# AIR CASEVAC in AFGHANISTAN



## kj_gully (7 Feb 2006)

OK, I will start with the requisite "I have already searched Army. ca, and have not found my question effectively addressed" with that out of the way, to my query: I have heard that there is some Combat air medevac/casevac happening in theater, or at least that there are Canadian medics pulling duty for the eventuality. Is this correct? what additional training is provided, what platforms are being utilized, and what kind of "action" are they seeing? On a similar, but different tack, how are lessons learned being passed back to Medics in Canada, and how would we inbred Airforce Cousins garner some of this battle earned Gen?


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## TangoTwoBravo (7 Feb 2006)

I can't speak directly to the details of platforms and who is doing what (since I'm not on the ground), although US Blackhawks and German CH53s were doing the medevac duties up in Kabul when I was there in 03/04.

Regarding Lessons Learned, you may find something on the Lessons Learned Knowledge Warehouse on the DIN.  Go to the Army Lessons Learned Centre (ALLC) website in LFDTS and you can searh the LLKW.  PM me if you hit a road block.

Further to that, a Lessons Learned Liaison Officer will be deploying shortly with the incoming task force (me)  :warstory:.  There is a long list of topics to collect on, but key lessons regarding medevac/casevac that come to my attention from our medics or my US Lessons Learned counterparts will get back to Canada.  I am not a medic (obviously), but I can act as a "transmitter" for the medical personnel in theatre (this applies to all areas).

Cheers,

2B


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## GINge! (7 Feb 2006)

I'm working on a capability deficiency report wrt a lack of dedicated battlefied aeromedical evac. 

I'd be interested on hearing more about this subject. 

I've found it difficult to determine where in DLR or DAR the medical branch is represented as far as procurement goes. I don't even think we have an offr/NCM on DLR staff. I might have an 'in' on the helicopter project, and I think the time to get the word in is sooner rather than later. 

Feel free to contact me off line with any input / advice. I'm doing this in my spare time while I attend the CHSM crse at Borden. 

Cheers,
Graeme


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## Armymedic (7 Feb 2006)

There is currently no, nor has there been any Canadian air CASEVAC assets in Afghanistan. The CF does not posess the helocopters capable in theater, not do we do any training in tactical Air (read helo) CASEVAC here at home. As the above poster mentioned, it is a capability deficiency in the CF.

As for CASEVAC from POI or role 1/2 to role 3, in Kabul it was the Germans Cougars / Turks Blackhawks or the US Army Blackhawks. In Khadahar, currently all air CASEVAC is done by the US Army. Call for CASEVAC was using the 9 line CASEVAC request (either US Army, or NATO modified).

Casualty movement beyond role 3 is MEDEVAC, and that is coord by the NMLO and could be via any NATO allies assets.

In the future...?

But seeing how we medics are just medically overqualified SAR TECHs  ;D, we really just need the platform to work off of.


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## kj_gully (8 Feb 2006)

I think that medics can do it. I know medics want to do it. I think there are medics who would be excellent at it. I just know that right now, no-one in Canada is saying too much about it. They want a bunch of Chinooks, they want to fill it full of troops, and fly in SAM infested skies. Someone is going to have to show up and make sure everyone is "black" , and possibly package up a few who aren't. We have skills, you have skills, but neither has enough skills to do it. My experience with the Army is that "they" are willing to take on a task, then cross their collective fingers that some folks in ranks have some experience. Often Bluster gets confused for experience, and the most qualified goes a couple rows back. We know some stuff that can help out, but we ain't army that's for sure, and we aren't CFMG either. We're just lurking around in orange playing EMT with the coolest ambulances.


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## Good2Golf (8 Feb 2006)

GINge! said:
			
		

> I'm working on a capability deficiency report wrt a lack of dedicated battlefied aeromedical evac.
> 
> I'd be interested on hearing more about this subject.
> 
> ...



