# SOF Combat medic question



## Ravage (May 29, 2009)

xSFmeds post inspired me to ask this:

US Army Special Forces Medical Sergeants, or 18 Delta (18D) are, without question, regarded as one of THE best and most proficient combat medics in the military - if not the entire planet.

They possess vast knowledge that enables them to handle not only trauma care, but sustained care if need be. All that in austire, maybe even extreme conditions. Conditions which normal(conventional forces/non military) medics will never see or experiance.

But the US Army is not the only branch of the Military that has specially trained meds, USAF Pararescue Jumpers are also specially trained meds, so are the SOA medics in the US Army 160th SOAR(A).

*What is the difference between those ?*

I understand that a 18D is a Special Forces Soldier first (warrior-diplomat) and a combat medic second. But so are the PJs....right ?


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## TLDR20 (May 29, 2009)

The major difference between an 18D and a 160th medic/PJ/SEAL corpsman would prolly be the clinical side of medicine. Being able to diagnose and treat austere medical problems as opposed to trauma problems. The SOCM course is the trauma portion and is 6 months long and trains trauma. The second half that 18D's go to is another 5 months and trains on medical problems.


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## Ravage (May 29, 2009)

And sister servises do not have that 5 month portion I would assume ?


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## TLDR20 (May 29, 2009)

Ravage said:


> And sister servises do not have that 5 month portion I would assume ?



The Army and Navy go through SOCM together, the PJ's have their own course. As for the second portion, 18D's go straight through and select SEAL and Recon corpsman return to Bragg to do the second half. PJ's, Rangers, and SOAR medics never do the second half as far as I know.


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## Fizzle (May 29, 2009)

So who usually does do the second half? I believe some of the SOF IDC Corpsman go right?


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## TLDR20 (May 29, 2009)

cback0220 said:


> The Army and Navy go through SOCM together, the PJ's have their own course. *As for the second portion, 18D's go straight through and select SEAL and Recon corpsman return to Bragg to do the second half. *PJ's, Rangers, and SOAR medics never do the second half as far as I know.





Fizzle said:


> So who usually does do the second half? I believe some of the SOF IDC Corpsman go right?



Read the highlighted portion


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## amlove21 (May 29, 2009)

nothing so far is wrong, as usual. clinical medicine is built into the PJ course. While it isnt nearly as extensive as some of the others, our OJT and follow ons help. 

As far as what is the difference between? I can only speak about PJ cause i am one and i'm not naive enough to speak about stuff i haven't experienced. That being said- we (PJs) are NOT medics, so you hit it on the head Rav. We are rescue specialists. We are there to effect rescue. If the mission calls for a dive, jump, overland, etc, we have that. We are also able to coordinate OR missions on a much higher level. While we are nationally registered paramedics (a huge difference, considering 18D, corpsman and SOAR medics are ATP certified, and not P recognized), it is not our only focus. So the clinical medicine does not hold the same importance as our trauma training. On a side note here, PJs are also ATP qualified medics. Well, the smart ones, anyway. I digress. 

that is how i see the difference. No one better, but all different. There you go.


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## formerBrat (May 29, 2009)

I would like to ask a question about the PJ course, since it is separate from the SOCM, course, was it always that way? At one time did all the SOF med types attended that course? If so, was the move kind of similar to what I've read about the AF having their own combat dive course now, to affect more students being slotted for the course due to lack of seating at the original combat dive course? Thanks.


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## HoosierAnnie (May 29, 2009)

I would recommend the article in the current issue of Special Weapons that deals with Pararescue.  I would *BUT*. . . After a few intro paragraphs, the author takes a turn to the current controversy over what aircraft pararescue is using and completely wanders away from what I asumed the intent of the article was, given the title "US Combat Search and Rescue Teams"

Can ya tell I'm feeling a lil cheated here?


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## Ravage (May 29, 2009)

Thanks for the input everybody!


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## x SF med (May 29, 2009)

Rav,
I have to take slight umbrage at your misquote from another post - I said SF Medics are the best COMBAT Medics out there - let me qualify that.

1. SF has a mission unlike any other in the military arsenal - it is diverse, but the main focus, mission one, is:
_"To Train, advise, organize and assist indigenous forces in their fights agaist oppressive governments"_
​2. SF medics (2 ea. per team) can be responsible for the training of medical personnel to support a Battalion size element (approximate BN size is 500 soldiers), build, organize, staff, and manage a field hospital. (Including veterinary services)

3. SF medics are integral to the fighting capability of the team itself - they are SF Soldiers first and render aid to others - to levels most other medics are not trained to accomplish.

4. I am biased - rightly so, but I would never disparage any other highly qualified SOF medic (well except for the PJ's, they're basically just rescue dogs, y'know -dog paddle, jump out of the back of pickups, stick their noses out of windows of moving vehicles, run around with kegs strapped to their necks, slobber a lot, generaslly good with kids, and well, not always too bright:eek::doh: - but, I digress)  They have a different mission than SF.

