# Afghanastan first aid training-pet



## Jarnhamar (5 Mar 2006)

I just completed my first aid training with the TF0306 group and I just wanted to say it was awesome.

The amount of confidence I have in just the day and a half training is probably 10 times what it was before.  This training NEEDS to be longer. We should do a week or two of combat first aid training at the very least.

I've been on two work up training twice before and took the first aid and I hate to admit but it was pretty straight forward and boring. st johns ambulance stuff. Basic first aid. Hey hey can you hear me i'm a first aider can I help you bla bla.  Whether it was my fault or the training I knew what I was doing but wasn't very confident overall at the end of it.  The new stuff we are getting taught is a no bullshit approach and it's great guys.
Your GOING to take caustalties, here is how to deal with them to save lives.  Gory videos and teaching aids that squirted blood.
Really looking forward to more first aid and casualty exposure during out ex in wainwright. Thanks guys.


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## medicineman (5 Mar 2006)

I think most people would agree that the training needs to be longer than the 2 days of "Combat Related" first aid training.  The problem is that, even though CO`s know that the training needs to be longer, if something needs to trimmed as far as training goes, first aid in whatever form is almost always one on the chopping block.  The training needs to be realistic, and alot of the time the stuff we need for the realism gets taken away.

I think though that as things develop in the Stan, the powers that be may in fact wake up and smell the burnt coffee.  Ensure that the positive feedback gets up the chain of command -  the more people that notice the better.

I`ll let Armymedic and his boys and girls take their credit now.   ;D

MM


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## JANES (5 Mar 2006)

This is what the brass needs to see.  The enthusiasm from the troops.  The reality of the training.  They are so stuck in their offices and clinics, they don't have a clue what the real world needs.  It is so unfortunate that we're in a time when we are taking casualties like we' haven't in a very long time.  It is so unfortunate that is taking all these casulaties for them to wake up.  And they are still not even waking up.  The troops need this training.  The medics need this training.  They need the gear.  Why are they so slow in providing it to them?  It has been almost 3 years since the first TCCC course.

Keep up that atitude.  Challenge yourself in training.  It will only benifit you and your buddies over there!  Good post.


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## Armymedic (5 Mar 2006)

Ghost...how come you guys don't come over and say hi....geez.  :'(

The idea of getting this as well as the other TMST training in early is that during practice and Ex tng you guys can start using what we taught you. If SOPs etc need to be changed to fit into the knew knowledge then you'll have time to do it. Like I said, practice, the first time you use your issued tourniquet should not be the time you take it out of the wrapper.

About the length. We have this 2 week period and another week at the end of the month to teach everyone of the roughly 2000 soldiers going over seas in Aug. So we teach each Coy group in 1.5 tng days. We all agree that teaching the classes we do (mine: TCCC concepts and tourniquet skill station) should be 2x or 3x 40 min lectures with demos and practice, but to do a 5 day course for each coy group would be a drain on everyones time and our very short personnel resources. And as it is, we lose 2 Saturdays teaching, and my whole UMS, a weekend during TB2, because of the TMST (not that working weekends is a big deal, but shows how short of time we are).

About the instructors and helpers. As MM can confirm getting instructors to teach is hard. Because of HSS, all the UMS have been raped of personnel. Every Sgt you seen instructing is an NCO IC of a UMS, and all of us report to the UMS to help for an hour before we come over to teach. For my combined UMS (3 RCR/2RCHA), we have the best of the manning because I am also deploying for range support of Thundering Bear 2. Myself and the tall blue beret wearing Sgt are the ICs, he has a MS and Pte, I have 3 Cpls. So seeing sick parade in the am we can muster a max of 1 MO or PA, 2 Sgts and 5 jr ncos. Each morning when we leave to go teach there are still 3-5 patients waiting to be seen for sick parade. As for the assistants and casualties, that is all of the remaining medical personnel left in the Fd Amb building, who are not HSS or at UMS. We quite literally have no one left.

We are talking about improvements. For instance running unit TCCC courses for all the cbt arms units (about 30 pers per unit) and using the TCCC cbt arms MCpls to assist in TMST instruction so that we do not need as many medical pers, developing videos as to demo care under fire, etc etc.


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## Jarnhamar (5 Mar 2006)

After the tourniquet class I decided to make my own (which I will continute to carry even after I have the CAT).  Tourniquet's were never stressed in the past as far as I remember. They seem like such an important life saving too, I'm glad we were taught how to use them, how to make improvised ones and the importance of them.  I'm going to stress to my buddies that they should make them even if it's just for the simulated training during the work up- get the guys used to using them. 

It's unfortinuate first aid is one of the first corners cut.  How I see it, that 1 and a half day class is probably going to be responsible for saving soldiers lives. I would argue that this stuff is probably the most important part of our work up training or one of the top 3.