It's CFMG's responsibility to procure appropriate equipment, certainly for airborne equipment -- DAR has nothing to do with it; I can't speak for vehicle borne/installed equipment and DLR's interaction.  For helo kit, the airworthiness of the said eqpt must be coordinated with DAEPM(TH) - Director of Aerospace Engineering Program Management (Transport and Helicopters)...they are a different group underneath ADM(Mat).

Cheers,
Duey


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## GINge! (8 Feb 2006)

Thanks for the input guys, both on & off line! 

I am a neophyte to the medical branch so I am running without a GPS here!

I don't want to get ahead of myself and situate the estimate by writing an SOR for an airframe 'like' a UH-60Q. The procurement process begins with the CDR, and I think with some further input & background reading I'll be able to write a decent report. You all know the reason we had leaky raincoats for 20 years? Nobody submitted a CDR, even though it was common dog that the rain coats leaked; there needs to be that official document to being the process.  

Well, I want to be the person who starts the ball rolling on a CDR for a purpose-built casevac helicopter. There are a multitude of reasons why Canada needs an integral casevac capability, and I think it is an idea I can sell on both its political and military merits. 

If I call 911 for an ambulance, I don't want a medic in a pick-up truck, I want a medic in an ambulance. I think that situation is analogous to a medic in a CH-146 (except they don't even fly in AStan)

Cheers,
Graeme


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## Good2Golf (9 Feb 2006)

Ginge, your mention of the CDR refreshed my memory...uhhhhg!  I wrote the Aviation CDR, and did have a capability placeholder for the CASEVAC function, but it was not to the level of technical detail that the CFMG folks would use to define and procure appropriate aeromedical evacuation (AME) capabilitys or systems.  you couldn't imaging how much of a hornet's nest on-board medical equipment can be...even pagers were outlawed on some aircraft and other aircraft have been known to have "interesting" occurances with flight/navigation systems and aeromedical equipment.  I think as close as we'll get is flex/on-call CASEVAC with minimal gear on-board, most of the treatment will already have been done by medics or all the TCCC-qual'd folks prior to a dustoff to the MOB.

Cheers,
Duey


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## kj_gully (9 Feb 2006)

Ginge, I returned from a Special Forces medical conference in Tampa just b4 christmas, and Casevac was a part of the presentations. You should definitely look into attending . The US Army has come up with some good solutions to use " opportunity" airframes in order to complete the Casevac mission. basically a modular system that can be transferred from the ground unit directly onto the bird, along with some good work on transferring care from one medic to the next. See www.somaonline.org for dates this year.



			
				Duey said:
			
		

> I think as close as we'll get is flex/on-call CASEVAC with minimal gear on-board, most of the treatment will already have been done by medics or all the TCCC-qual'd folks prior to a dustoff to the MOB.
> 
> Cheers,
> Duey



Duey, while your expertise in Aviation is unquestionable, I would have to challenge you on your rather imperial "dustoff" hypothesis. I believe that if you advance this course of thought, you are doing a grave disservice to soldiers. If evac is held until "most" of the work is done by TCCC (first responders) and the tiny medical det on the ground, soldiers will die. The whole premise of Casevac is to seperate the wounded from the battle and onto definitive care @ the absolute earlist opportunity.Having a dedicated crew available to take minimally stabilized casualties off the hands of the overworked platoon medic is a must.


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## Good2Golf (9 Feb 2006)

Whoa, whoa, whoa kj_gully!   Grave disservice to our soldiers?  WTF???   