Any true COMBAT medic is worth his weight in gold to his Team, SF medics can be worth their weight in platinum, not only to their team but occasionally to a bigger population.

Does this make sense to everybody, even the Marines and PJs?


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## Ravage (May 30, 2009)

Yup Sarge !


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## TLDR20 (May 30, 2009)

Well said X SF Med.


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## JustAnotherJ (May 30, 2009)

amlove21 said:


> That being said- we (PJs) are NOT medics, so you hit it on the head Rav. We are rescue specialists. We are there to effect rescue. If the mission calls for a dive, jump, overland, etc, we have that.



Ok Ok...We both know that at least 70% of the PJ community would castrate you for that statement.


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## x SF med (May 30, 2009)

JustAnotherJ said:


> Ok Ok...We both know that at least 70% of the PJ community would castrate you for that statement.


 
per my comment, and borrowing once again from Bugs Bunny.....

"Dogpile on the PJ, Dogpile on the PJ...":doh:

Hijack complete, now back to our regularly scheduled programming.


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## JustAnotherJ (May 30, 2009)

I yield I yield...don't want an SF Dogpile on me. You definitely have us beat in numbers.  i mean...look at all of you 1000s of SF types...and us poor PJs only numbering in the high 200/low 300 range....Hey, it's good to see at least when the Army lowered it's standards and started taking ex-cons, geriatrics and obese people, it also bolstered the SF community.  Are maternity ACUs popular in SF?


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## x SF med (May 30, 2009)

JustAnotherJ said:


> I yield I yield...don't want an SF Dogpile on me. You definitely have us beat in numbers. i mean...look at all of you 1000s of SF types...and us poor PJs only numbering in the high 200/low 300 range....Hey, it's good to see at least when the Army lowered it's standards and started taking ex-cons, geriatrics and obese people, it also bolstered the SF community.  Are maternity ACUs popular in SF?


 
JAJ-  I used to like you as part of the KradleStomping Crew:confused: - the dogpile mentioned, was by the 70% of the PJ's that disagreed with amlove, put on him by his own community...  thus the quote of your ever-so-sage advice to him to never utter that statement in public again, for fear of his manhood being removed forcibly by the remainder of the PJ community...:eek::doh:

I apologize for any miscommunication, and will accepot the castigation above, due to the fact I was clarity-challenged in my post.

This, does not in any way mean that your comment does not cut me to the quick, nor that I think you are any less of a bastard for making the comment - I still respect you and your job, you Bastige.:doh:


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## TLDR20 (May 30, 2009)

JustAnotherJ said:


> I yield I yield...don't want an SF Dogpile on me. You definitely have us beat in numbers.  i mean...look at all of you 1000s of SF types...and us poor PJs only numbering in the high 200/low 300 range....Hey, it's good to see at least when the Army lowered it's standards and started taking ex-cons, geriatrics and obese people, it also bolstered the SF community.  Are maternity ACUs popular in SF?



OUCH!


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## JustAnotherJ (May 30, 2009)

x SF med said:


> JAJ-  I used to like you as part of the KradleStomping Crew:confused: - the dogpile mentioned, was by the 70% of the PJ's that disagreed with amlove, put on him by his own community...  thus the quote of your ever-so-sage advice to him to never utter that statement in public again, for fear of his manhood being removed forcibly by the remainder of the PJ community...:eek::doh:
> 
> I apologize for any miscommunication, and will accepot the castigation above, due to the fact I was clarity-challenged in my post.
> 
> This, does not in any way mean that your comment does not cut me to the quick, nor that I think you are any less of a bastard for making the comment - I still respect you and your job, you Bastige.:doh:



I understood 7 words in that post....did you just call me a homo?


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## Muppet (May 30, 2009)

Whilt I have nothing constructive to say, I find this fun to watch. That is all.

F.M.


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## amlove21 (Jun 1, 2009)

JustAnotherJ said:


> Ok Ok...We both know that at least 70% of the PJ community would castrate you for that statement.



I would agree with you. And, then by simple logic- I would have to disagree with every single medevac flying bullshit mission loving PJ out there right now. I am NOT CCAT. I dont want to do patient transfer. IMO, calling ourselves strictly medics and being aircrew has handed us the bullshit fight with Army birds for casevac/medevac, and we sold our soul for Big Blue money. And fuck that on top of it. Fuck a platform, ill ride a bike in if i need to, or walk.  So I see your point, and I understand that its not the popular opinion, it's just my (very new and impressionable) opinion. 

And as for you, Senior Trollhead- I think you have valid points too. For instance, you guys hand out meds like PROS! i mean, antibiotics for DAYS! And the Blackberry that you plug symptoms into and out pops pictures of symptoms, possible diagnosis, and suggested courses of treament? Thats an awesome diagnostic tool. But what happens when a PJ ("inferior drooling rescue dog", was it? :)) jumps in on your stack, the "shooter" comes out and the med pack goes bye-bye to the J anyway- cause sometimes being able to carry a keg on your back and still run with SF teams comes in handy, eh? 