I wish I could take the TCCC course. I think it needs to be taught right along side our basic first aid. (I know there are a million other factors which are above my head).  If I'm interviewed by the media or when I speak to my chain o fcommand at my home unit i'm going to bring the importance of this stuff up.

The stuff the medics were impressing on us has me looking into taking some kind of additional first aid training (out of my own pocket) while we have our pre-deployment leave. It's either going to save my life or my buddies, small price to pay.

Just an observation too WRT stand training, I know it's important for PTEs and CPLs to get hands on doing first aid( AND being in charge) and you can only have so many people active in a stand but I think we need to remember to make sure the higher ranks get practice doing first aid and dealing with crowds - not just observing or acting as enfor.  Everyone is going to get their hands dirty over there irregardless of rank.


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## Roger (5 Mar 2006)

It was part of the first aid course in the 70's but they started not to teach it in the early 80's. I think it was thoguht that there was to much of a chance of losing the limb.


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## medicineman (5 Mar 2006)

Chop said:
			
		

> It was part of the first aid course in the 70's but they started not to teach it in the early 80's. I think it was thoguht that there was to much of a chance of losing the limb.



The problem is that we are using what is essentially the same First Aid course I`d be teaching to someone off the street.  Ergo, what the civvies are taught, with the exception of CSR and NBCW and Self Aid, it`s the same off the shelf course for us - when tourniquets went the way of the Dodo, it did the same for us.  That, and I think that someone somewhere decided that we didn`t want to do "warlike" stuff awhile back (oh no, Heaven forfend). 

MM


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## Armymedic (6 Mar 2006)

Ghost778 said:
			
		

> Just an observation too WRT stand training, I know it's important for PTEs and CPLs to get hands on doing first aid( AND being in charge) and you can only have so many people active in a stand but I think we need to remember to make sure the higher ranks get practice doing first aid and dealing with crowds - not just observing or acting as enfor.  Everyone is going to get their hands dirty over there irregardless of rank.



You are right but:
Remember who's job is the mission and who is taking care of the casualties. Sgts and Up should get thier hands dirty too, but they need to be outside of the actual care (minus thier own) and worrying about keeping control and providing leadership. Of all the rotations, only OC and CSM have consistantly stepped out of my stand to observe, but I have had Capts and WO be involved as participants. So some are getting in there too.


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## kj_gully (19 Mar 2006)

I was going to PM this to Armymedic, but decided to post instead... is there any thought on creating a cell within CFMG  to teach and develop TC3 or concepts to the rotos? A dedicated group of SME's could work up the whole battle group, including the medics. Are there medics posted to ...chilliwack or borden or wherever as dedicated instructors, or is your training run entirely by the JI? If there was a developed program even fellas the opposite of army (like me) could come out and support pre deployment training by teaching in areas relavent to their experience. Our school has a dedicated cadre of instructors, and while like all schools very busy teaching our own, could maybe support a tasking if it was given enough priority, . Not saying we should or want to run your training, just that there are resources out there that could share the load and this is important stuff. It would look a lot like the big guys vision of transformation if anyone with medical experience was helping get deployments better prepared.  The Navy has a cadre of SME's who's sole job is conducting readiness inspections of the ships as they workup to operational, the same concept could work here.Someone to come from outside the battlegroup to conduct the training, so the medical pers going over are free to get themselves ready.

just a late night thought.


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## medicineman (19 Mar 2006)

It`s something being looked into when we sit the TP writing board in Apr - it`s still an unanswered question as to who is going to provide the training and where it`ll be done.

MM


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## Armymedic (19 Mar 2006)

gully,

This type of training is very manpower intensive, as MM can agree. Having a dedicated cell will not go over well as the majority of the most suitable instructors are already supporting units. The reality is, the units will not let their best instructors (more often then not, also the best of their tactically sound medics) go off to another area away from their unit.

Basically what I am saying, is sure, they may set up a cell, but it won't nec be the best persons there instructing. More then likely they will supervise standards.


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## Scoobie Newbie (19 Mar 2006)

Is there any follow up training once deployed?


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## Armymedic (19 Mar 2006)

Not unless HSS does it for you over there. Chances are there will be no formal refresher training.


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## HItorMiss (19 Mar 2006)

Would the TCCC's qualified people be able to run minor refersher training on such things a quickclot and CAT use as well as doing some theory work with bleeds and burns?

Seeing as it would relieve the responsibility from the HSS staff to do something like that, And their will be senior qualified people there who could run the refresher no?


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## medicineman (19 Mar 2006)

According to the QS (and the new soon to be TP) refresher will have to be done every 90 days and a full course every 2 years.  In all likelyhood, the refresher will be done by the HSS staff for the "scary" stuff.