I am not for a second proposing that aviators would wait until primary first aid had been completed to come in for a CASEVAC!  What I am saying is we do not have the luxury of having dedicated MEDEVAC assets (dedicated, thus Geneva Convention Conv.I-Art.36 protected)  We will only have 6 to 8 helos in theatre and their principle mission will be to insert/extract and support our troops in tactical mobility operations.  Part of such tactical mobility operations will be conducting "on-call" CASEVAC (vice MEDEVAC, remember, the aircraft was maxed out with armed/equipped troops...no room for machines that go ping) in a holding area during conduct of the ground operation after initial force package insertion.  If soldiers are wounded, the best chance of survival is a medic or TCCC-trained fellow soldier to treat the wounded and do their best to stabilise them until we can get in from the HA to dust off from an ACCP (air casualty collection point). I'll tell you now, when we get to Kandahar, there will be no luxury of having a dedicated MEDEVAC crew "sitting" on the tarmac, waiting for an evac call.  We'll be busy humping our asses putting troops where they need to be, when they need to be.  Any aircraft that is a dedicated MEDEVAC asset is precluded from engaging in any combat operations (again Geneva Conv I. Art. 36 and dustoff.org background info).

I'm sure you might get insulted if I insinuated that you were going to stand around having a smoke while your buddy was injured, just waiting for some CASEVAC/MEDEVAC helo to come to his rescue...

Duey


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## kj_gully (9 Feb 2006)

You are making my point for me, in a way. If we cannot dedicate an ambulance for our wounded, regardless if it will be shot at or not, then we are possibly killing soldiers. I saw an excellent presentation by a SSGT in tacaviation who had some cool sounding job like "Special Operations Medical Evac coordination element" or something equally important and official. He was (is) part of a medic crew that would insert in the same chopper as the assault, in addition to the intregal medic. (we're talking Chinooks here, not griffons) he stayed with the chopper, and would be prepared toreceive the injured from the op. Possibly depart prior to the main force, or possibly provide care until all were aboard. We will require @ minimum this kind of "2nd line" care, or be negligent in our responsibility to the troops. BTW, the US is applying the same standard of care to the Afghan indig troops under their command,(maybe not under their command, but with Green Beret advisors) it will be a shame if Canadians end up with an evac plan that is below the Afghan Military standard.


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## Good2Golf (9 Feb 2006)

kj_gully, I am not at all disagreeing with your point about "what CASEVAC should be."  I am, however, pointing out the reality of how the aeromedical Evacuation (AME) flavour of CASEVAC would likely be conducted over here by CF aviation assets.  A big yellow and red chopper flying around Canada with plenty of space/payload for medical and rescue equipment on-board with a number of highly trained rescue personnel is just not going to happen over here.  CA aviation over here will be a combat capability first and foremost, and other capabilities that are required to support those operations will be conducted when and where possible.

Considering some of the information you've added to the conversation, let me run a scenario:  

I've inserted the force package, egress the insertion point/LZ to the holding area (HA), wait for package exfil call, I get a dust-off call prior to exfil call, I leave the HA and proceed soonest to the ACCP, pick-up the wounded, egress in dust-off mode to the Role 1/2/3 facility as applicable, then return for the exfil of remaining force package.  Roger that so far....

OK...a few questions:

- What did the SOMECE do to aid the situation?  I can only see him increasing the likelihood of maintaining, or possibly improving the stability of the patient prior to arrival at the Role 1/2/3 facility. 

- Who generates this individual and to what standard?



> ...I would have to challenge you on your rather imperial [*not sure what this means*] "dustoff" hypothesis. I believe that if you advance this course of thought, you are doing a grave disservice to soldiers...



- What disservice have I done to my fellow soldier by proceding as outlined above?



> ...If we cannot dedicate an ambulance for our wounded, regardless if it will be shot at or not, then we are possibly killing soldiers...



- What point you are trying to make with the statement above?  Since we don't have CA helos to conduct CASEVAC in theatre, until we get them [notwithstanding dedicated US CASEVAC in RC(S)], are you advocating that we should have CA Amb Bison's as integral elements to all CA patrols?



> We will require @ minimum this kind of "2nd line" care, or be negligent in our responsibility to the troops. BTW, the US is applying the same standard of care to the Afghan indig troops under their command,(maybe not under their command, but with Green Beret advisors) it will be a shame if Canadians end up with an evac plan that is below the Afghan Military standard.