Here is my final thought- again, i dont think any one service has the market cornered on this issue. In fact, i would be willing to pose that you are deficient to the extent you specialize. The more you focus on one aspect of your game, the less rounded you will be.

But on a butthurt note, I challenge ANY team to put me on it for a month, and when that month is up, you ask THEM if they would want my "...PJ's, they're basically just rescue dogs, y'know -dog paddle, jump out of the back of pickups, stick their noses out of windows of moving vehicles, run around with kegs strapped to their necks, slobber a lot, generaslly good with kids, and well, not always too bright" self to keep rolling with them or not. I would like to hear that answer, good or bad. 



fuck you all. I love this place.


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## QC (Jun 1, 2009)

And now a word from our sponsor...


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## x SF med (Jun 1, 2009)

JustAnotherJ said:


> I understood 7 words in that post....did you just call me a homo?


 
Nope, didn't call you a homo - I was agreeing with your assessment of amlove's post and recalling the days of Kradle stomping...  he still hasn't shot me yet, has he come after you?


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## x SF med (Jun 1, 2009)

amlove21 said:


> I would agree with you. And, then by simple logic- I would have to disagree with every single medevac flying bullshit mission loving PJ out there right now. I am NOT CCAT. I dont want to do patient transfer. IMO, calling ourselves strictly medics and being aircrew has handed us the bullshit fight with Army birds for casevac/medevac, and we sold our soul for Big Blue money. And fuck that on top of it. Fuck a platform, ill ride a bike in if i need to, or walk. So I see your point, and I understand that its not the popular opinion, it's just my (very new and impressionable) opinion.
> 
> And as for you, Senior Trollhead- I think you have valid points too. For instance, you guys hand out meds like PROS! i mean, antibiotics for DAYS! And the Blackberry that you plug symptoms into and out pops pictures of symptoms, possible diagnosis, and suggested courses of treament? Thats an awesome diagnostic tool. But what happens when a PJ ("inferior drooling rescue dog", was it? :)) jumps in on your stack, the "shooter" comes out and the med pack goes bye-bye to the J anyway- cause sometimes being able to carry a keg on your back and still run with SF teams comes in handy, eh?
> 
> ...


 
Brother, the sarcasm and irony of the rescue dog section somehow got lost.  I apologize if that came across wrong,  nothing but respect for you guys.  I am proud to have been given a coin by a PJ from the 67th ARRS when we worked with them.  

What is this blackberry diagnostic tool of which you speak?  I had a Merck and a Taber's  and lots of studying  -  no machine Dx'd my patients.

Bring the keg over any time, I'll make sure there is seared animal flesh to wash down.


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## JustAnotherJ (Jun 1, 2009)

x SF med said:


> Nope, didn't call you a homo - I was agreeing with your assessment of amlove's post and recalling the days of Kradle stomping...  he still hasn't shot me yet, has he come after you?



So....you did call me a homo! :)  However speaking of flaming homo fucktard pantywastes, Kradle hasn't made the attempt to contact me.  But I'm pretty sure that I could sick my wife on him (all 105 lbs of her) and by the end of it, he'd be wearing his own nutsack as a swim-cap....Can we lift the ban on that guy...I know I miss his antics, and I can only assume X SF Med does as well.

p.s. I want to make it clear for everyone and apologize for any offenses.  My slam on SF was entirely in jest.  I love all Special Forces like a sister...a loose whorish sister...with a cool beard that i wish i could grow.


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## mayuiers (Jun 2, 2009)

JustAnotherJ said:


> I love all Special Forces like a sister...a loose whorish sister...with a cool beard that i wish i could grow.



Well said sir. well said...


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## x SF med (Jun 3, 2009)

JustAnotherJ said:


> So....you did call me a homo! :) ...
> 
> p.s. I want to make it clear for everyone and apologize for any offenses. My slam on SF was entirely in jest. I love all Special Forces like a sister...a loose whorish sister...with a cool beard that i wish i could grow.


 
JAJ- Love you too, lots, mean it, really... like the little brother that has to wear the crash helmet and knee pads at the playground. I bet you are an excellent driver, aren't you?

Oh, and you are not a homo, jut identity challenged, I expect you to apply for a gov't job after you retire, and then show up in a dress on your first day.:eek:


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## car (Jun 3, 2009)

Boy, the popcorn has sure been good whilst watching reading  this one.


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## JustAnotherJ (Jun 4, 2009)

x SF med said:


> JAJ- Love you too, lots, mean it, really... like the little brother that has to wear the crash helmet and knee pads at the playground. I bet you are an excellent driver, aren't you?



Dad let me drive on the driveway.

But all joking aside...do you have some gay retard fetish or what?  Hit up craigslist, i'm sure you'll get some bites there...or at least some dude who'll role play for you.

.....