And yes, it`s manpower intensive - you need a decent sized trg cadre to run just a small course with 15-20 pers on it, not to mention a budget, medical and military supply/resupply, and all that other logistical stuff.  My reccomendation for a central cell would be somewhere like here in Gagetown or Wainwright where a school could sponsor the cadre.  The staff would in fact be posted there -  the medical side would have to be people that have ops and instructional expericence - that way there`d be little or no haggling over losing people.  Would be like a well deserved break/reward.  Of course, I`m sure CFMG will find a way of screwing it up.    

Watch and shoot as it were.

MM


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## Armymedic (8 Apr 2006)

Next week we are teaching all the HSS role 1 medical pers.

Apparently this will be the first large scale TCCC instruction to medical personnel.

Time to move a bit towards tactics (ass down, rifle up) and ensure our guys don't do something stupid or try to do too much while treating their casualties.


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## kratz (17 Dec 2006)

TCCC can only be instructed by medical staff under supervision of an MO. The value of the course can not be understated, but it was intended to replace basic first aid. Under the references, standard first aid (FA) training is a unit CO's responsibility but many bases have noted the value of having a trained, dedicated FA training cell. I am aware of my own work in Halifax as well as Gagetown, Esquimault and NRHQ. If there are other cells, post a contact or email me.


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## medicineman (17 Dec 2006)

kratz said:
			
		

> TCCC can only be instructed by medical staff under supervision of an MO. The value of the course can not be understated, but it was intended to replace basic first aid.



Actually TCCC is/was meant to augment the training people have, not replace it - you have to know what the rules are before you can break them, and some standard first aid does apply after the the immediate threat is taken care of.  Some CO's have taken upon themselves to think that it replaces the routine first aid training.  Small problem (and I understate small) is that it contains some delegated acts that can only be used in a combat situation - hence it isn't a replacement.  Also, if it was meant to replace the training, everybody and their dog would get it, as opposed to the "Combat Related First Aid".

MM


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## GO!!! (17 Dec 2006)

I just did the TCCC as part of my pre-deployment training, and while the medical training was excellent, the "tactical" part left something to be desired.

I think the course as it is taught right now has some serious flaws, most of them related to time and resources (surprise).

1. Selection of instructors. This course is manpower intensive, but care has to be taken to include instructors who either have extensive trauma experience or have seen and successfully dealt with field injuries. Too many times, senior instructors would just read right off the power point, and never answer any questions - they just did'nt know. After the class, a Coy medic from one of the recently deployed infantry coys would answer the question. 10 years as a flight medic in Cold Lake does not a TCCC instructor make.

2. The difference between civilian paramedic/first aid work, and military lifesaving. These two approaches are nearly diametrically opposed in terms of practices, their thought processes only coming together in terms of the desired results. Examples of this include the paramedic approach, articulated in the BTLS texts, which advocate the extensive use of IVs, c-spine immob. and tourniquets only as a last resort, while the opposite is true for all of the training on this course. 

It seems counter-productive to me to train all of the military medical professionals in two systems, but downright dangerous to do so when training the cbt arms troops. I think that the whole St. John's first aid system should be scrapped - it has little or no bearing on realistic military training. Replace it with TCCC mods 1-4, with progression by rank and need (deployment). SJA is a lodestone around the neck of the military establishment, and seems to be oriented towards justifying civilian quals for military members over actual cbt lifesaving.

3. The "tactical" in TCCC needs to be re-thought. There is little utility in training in a vacuum, with none of the actual soldiers in their positions as they would be in while deployed. To this end, I would advocate doing TCCC by platoon or coy, so that the medical training would actually be used in conjunction with the tactical training we do for a living. 

The defence for this is that everyone must be able to "step up", which is true, but to me, that means that a rifleman can take over the section, a MCpl or Sgt can lead the platoon, and a Platoon commander can lead the company. It does *not* mean that all infantrymen are interchangeable, regardless of rank. It is a waste of time to make someone with less than a year in the army "take control" of a scene, when there are leaders there. 

4. The Chain of Command. I'm not sure if this is as set in stone in the medical world as it is in the Infantry world, but a major failing of TCCC is the fallacy that medical/tccc personnel, in the sect/pl/coy context, are in charge of anything. All candidates on the course were instructed to begin giving orders to those around them in reference to CCP placement, cas evac, care etc. the minute a casualty was sustained. This will never happen! The medical pers exist to advise the CoC, and care for the wounded, not become one themselves!

Having said all of this, overall TCCC was an *excellent course * that I would reccommend to anyone deploying - it's flaws notwithstanding, it is a real breath of fresh air in terms of learning the basic techniques and procedures that will save lives, and stripping away all of the crap (like performing the heimlich manoever on morbidly obese pregnant women) that we never needed in the first place. 

Guys in my unit and others clearly state that what they learned on course before deploying resulted in others being alive today. That's a pretty powerful statement in itself.

I hope that the v2/v3 of this course continue to improve!


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