- Finally, by "2nd line", do you mean on-board Role 2 medical care?  Is this capability provided by the SOMECE that you mentioned earlier?  

Oh, and the word "negligent"....that is a very strong word, kj_gully -- who would be negligent? CFMG?  Comd CEFCOM?  Comd TF?

Re: support to ANA troops injured and supported by US dedicated CASEVAC capabilities, our troops will also CONTINUE to be supported by US dedicated CASEVAC assets in RC(S) as has happened in the past, so the AME plan is the same and NO, Canadian troops would not have an evac plan that is below Afghan Military (when in the company of US Forces/advisors) standard.  

I will tell you this -- having sat down with the US Army Aviation Aeromedical Evacuation proponent director LTC in Ft Rucker, AL last year and passing all the information I could glean from them to CFMG and the appropriate organizations in the Air Staff and 1 Cdn Air Div, I too am disappointed that there is not something more being done by the medical world to forward the AME services that could be provided on any number of aircraft fleets currently operating in the CF.

Duey


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## GINge! (9 Feb 2006)

Great stuff. Slight clarification, I am referring only to rotary aviation here, not C130's,Dash-8's, etc.

One of the reasons I am looking at battelfield air casevac is not ONLY to support airmobile insertions, but to support all ops. 

I am thinking that with our whole non-contiguous battlespace, that sending an LSVW ambulance (or even a Bison) through bad guy country to pick up casualties is too risky. Not to mention the increased transit times. OK, so we give the ambulance a LAV-3 escort...we've now taken combat power away from the patrol/mission at hand. 

I don't think air casevac should be relegated to an ancillary role for the flight. With a properly kitted out air casevac, we aren't really losing combat power, as I envision it will be sent over & above any UH, and therefore not detract from that mission.

Let's not forget that combat power is a bit nebulous - morale is a critical factor to combat power, and I believe with my hand on heart that when troops know there is a speedy dust off with the machine that goes ping (haha, love that one!) on stand-by, then their morale will be a few notches higher. 

Plus, it looks like our casualties are occurring in <6 cases. That (I think) is within the load for a single chalk of a medium casevac chopper. 

Duey, I know you have the real picture of how AME would probably look both practically while in theatre & the staff duties involved in pushing the idea through the chain, but unless we at least try to change it, we'll always be stuck with the status quo. Maybe my newness is giving me a false sense of optimism, but I honestly believe this is within the realm of the possible. If it is not a protected document, I'd like to see the Avn CDR if it is OK to email me a copy. I would be more than happy to coord with the SME at CFMG to at least give this idea an honest try.

As I understand, DAR is in the process of acquiring new helicopters, and such a report would need to make its way through the chain before anything is finalized wrt procurement. Tell me who at CFMG and 1 CAD to send it to, and will see that the CDR gets there


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## Good2Golf (9 Feb 2006)

GINge, keep up the spirit...that's exactly the energy and drive we need!  

Just a few points you've made work slightly against each other...I agree with your point about a LAV escorting a BISON (or perish the though over here a box-LSVW) taking away from combat power...but is that not the same with very limited aviation resources as well?

To "add on" the aviation CASEVAC capability will take a far greater number of personnel to support, remember we have  sufficient rotations at home to sustain this new, additional capability.

Imagine having to sustain the continuous deployment of a Field Amb for each rotation of even one deployment, say Op Archer here?  We're thinking about putting a Bison along with every...say...troop/section?  You guys have lots of trained folks ready to support a field amb-level deployment, right?  See where this is going?

Capabilities must be considered from within the entire package that branches can provide to the overall force package.  I can't speak for others, but I can very clearly speak on aviation, and that a dedicated CASEVAC capability, separate from a sustained tactical mobility element in theatre, would definitely break 1 Wing.  For those who don't know, we also had responsibility for generating TUAV "dumped" on our lap by our Air Force masters after they wrestled with the Army over the capability, saying "they" could and should do it...guess how many PY's the Air Force gave 1 Wing to do that?  Yup... :

This is to say that  the perfect world slams into a pretty hard wall when it comes to people...