I just choked on my own vomit from a detailed mental picture of how that shit would play out....you disgust me.


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## x SF med (Jun 5, 2009)

JustAnotherJ said:


> ...I just choked on my own vomit from a detailed mental picture of how that shit would play out....you disgust me.


 
Okey Dokey, then my job here is done.:confused:

I shall wander off into the sunset to foment evil and dissent among unwitting and undeveloped cultures now...  or maybe move up to baiting and prodding SEALS with sharp sticks, now that I have honed my skills on PJs, Rangers and Marines....:doh:


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## Muppet (Jun 5, 2009)

x SF med said:


> Okey Dokey, then my job here is done.:confused:
> 
> I shall wander off into the sunset to foment evil and dissent among unwitting and undeveloped cultures now...  or maybe move up to baiting and prodding SEALS with sharp sticks, now that I have honed my skills on PJs, Rangers and Marines....:doh:





Ain't nothing like fostering HATE and DISCONTENT brother.:):)

F.M.


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## Nasty (Jun 8, 2009)

I had,what I believed to be, some constructive comments to add to this thread; but you guys scare me and I think that I'll just keep my trap closed :).


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## JustAnotherJ (Jun 8, 2009)

If by "scare," you mean, "fear for your anal virginity."  Don't worry...that crusty ex 18D has that effect on everyone...but when i said "Don't worry," I really meant "Watch your ass and invest in a chastity belt or you'll never be left alone by that sicko and his afro-merkin"


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## 08steeda (Jun 8, 2009)

I feel like a spectator at the French Open. Back and forth, back and forth!!!! A little cheering! Back and forth, back and forth!


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## x SF med (Jun 9, 2009)

JustAnotherJ said:


> ...but when i said "Don't worry,"...


 
And I thought you were referencing either "the Hitchhiker's Guide to the Universe" or Bobby Mc Ferrin...:doh:

That's what I get for thinking...


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## JustAnotherJ (Jun 9, 2009)

x SF med said:


> That's what I get for thinking...



I thought I smelled something burning.


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## LibraryLady (Jun 9, 2009)

JustAnotherJ said:


> I thought I smelled something burning.



Is that why the smoke detector keeps making that horrid noise?  :uhh:

LL


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## 0699 (Jun 9, 2009)

JustAnotherJ said:


> I thought I smelled something burning.



Must resist....


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## x SF med (Jun 9, 2009)

JustAnotherJ said:


> I thought I smelled something burning.


 
Nope, 0699 found an old book of matches in the street and is playing with fire over by the ammo dump:eek::doh:  We may want to move over to the commo bunker on the other side of the compound for safety, plus I heard they always have beer...  wanna go glom some beers until we hear the sound of a retired Marine exploding?


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## car (Jun 9, 2009)

x SF med said:


> Nope, 0699 found an old book of matches in the street and is playing with fire over by the ammo dump:eek::doh:  We may want to move over to the commo bunker on the other side of the compound for safety, plus I heard they always have beer...  wanna go glom some beers until we hear the sound of a retired Marine exploding?



It's too hot for a fire. Let's just drink the beer.


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## x SF med (Jun 9, 2009)

car said:


> It's too hot for a fire. Let's just drink the beer.


 
Never too hot for a retarded Marine to light fires... That's why we have to keep making sure he doesn't get at the matches...:eek:


BEER GOOD, UG, BEER VERY GOOD!


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## Ravage (Jun 10, 2009)

I see my post initiated ethnic cleansing


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## x SF med (Jun 10, 2009)

Ravage said:


> I see my post initiated ethic cleansing


 
What on earth do you mean?  The PJs, Navy Medics, AF medics, and Marines are still here.  HMMMMMMMM, so are you for that fact, and if we were gonna ethically clean anything, it would be the Philosophy guy from Poland who thinks he's an NCO, because ethically that would be the right (or is that the wrong???) thing to do.:doh:

Now let me get back to asking if the PJs,   if theywant to steal the beer from the Marine Commo bunker while the Gunney (Ret.) plays with matches over at the ammo dump - we can get lit while the Gunney becomes the evening's fireworks.


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## 08steeda (Jun 10, 2009)

This thread should be a sticky!!!! This is some funny chit!!!! 

We are gonna need resupply soon! Cause with this crowd the beer in the Commo bunker isn't going to last!!!

Can we call in a LAPES drop from the Commo bunker and put it on the Marines Tab?


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## Muppet (Jun 10, 2009)

08steeda said:


> This thread should be a sticky!!!! This is some funny chit!!!!
> 
> We are gonna need resupply soon! Cause with this crowd the beer in the Commo bunker isn't going to last!!!
> 
> Can we call in a LAPES drop from the Commo bunker and put it on the Marines Tab?





:)

F.M.


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## 0699 (Jun 10, 2009)

x SF med said:


> Nope, 0699 found an old book of matches in the street and is playing with fire over by the ammo dump:eek::doh:  We may want to move over to the commo bunker on the other side of the compound for safety, plus I heard they always have beer...  wanna go glom some beers until we hear the sound of a retired Marine exploding?



