the role 1 guys and vice versa.
> When I was in theater there was no animosity that I experienced. It was totally Team...as it should be.
> 
> Thank you St Mikes and o31@.
> 
> GF Out



RN PRN:

I think you made your point well - and I agree with your premise.

I think it is possible that you were "taken wrong" by some folks - ONLY because of the medium, not the message.

These forums are tricky things, you write what you think to be intelligent, well thought out, and articulate messages.  Many agree with you.  Others, with absolutely NO malice, will interpret your posting in another way - and then off we go on a tangent, which tangent is essentially meaningless to your original intent.

Having said all that - by reading this thread I've gained an insight into the medical role(s) that I never had before - thanks to ALL of you for that, knowledge is a "good thing" - no matter its' source.


Roy


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## Gunner98

The Librarian said:
			
		

> Maybe my memory isn't the best here but weren't a component of Cdn Fd Hosp deployed, employed and operational during the first Gulf War? With an Inf Secur Coy if I recall correctly. Am I confused?



Librarian - you are not confused.  Approx. 530 Cdn medical pers deployed during Gulf War, most to Saudi Arabia.

"ASC I of the 1 Cdn Field Hospital arrived in Al Jubayl on the 29th of January 1991 and deployed up to Al Qaysumah on the 8th of February 1991. In addition, 52 Canadian personnel served with other coalition units. A Canadian surgical team served aboard the USNS Mercy. They were also other Canadians working with our embassy in Riyadh and on security detail to important cities such as Dubai. Following the Gulf War, a Canadian Medical Contingent was sent to Southern Turkey/Northern Iraq to assist with the management of Kurdish refugees." Source -  http://www.dnd.ca/site/Reports/Health/appendixE_e.asp


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