Fortunately, kit is easier...and we know how hard it is to get kit.

I would like nothing more than the plunk my behind into another CH-47 cockpit...no, make it an MH-47G with radar, refuelling boom, FLIR and M134s bristing from the doors!  I would have plent of room on board to have that robust capability that kj_gully mentioned!  The sooner, the better!  ;D

Now, how to get there from here...the Aviation CDR contains significant detail on CASEVAC under the Army SUSTAIN and PROTECT operational functions sections.  I don't have DIN over where I'm working, but if you put "Aviation CDR" in quotes and search the DIN, pick the link either to the 1 Wing DIN site or the Army's DGLCD web site, you'll get to it.  It took me almost two years to write the document, and I tried to get as much vital and important info into it, I think it's all there -- any greater level of detail will have to be flushed out by folks (like CFMG for the AME issue) who are better qualified to speak to specific issues.  The CDR is in the hands of the DAR guys procuring the new heavy lifter...I know there is provision for [XX] stretcher cases and electronic hook-ups for PMEDs (port elec med dev) in the requirement documents.  The CDR was also directed to Med folks in 1 Cdn Air Div and the Air Staff.  There is also a section in DG Health Svcs that deals with these issues but I can't recall the name of the LTC with whom I spoke in Ottawa.

Keep the faith, GINge!  Nothing would make me happier than coming back into theatre here in the big beast I flew many years ago, conduct operations, and NOT have to use whatever medical capability you and I and others have worked towards getting into aviation.

Cheers,
Duey


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## kj_gully (9 Feb 2006)

Whew! OK, here goes... 1st, let me say, that while qualified to the same(ish) standard as our Army medics, I have only a rudimentary knowledge of their current employment in theater. Also I am far from an expert on our Allied medics, aside from the aforementioned conference. having said that, I believe that my points are valid. The scenario you posted in this last post is exactly the situation that the "SOMECE" (remember this is just my made up name for this guy) describes. He is an advanced level Medic, with a broader scope of protocols in his repetoire. He is well versed in Aviation Medicine, and provides a higher level of care than can be provided by the medic on the ground, who while possibly having equal skill&knowledge, is incapable of rendering this level of care due to the # of casualties in the field, or the size of his jump kit.Your previous post:I think as close as we'll get is flex/on-call CASEVAC with minimal gear on-board, most of the treatment will already have been done by medics or all the TCCC-qual'd folks prior to a dustoff to the MOB. Paints an entirely different picture, more of  troops "smoking' on the Lz with a Casualty full of ST John Tubular slings, shell dressings with safety pins, and occlusive dressings on the chest wound (with three sides taped) I see now that was not your intent. I am sorry for the confusion on the term "ambulance" I was referring to having a chopper to do ambulance duty. As for who creates the Medic, I think it's logical that the Army builds it. Much like a DMT (Diving Med Tech) or Air evac medic, they need a course to give advanced training . Armymedic proposed in another thread using the CSOR medics. Now diluting this force's medics by doing double duty sounds wrong to me, adding some more to the ORBAT may be the answer. We can do it, if we employ the combat support SARTechs in that role. ( AND give us some c8s and smoke  )
I am a long way from the coal face, but I haven't always been this far in the rear. I fear the Military going into battle with a "hope it don't happen" mindset, rather than the "if this does happen". As for "role 2' capability, I am unfamiliar with the lingo. If i have answered this above, good if not. I will try again next post.

To conclude, for now, the word negligent was used intentionally to hilite the importance of setting a high standadard of casualty care. In my (again somewhat dated, but relevant) experience, Casualty care and evac plans were talked about only in the very simplest of terms. The fact that there is no formal training, or course within our forces reiterates the lack of priority. I am sure that within our elite forces there is a lot more cohesion, but unfortunately do to opsec, the lessons learned aren't passing to the line troops. Maybe CSOR will provide a conduit for this, but unfortunately troops are deploying into harm NOW.