Hey!!  I'll be 42 next month; I've only started three "accidental" fires and only set myself on fire once.  It could be a LOT worse... >:{


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## x SF med (Jun 10, 2009)

0699 said:


> Hey!! I'll be 42 next month; I've only started three "accidental" fires and only set myself on fire once. It could be a LOT worse... >:{


 
Yeah - you could be unsupervised and have matches...:doh:

BTW - I need new pics of the match, I'm beginning to wonder if you still have it.


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## HoosierAnnie (Jun 10, 2009)

x SF med said:


> Now let me get back to asking if the PJs,   if theywant to steal the beer from the Marine Commo bunker while the Gunney (Ret.) plays with matches over at the ammo dump - we can get lit while the Gunney becomes the evening's fireworks.



Just don't make me come down and open up the clinic after hours.  And xSF, remember "shitfaced" just isn't a good diagnosis for the triage tag  ;)


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## 0699 (Jun 10, 2009)

x SF med said:


> Yeah - you could be unsupervised and have matches...:doh:
> 
> BTW - I need new pics of the match, I'm beginning to wonder if you still have it.



It's getting shipped up this week; I'll post new photos once it arrives.


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## QC (Jun 10, 2009)

I heard he committed suicide.


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## amlove21 (Jun 10, 2009)

Bobby McFarren didnt commit suicide- thats what the drunken PJs WANT you to think. I went to france for like 7 days and just LOOK what happened to this thread! 

WTFO! I love this place.


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## Boondocksaint375 (Jun 10, 2009)

Keep the thread on track people, it'll be cleaned up soon.


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## x SF med (Jun 10, 2009)

Boondocksaint375 said:


> Keep the thread on track people, it'll be cleaned up soon.


 
But, Boss - we discussed the merits of the different services' medical capabilities, and then moved on to a new subject.


Ok, let's get back on track...  Gunney can still blow up the ammo dump, but we have to move the party to the aid station and drink the medical alcohol instead of stealing beer from the Commo guys.

This also puts the PJs SF Medics and Navy Corpsmen in the right place to put Gunney (aka Humpty-Dumpty) back together again.

Since this will be a semi-combat medical exercise -  Who will describe the types of injuries we can expect once the Gunney starts throwing lit matches into an ammunition storage facility?


:uhh:


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## 08steeda (Jun 10, 2009)

We could start here:

http://www.shadowspear.com/vb/showthread.php?t=19760

It could happen! As stuff cooks off it could go thru someones boot, right???


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## 0699 (Jun 10, 2009)

x SF med said:


> Who will describe the types of injuries we can expect once the Gunney starts throwing lit matches into an ammunition storage facility?
> 
> 
> :uhh:



Crushing?  Burning?


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## x SF med (Jun 10, 2009)

0699 said:


> Crushing? Burning?


 
Not bad - but you, as the patient/casualty are currently unconscious, so you need to stay quiet or we let HeloMedic work on you, even better - Racing Kitty will be allowed to create one of her explosive pieces of art and wire it to your jaw...


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## 0699 (Jun 10, 2009)

x SF med said:


> Not bad - but you, as the patient/casualty are currently unconscious, so you need to stay quiet or we let HeloMedic work on you, even better - Racing Kitty will be allowed to create one of her explosive pieces of art and wire it to your jaw...





:)


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## Uglyduck (Jun 13, 2009)

x SF med said:


> Since this will be a semi-combat medical exercise -  Who will describe the types of injuries we can expect once the Gunney starts throwing lit matches into an ammunition storage facility?
> 
> 
> :uhh:



How about full thickness burns over 80%, a flail chest, and crush wound to left testicle...but thats only assuming he survived the blast in the first place and long enough to crawl, hobble, or hitch a ride to the aid tent where the debauchery is ensuing to seek help from the paragods with superglue in hand.


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## x SF med (Jun 13, 2009)

Uglyduck said:


> How about full thickness burns over 80%, a flail chest, and crush wound to left testicle...but thats only assuming he survived the blast in the first place and long enough to crawl, hobble, or hitch a ride to the aid tent where the debauchery is ensuing to seek help from the paragods with superglue in hand.


 
Our Gunney is a Marine, tough, with killer instinct, and he got into the matches....  But he was blown clear by the initial blast - thus miraculously "only" sustaining the injuries described (why did none of the rifle ammo puncture him during its ignition? nobody knows, but God tolerates Marines, because they keep heaven full of fresh souls...[yes, I recently watched FMJ] so this could have been God's mercy on the Gunney):

Gunney, I have to say, this is a real buzz-kill, the party was getting rolling, and the Nurses were really getting into the Joint Special OPs Medical Party held by the 18Ds, PJs, and Navy Spec Ops Corpsmen - with strap-hangers like Helo and 91B - but we have to get to work to save you now, you owe more beer than you can ever repay.

So we now have a smoldering, one-nutted Gunney with a chest that looks like a private parked a deuce and a half on it ...  After we take Gunney's matches away - What are we going to do?


*MEDIC!!!!*


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## amlove21 (Jun 13, 2009)

oh! me first! 

Get helo medic on the horn to exfil ASAP as we approach the Gunny. 

18D starts at the head with c-collar, airway and interview, rapid assessment of breathing, and a dart to the affected flail side. Flail controlled with large bulky NON circumferential wrap. Full assessment of possible barotrauma for blast, to include poss. TBI (hard to tell, cause Gunny was already a little, um, off).  

PJ starts at the feet with reflex and general survey, with special attention to pelvis (blast injury calls for pelvic instability to be life threat numeral dos) and a quick assessment of that nasty testicular torsion problem. 18D and PJ meet at the abdomen with a quick back brief of what they got, and a report to the Navy Corpsman, who has been getting out the hypo kit, spiking 2 liter bags Lactated Ringers (choice for burns) and 1 500ml of hextend (for blood loss and possible hemorrhage) along with the backboard. Parkland Burn Formula (%Bsa burn x wtKg x 4cc) would give us 2L fluid for the first 8 hours to get us to 32L total x 24 hr period. After 1st 24, maintain a 2L maintenance dose. Im guessing that the Gunny is a steely eyed barrel chested square jawed death dealing pork eating freedom fighter, weighing in at 100kg. 

Patient is URG SURG. Helomedic reports as such requesting bird w/o seats and ZERO medic transport personnel (you're fucking right i'm going on the bird, get off).

18D assess need for intubation/field RSI/crich, PJ applies MAST and clears legs and lower spine, HM1 wraps, straps, checks, and clears PT for ride, applying appropriate eyes and ears for PT comfort. Helomed checks flight plans for change in altitude, and necessary adjustments (ET tube with saline, pressure infusers being titrated, drip rates monitored).

As the helo lands, 1gm Ertapenem on board, 2 16g Large bores running LR wide open, pain meds as req (Gunny has still been talking shit, asking where the fuck all his REAL warriors, his marines, are and why all these dork sister services are doing all the treatments), so all he gets is some Toradol from the 18D. Kidding. If youre awake Gunny, you get the 1200mcg fentanyl taped to your finger. If youre going in and out, nubain or morphine, with a naloxone chaser on hand of course, just in case youre a light weight. 

Ride out with a call to local Trauma 1 with blood typed and crossed on standby, bright lights and cold steel on standby. 

What did i miss?


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## x SF med (Jun 13, 2009)

Outstanding. We can get back to the nurses while cursing out the Gunney for interrupting our party.

although - after the initial assessment when we found out his wounds were minor (for a Marine)... we could have hit him in the head with a brick for anesthesia, given him an aspirin for analgesia, placed a sandbag on his chest for the flail, and dumped a Lister bag full of ice water on him to keep him damp until Helo medic got there to transport him... (not really, but the mechanics are pretty close).

Amlove gets the first pick in nurses when we get back to the party.


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## Muppet (Jun 14, 2009)

Holy fucking mackrel........that was awesome. I need C.M.E.'s for that. Who needs cold steel. All that needed to be done was done. I am sure proud to be associated with medical professionals such as those listed. Am I considered a strap-hanger?

F.M.


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## Muppet (Jun 14, 2009)

amlove21 said:


> oh! me first!
> 
> Get helo medic on the horn to exfil ASAP as we approach the Gunny.
> 
> ...




L.R. wide open. Whats happen to the hypotension rescus. thing?:) M.A.S.T. still being used in the service?

F.M.


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## amlove21 (Jun 14, 2009)

are you kidding about the mast pants? For the love of pete- they have "military" in the actual freaking title!!!! REGARDLESS of whether or not their efficacy has been proven- it hasnt, and some would argue that while increasing periphrovascular resistance assists in BP maintenance, it actually stresses the trauma pt's heart- the military bought WAY too many of these things after vietnam. Lowest bidder, biggest supply, least amount of negative research (and in this specific case, NO research is equal to "no bad findings") wins most times. 

As for the hypotensive resus- you know, for this specific case, i would argue that the systemic insult due to severe dehydration due to burns and straight up trauma would outweigh the possibility of his ICP becoming an issue. Let alone the fact that most likely his BP is in the shitter anyway and wide open is really just making him pump clear fluid anyway. Its the classic "Which kills first? The extreme dehydration pulling fluid from the tissues or the extra fluid being deposited in the brain case due to swelling?" Hell, we may even wanna go around a couple times about the possibility that his body trying to compensate for the loss of fluid in the 80% burn could even KEEP HIS ICP IN CHECK!

But if his ICP was the issue, you can forget about the hextend, monitor the blood pressure to stay between 80-110 (sure, 90 is the book answer for keeping ICP under wraps and not blowing clots), and monitor for the cushings. Shit can the osmotic diuretics (CE for both the burn and ICP now).