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## TangoTwoBravo (9 Feb 2006)

Once again, I cannot speak to the SF bit, but the Army will have a method and conduit in theatre to collect and pass back lessons.  Evacuation lessons learned in theatre will be collected, sent back to Canada, analysed and desseminated.

Cheers,

2B


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## Armymedic (9 Feb 2006)

I have so much to add to this thread, but no time tonight. The weekend I will add more. Quickly, here are a couple points to add.

Acquisition of an air frame would be a good first step, use of current airframes can be our initial stages.

Crew: Med techs need to be qualified beyond PCP (close to SAR Techs). My idea (and it has been pushed up) is that higher level of Med techs get higher levels of prehosp tng. ie Pte=PCP, Cpl/MCpl=ACP, Sgt=Critical care Paramedic. That for for the fd, or CCP CASEVAC. This "SOMECE" sounds like someone who has similar quals as I (Med Tech Sgt) do for calling in and sorting out CASEVAC. If we were to use a dedicated theater CASEVAC resource then we need to look at a crew of pers like a PA, Anesthesia, crit care nurse, like what some foreign countries use.

Either way, we have no current capability to do in theater CASEVAC in Afghanistan, thats why we need the Dutch...they do it, and do it well.


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## Armymedic (12 Feb 2006)

So back to CASEVAC.

First, it isn't even on the radar of the operational commanders for the CF to provide. As it stands the Dutch and the British have extremely efficient and experienced Helo evac assets. Thanks to our experience in MND(SW), (N) etc with those two allies in Bosnia, our commanders are quite knowledgeable and comfortable with these two countries providing this support to our troops. Even with our own capable CF helos in Bosnia, our Griffons (the high priced limos they were) were very hesitant to take on even routine air transport of a casualty from Zgon to Zagreb or the US Camp near Tuzla.  The British and Dutch provided the service with dedicated Helo casevac crews which usually include a flight nurse, or critical care paramedic, with an anesthesiologist or even an Emergency/Flight doctor on board. They have the kit, they have the people already trained and in their service. We have neither. Sorry on this level, our SARs or medics alone do not compare.

Second, because they are comfortable having other countries do it for us, they see no need to expand our capability. Well, we were never allowed to teach cbt first aid or application of tourniquets to troops until after a major change of attitude happened after Canadian soldiers died. We saw this again after the iltis mine strike. It will take a major disaster in which our allies are not fully capable for our leaders to say, "holy crap, we should do that ourselves". Until that change of attitude happens, we will not get the airframe, nor the addition personnel for manning such a capability.

Finally, theres the need. What historical precedence have we to suggest do we need such a capability? Through coalition medicine with NATO allies, everyone agrees not every country save the US can provide every type of medical service required to an army in the field. Canada sees no need to push for dedicated national CASEVAC assets. What we do provide with or Bison Ambs is the top notch ground evac system in NATO. Medical commanders have no doubt sliced the role 3 pie to ensure that we do have CASEVAC assets for Canadians in Afghanistan (Dutch) once our coalition takes over the area. In exchange we may provide something like the MRI machine or addition OR staff in exchange.

One thing that needs to change is our current medical evac doctrine. We still teach and practice the cold war models of evac, by ground from CCP to UMS to Fd Amb staging and BMS facilities, to the fd hosp. Currently in theater, its point of injury right to fd hosp, by air or by ground dependant on priority. There is a whole bunch of attitude that needs to change. 

We currently have the kit required for tac helo CASEVAC, we have personnel trained enough to fill the role with minimal additional training. We lack the "ambulance". Given the current fiscal climate, and for the reasons I mentioned above, I can't see the CF procuring any dedicated CASEVAC helos capable of operating in Afghanistan any time soon. The best we can hope for, and historical precedence rules here, is a current tactical helo that is converted on call, or on a mission by mission basis.


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## Good2Golf (12 Feb 2006)

Armymedic, WELL SAID!  I would not change a single thing that you've written.