And for the record MAST pants are ridiculous and i cant think of any real world pt i would consider using them on. I mean, really.


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## x SF med (Jun 14, 2009)

MAST - used without full pressure., will act as a vapor barrier and keep the pt from dehydrating - a survival blanket would also work.

Since it appeared to be an all clear from trauma other than burns - keeping moisture on the burned skin is an A-1 priority - use what you have - in this case - MAST trousers as a vapor barrier could be considered - as a BP stabilizer, notsomuch (IMHO) - we are talking about a pt losing lots of fluids quickly, transpoort is the best hope - major burn stabilization for extended periods (over 3hrs) is nearly impossible in the field under the best conditions - get em cool,damp and covered, then get them gone is going to give the best chance at survival.


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## Muppet (Jun 15, 2009)

amlove21 said:


> are you kidding about the mast pants? For the love of pete- they have "military" in the actual freaking title!!!! REGARDLESS of whether or not their efficacy has been proven- it hasnt, and some would argue that while increasing periphrovascular resistance assists in BP maintenance, it actually stresses the trauma pt's heart- the military bought WAY too many of these things after vietnam. Lowest bidder, biggest supply, least amount of negative research (and in this specific case, NO research is equal to "no bad findings") wins most times.
> 
> As for the hypotensive resus- you know, for this specific case, i would argue that the systemic insult due to severe dehydration due to burns and straight up trauma would outweigh the possibility of his ICP becoming an issue. Let alone the fact that most likely his BP is in the shitter anyway and wide open is really just making him pump clear fluid anyway. Its the classic "Which kills first? The extreme dehydration pulling fluid from the tissues or the extra fluid being deposited in the brain case due to swelling?" Hell, we may even wanna go around a couple times about the possibility that his body trying to compensate for the loss of fluid in the 80% burn could even KEEP HIS ICP IN CHECK!
> 
> ...




Yep. Forgot about the burns. I agree. I.C.P./M.A.P. with a SYS/BP. of 90/p should be cool. I guess we can also consider Rhabdo. with the severe trauma and burns and the fluids would also help as long as all bleeders are controlled.

I am hurt also. I am not considered a strap hanger?:doh::)

F.M.


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## Muppet (Jun 15, 2009)

x SF med said:


> MAST - used without full pressure., will act as a vapor barrier and keep the pt from dehydrating - a survival blanket would also work.
> 
> Since it appeared to be an all clear from trauma other than burns - keeping moisture on the burned skin is an A-1 priority - use what you have - in this case - MAST trousers as a vapor barrier could be considered - as a BP stabilizer, notsomuch (IMHO) - we are talking about a pt losing lots of fluids quickly, transpoort is the best hope - major burn stabilization for extended periods (over 3hrs) is nearly impossible in the field under the best conditions - get em cool,damp and covered, then get them gone is going to give the best chance at survival.





I agree also S.F. I did not think of the MAST being used in the point you are thinking. In the civ. world, they are being phased out for the obvious.......... Good points all around. Bring this all to my group please. Good learning experience.

F.M.


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## amlove21 (Jun 15, 2009)

no, you are definitely a strap hangar, FM. A sensitive one, at that. You big baby!


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## Muppet (Jun 15, 2009)

Thanks alot.....................:doh:

F.M.


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## HeloMedic1171 (Jun 16, 2009)

HoosierAnnie said:


> Just don't make me come down and open up the clinic after hours.  And xSF, remember "shitfaced" just isn't a good diagnosis for the triage tag



bullshit.  it's right next to SPAW.  Status Post Ass Whooping.



x SF med said:


> Ok, let's get back on track...  Gunney can still blow up the ammo dump, but we have to move the party to the aid station and drink the medical alcohol instead of stealing beer from the Commo guys.



deal.  WAIT - how the fuck did you know about the "cough medicine"? ??



x SF med said:


> Not bad - but you, as the patient/casualty are currently unconscious, so you need to stay quiet or we let HeloMedic work on you, even better - Racing Kitty will be allowed to create one of her explosive pieces of art and wire it to your jaw...



hey hey hey....  I provide top-notch modern-day battlefield medical care to the masses...   though, it IS 0126... you're gonna have to take this one, I gotta hold someone's hand out to a bomb site.  RK left and they sent a couple idiots to replace her and her professionals. :uhh:



Uglyduck said:


> How about full thickness burns over 80%, a flail chest, and crush wound to left testicle...but thats only assuming he survived the blast in the first place and long enough to crawl, hobble, or hitch a ride to the aid tent where the debauchery is ensuing to seek help from the paragods with superglue in hand.



fair enough.  but why a spoon, cousin?  why not an axe or a knife....



amlove21 said:


> oh! me first!
> 
> Get helo medic on the horn to exfil ASAP as we approach the Gunny.