Cheers,
Duey


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## elminister (12 Feb 2006)

Armymedic, can you not push for your aboved suggestion. ie based on rank you get a specific qualicatio? I like that idea and think it would work wonders in the CF.


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## medicineman (12 Feb 2006)

elminister said:
			
		

> Armymedic, can you not push for your aboved suggestion. ie based on rank you get a specific qualicatio? I like that idea and think it would work wonders in the CF.



The powers that be still haven`t come to grips with getting the Junior/Middle Techs up to the PCP level, much less ACP or CCP.  As it stands, our 6A course is little more than a taste of basic staff work without any real medical focus other than in Med Regulating and Ops Planning.  At least at my level (bitter and twisted as it is  ;D) it seems that the vision just isn`t there beyond the tip of the nose.  Armymedic - what are your thoughts?

As for the Brits and or Dutch doing the CASEVAC, I agree with AM.  The Brits have their stuff in order, and unless things have changed since I got my AirEvac wings, the Dutch crews all still have to do our course in Trenton - there were a few on my course in fact, so I`d trust them as well.  The Dutch also had a Role 2+ in Kabul while I was there and I always found them to be pretty switched on medically.

My $.02.

MM


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## kj_gully (12 Feb 2006)

Beautiful stuff, and just about what I have been expecting. I think it is important to mention for anyone outside the convesation who is viewing this that there is a Huge difference between CF air medevac, for which there is a course, and a specialist badge, and which we all have recently seen utilized with the repat of our Canadian casualties to Edmonton, and this requirement of in theater Casevac, from the battlefield to surgical steel. Armymedic & medicineman, would it be fair to say that CFMG has lost the prehospital & trauma focus for medics, and put more emphasis on clinical skill? I have been away from the Army for 10 years, but it seems that it may still be difficult to get medics out of the UMS/ Base hosp? has the PCP program improved "your" abilities in Trauma care? We are required annual competency training in ER/OR, do you have a similar requirement to maintain your qual? Is there any thought/value to have a formallized ambulance "ride along" program for medics in Canada?


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## Armymedic (12 Feb 2006)

kj_gully said:
			
		

> would it be fair to say that CFMG has lost the prehospital & trauma focus for medics, and put more emphasis on clinical skill?
> 
> has the PCP program improved "your" abilities in Trauma care? We are required annual competency training in ER/OR, do you have a similar requirement to maintain your qual? Is there any thought/value to have a formallized ambulance "ride along" program for medics in Canada?



Answering direct to the quotes: I would say we are getting away from clinical and more into the prehospital care, esp for QL 3 Med Techs. They currently have no role in a CDu, UMS, or MIR.

The new MCSP (maint of skills) is pushing for biannual training in outside agencies (amb ridealong, ER, OR rotations). The program is following what you're (SAR Techs) doing as well as the higher med professionals do in CFMG. It is improving.

Also ref airmedevac course with the badge et all:
That course deals with fixed wing strategic air medevac, and deals very little with tactical (read helo) evac. In fact, while it would be benificial for a med tech who is in the helo to be airmedevac qualified, anyone who is familiar with aircraft emergency drills (parachute qualified for instance) and familiar with the equipment can do the job in the tactical senario (and I have.)


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## medicineman (12 Feb 2006)

Hard to say if it's improving trauma care as it were - though the focus is more on pre-hospital care.  Alot would depend on where you're doing your ride outs and such, as contrary to popular belief, paramedics don't live and breathe trauma day in and out  (unless you live in Detroit, LA, bad days in Toronto or Montreal or Vancouver).  A great majority of calls are still for medical problems - if that weren't the case, there wouldn't be the likes of BTLS or PHTLS out there.  Even with my tour in Croatia, where we had alot of mine strikes, the big thing we did was still mainly primary care medicine with some emergent stuff like having to suture up people and such.

I think they ought to add TCCC or TEMS into the program at an early point though - if you get in your head to think like a civvy medic with bells and whistles handy, you may have a hard time adapting to the "real" world when the fertilizer hits the ventilator.  The other thing they have to bring back in training is the old Phase 2 in a medical facility for at least a month, that way they get more clinical exposure and get a chance to develop some clinical instincts and start listening to them.  The extra clinical exposure would give them a chance to see sick people and see the illnesses evolve and variations on some of those illnesses.

MM


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## jonno47 (26 May 2006)

Hi guys. Apologies if I am coming in a bit late on this one and I apologise if I seem to be promoting a product, but I'm interested in your comments anyway. My company has just introduced the world's smallest and lightest casevac system which is beginning to make an impression the defence market and I'm interested in getting it to where it should be used - in the field helping to save lives. If you want to contact me offline I can direct you to our website where you can get an idea of the product and give me your opinion. I must stress that I'm not selling it direct to individuals as such, but am interested in bulk supply to bona fide defence and rescue organisations. So your Med branch might be interested.
It's designed to fit in your webbing and offer an immediate method of getting a cas out of danger and on to the next stage of their treatment, so it helps to save time.
Just for info: I'm a Brit, have served in Bosnia and other places (with some of your colleagues as well) and my experience includes Fd Amb. I'm still on our Reservist list so I think I can speak with some experience.
Thanks for reading - sorry for the commercial, but saving lives sometimes transcends material rules...sort of!
Regards to all
Jonno47


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## GINge! (2 Jul 2006)

Armymedic said:
			
		

> One thing that needs to change is our current medical evac doctrine. We still teach and practice the cold war models of evac, by ground from CCP to UMS to Fd Amb staging and BMS facilities, to the fd hosp. Currently in theater, its point of injury right to fd hosp, by air or by ground dependant on priority. There is a whole bunch of attitude that needs to change.



Unfortunately, this is still the case.

I am just finishing the BFHS Course and there was no mention of how current evac is conducted. The only training on evac is a simple medical estimate that involves the siting of AXP, ARP, etc, in the typical CMBG vs Granovia defensive posture. The only practical mention of Air CASEVAC (which btw is regularly referred to as both Air MEDEVAC and Aeromedical Evacuation, when in all cases it is a CH-146 - I digress)..the only mention of Air CASEVAC is that we have to notionally site an HLZ when deploying the UMS(-). 

I think it would be hugely worthwhile if someone with experience in AStan would be willing to lend their services as a guest speaker at CFMSS for the BFHSC serieals to tell us what the 'real' world is like. There are at least 3 offrs slated to Fd Amb positions, and none have seen a Fd Amb deployed on the ground, or worked with a UMS or Amb Pl staffed medics. This is not a slam against CFMSS  - they are doing the best they can with what they have. I'm just curious who is responsible for updating med doctrine? Do we have HCA/PA/MD/RN/Med tech anywhere on DAD/DAT staff? 

PS: FWIW, the CDR I was mentioning earlier has not yet been written, however, I managed to turn the subject into an essay for the Health Services Management course and nailed the A+; so a huge belated thanks to everyone who assisted me on that topic.


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## kj_gully (9 Oct 2009)

Well, I am going to resusitate this Thread from "back in the day" to illustrate that I am not as foolish as I may have seemed. More importantly, by far though is to ask about the CASEVAC training that is being provided to CF medical personnell, as reported in Maple Leaf Recently.http://www.forces.gc.ca/site/Commun/ml-fe/article-eng.asp?id=5629 Does anyone in here know about it? I would like to receive more aeromedical training than I have up to now as someone who "routinely treats patients in a helicopter" or however it was put in the article. I believe that this training may be more beneficial han the traditional aeromedical training given to the Air evac teams.


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## Cansky (9 Oct 2009)

One of my cpl's just returned from this course last week.  I will get further info and posted after the long weekend.  What I do know is it's a week long training.  Encompassing both day and night flying excercises.  More to follow.
Kirsten


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