done..... but you don't have much time.  i give you 10 mikes before I'll need smoke, signal, or signage..... wait.... I see the conflagrated ammo dump.  meet me on the SW side, upwind, and I'll be feet first close to the MAS.



amlove21 said:


> Patient is URG SURG. Helomedic reports as such requesting bird w/o seats and ZERO medic transport personnel (you're fucking right i'm going on the bird, get off).



fuck you!  I'm not cleaning this mutherfucker after you make me walk back....  hop in gramps, and give me some pointers, but this is my bitch, and you better hold the fuck on.  (i ain't givin you my seat when there's a perfectly medically useless marine that might have to ride door gunner) 



amlove21 said:


> 18D assess need for intubation/field RSI/crich, PJ applies MAST and clears legs and lower spine, HM1 wraps, straps, checks, and clears PT for ride, applying appropriate eyes and ears for PT comfort. Helomed checks flight plans for change in altitude, and necessary adjustments (ET tube with saline, pressure infusers being titrated, drip rates monitored).


  alt is fine, we're riding low, fast and clean.  just watch him, keep him warm, and check check and recheck.  eyes and ears won't stay on unless you tape them, rotors are unforgiving and absolute on the demand for plastic sacrifices.



amlove21 said:


> As the helo lands, 1gm Ertapenem on board, 2 16g Large bores running LR wide open, pain meds as req (Gunny has still been talking shit, asking where the fuck all his REAL warriors, his marines, are and why all these dork sister services are doing all the treatments), so all he gets is some Toradol from the 18D. Kidding. If youre awake Gunny, you get the 1200mcg fentanyl taped to your finger. If youre going in and out, nubain or morphine, with a naloxone chaser on hand of course, just in case youre a light weight.


negative.  1 gm Rocephin, and ditch the MAST.  I have blankets on board.   fuck his real warriors, they fainted at the sight of blood.   as for awake - lollipops are fine, but if you cric him or RSI him I'd rather you just let me pop him with 10mg of Morphine or more, as needed, he won't scream that way and he'll be a lot less able to rip things out of him enroute.  besides, I know you have narcan, mine's in the bag, next to the morphin AI's.  



amlove21 said:


> Ride out with a call to local Trauma 1 with blood typed and crossed on standby, bright lights and cold steel on standby.
> 
> What did i miss?



got a friend at 10th CSH, they're already prepped and impatient.  sounds good to me. :)



Firemedic said:


> Thanks alot.....................
> 
> F.M.



don't worry..... it's that south philly nature to be sensitive and caring....


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## Muppet (Jun 16, 2009)

Thanks Helo. Gotta a problem "wit" that?

F.M.


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## HeloMedic1171 (Jun 16, 2009)

neh, ya fuggin jergoff.


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## Muppet (Jun 16, 2009)

Now thats what I call S. Phila. :cool:

F.M.


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## x SF med (Jun 17, 2009)

Why do I see HeloMedic dressed as Corporal Agarn, singing "Up, Up, and Away in my beautiful balloon..." during take off and landings?:doh:


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## Muppet (Jun 17, 2009)

x SF med said:


> Why do I see HeloMedic dressed as Corporal Agarn, singing "Up, Up, and Away in my beautiful balloon..." during take off and landings?:doh:





:eek::):)

F.M.


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## HeloMedic1171 (Jun 18, 2009)

only because I don't have a "balloon" at the moment.....  but when I do, I just might  

though, I think "thunderstruck" is the unofficial AVN Theme song.... :uhh:


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## x SF med (Jun 18, 2009)

FM-
F-Troop, and the gayest song ever - they fit for Helo, the whole Cavalry Comedy, and gayness thing...


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## HeloMedic1171 (Jun 18, 2009)

says the guy with the naked troll av-a-tar!!!!  :uhh:

guess it take one to know one, huh, Trollmaster?


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## Muppet (Jun 18, 2009)

HeloMedic1171 said:


> says the guy with the naked troll av-a-tar!!!!  :uhh:
> 
> guess it take one to know one, huh, Trollmaster?





SHENANAGAINS!!!!!

F.M.


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## Sicarii (Sep 25, 2009)

amlove21 said:


> While we are nationally registered paramedics (a huge difference, considering 18D, corpsman and SOAR medics are ATP certified, and not P recognized), it is not our only focus.



My PJ brother.  I was an instructor at the Special Operations Medical Training Center at Ft Bragg in the late 90s.  At that time PJ students did attend the SOCM course (they had two instructors on the staff).  In that course all (SF students, Marines, Rangers, and PJs) participated in the NREMT-P training.  The AF students were not, repeat not required to pass the EMT-P standard; they were only required to attain EMT-I.  Granted this was 10+ years ago, but I wanted to counter you point (if I clearly understood it...:doh:).  All SOF Medics are "P" recognized, and SF Medics have to recert every two years.

...guess I should have kept reading the post...  this string didn't go where I thought it was going...


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## TLDR20 (Sep 26, 2009)

Yeah the above post is outdated information. No paramedic cert in the 18D course.


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