Premedical Training?

That's just the process that wherever you looked at does. The only reason you'd be doing county protocols at all is if it's a local EMS agency that's doing the training and those programs are geared to be a feeder for employment WITH that agency, and they'll pick up whoever was a good performer in the course as per the results from the course as well as proctor report cards during the ER/EMS rotations. Any collegiate level course isn't going to incorporate it because there's no point (no guarantees that you're hunting for employment in that county or even state, no specific agency feeder design)...

Most Paramedic schools nationwide incorporate EMT-B as part of the program right out the gate, if you come in with it great but it's not a necessity and you're still sitting through the classes so that everyone's on the same sheet of music.

I honestly don't see the point in EMT-B time prior to Paramedic training being a requirement anyway, because that "time working" can vary from
  • having been a security guard/medic at a remote site with zero patient contacts whatsoever
  • Transport company where you're just an overqualified handicapped van driver with an AED and not even a BLS bag
  • actually running with the primary ambulance service for the second highest call density of the state and often doing turn and burns at the ER
  • working the front line on a rescue engine
There's no guarantee of anything with regards to prior "experience", especially at the Basic level.

The board just helps weed out people who just aren't a decent fit for the program and career field when there's limited space in the course... and what is most important is what they actually teach you in the course.

Anywhere you go, you're going to be doing protocol certification within the agency you work for prior to getting cut loose to "go forth and heal the peoples", and you'll most likely be teamed up with a senior crew anyway as a new hire before really and truly being "on your own". Scope of practice varies wherever you go, and protocols are just a combination SOP for what to do... as well as a CYA for how much risk that agency is willing to take on patient care. Your protocols also vary within the military as well.

Case in point:
In California many local protocols will not allow paramedics to even intubate and if they are allowed you would definitely have to get the OK from the medical director.

Without ER rotations to maintain currency on the ability to throw a tube, those "Paramedics" are going to be pretty useless... and I would argue they're close to useless anyway at that point since the time spent on the radio asking permission is time that patient DOES NOT HAVE AN AIRWAY... but I digress...

The scope of care, method of/order of concern of care, as well as equipment carried was a full 720 rotation with a moonwalk thrown in, between civilian NREMT-B, and Ranger medical operations. The only thing that kept us "straight" so we weren't all fucked up once the course was done was the RMED operations classes during/immediately after passing the course, as well as follow-on training afterwards (RFR, PHTLS, live tissue, tactical care considerations classes, etc), that kept us oriented on what we would be doing as squad EMT's individually as well as new parts to the casualty care team, working under the tutelage of our platoon medics and senior medics for the company and BN.

I can totally see someone who's been a medical professional in the civilian sector being totally fucked up in military medical training. There's so many CYA considerations civside that are ignored in the military because they don't make sense as a necessity to render proper aid for a given injury.

To bring it all back to the original focus, I would say anatomy classes would be useful and give you a bit of a leg up IF you are already in college... if you're not, just buy an anatomy book and read through it so should you get to that point in training, you won't be totally lost. Any actual dedicated civilian medical training is of... questionable utility given the significant divergence between military equipment and methods of care, and civilian medicine.
 
As an aside/chuckle point, the former PJ and I had a fun time screwing with one paramedic in our department in AK. Said "Paramedic" thought they were hot stuff and that they could do everything we did while active duty. We just nodded our heads with a "Yup yup" and went back to pre-shift checks on the apparatus.

Their rig and our rescue engine responded to a motorcycle vs quad high speed accident and the duty Medic-1 straight up told said paramedic "Go back to the truck and stay in it" since they couldn't figure out where stuff was in their bags/on their rig, nor how to apply a KTD right... and we seamlessly corrected all of it while continuing patient care, coordinating scene safety, and facilitating a multiple helicopter evac with 2 offset LZ's via radio with the birds crews.

They shut up pretty quickly afterwards about their hotshitness. They also got a job, then got fired from it, with the med helo company since they sucked and also couldn't maintain weight standards to ride the birds.
 
As an aside/chuckle point, the former PJ and I had a fun time screwing with one paramedic in our department in AK. Said "Paramedic" thought they were hot stuff and that they could do everything we did while active duty. We just nodded our heads with a "Yup yup" and went back to pre-shift checks on the apparatus.

Their rig and our rescue engine responded to a motorcycle vs quad high speed accident and the duty Medic-1 straight up told said paramedic "Go back to the truck and stay in it" since they couldn't figure out where stuff was in their bags/on their rig, nor how to apply a KTD right... and we seamlessly corrected all of it while continuing patient care, coordinating scene safety, and facilitating a multiple helicopter evac with 2 offset LZ's via radio with the birds crews.

They shut up pretty quickly afterwards about their hotshitness. They also got a job, then got fired from it, with the med helo company since they sucked and also couldn't maintain weight standards to ride the birds.

Say what? NO VS-17's? Birds can't land without VS-17's!!! :wall::ROFLMAO::ROFLMAO::ROFLMAO::rolleyes:
 
My VS-17 at that point was THE BIG FUCKING FIRETRUCK I DROVE THERE...

Here, let me play you the sound of my people.


Video's not me driving... easy to tell. No air horns at the traffic.


It's KGB, you've GOT to use your air horn with all the idiots. Is it bad when a then 14 month old hears one with a big drooly grin says "Daddy" every time it sounded?
 
The difference in thinking makes sense.
As a former instructor in a course very similar to what the medical portion of the Pj school is like I would tell you to learn all your hands on skills in the schoolhouse. Our most fucked up students were ex-nurses,paramedics, and EMT-B's. Tactical medicine is a different animal, and you will have to unlearn bad habits rather than just learning new good habits.

Any suggestions on how to help ease the learning curve from civilian to military medicine or just keep it simple and shut up, listen, and learn?
 
The difference in thinking makes sense.


Any suggestions on how to help ease the learning curve from civilian to military medicine or just keep it simple and shut up, listen, and learn?

Just try and start with a blank slate vs trying to act like you know what is up.

Just from a TQ application perspective. I had a student in an advanced trauma lab not put a TQ in a non bleeding amputation because it wasn't a protocol he was used to. He only had 3 weeks to learn it, and when the stress was ratcheted up he reverted to his old methods.
 
Just try and start with a blank slate vs trying to act like you know what is up.

Just from a TQ application perspective. I had a student in an advanced trauma lab not put a TQ in a non bleeding amputation because it wasn't a protocol he was used to. He only had 3 weeks to learn it, and when the stress was ratcheted up he reverted to his old methods.

Alright, I will make sure to keep that in mind when the time comes. Keeps things in perspective and reinforces the idea that there are always things to learn and improve.

Maybe its because I am just fresh out of EMT school and have limited exposure to various protocols, but I don't understand why one wouldn't suggest applying a TQ to an amputation that wasn't bleeding. Point taken though.
 
Most civilian protocols did/do not call for TQ application except as a last resort. In military medicine it is the first solution.
 
To append to TLDR, Individual providers also can use tourniquets as a temporary solution while other measures are put in place to control bleeding. TQ by caregiver and/or injured individual, apply bandages/etc, back off TQ to see if your interventions worked. It all depends on the situation.... but civilian side, you throw one on and you don't take it off and it's a BIG DEAL that you put it on.

Even though there's plenty of studies shown that all the other various things like tissue ischemia and repurfusion injury aren't nearly as bad as once thought as well as not nearly as bad as the alternatives to.. well, dying for one.
 
To append to TLDR, Individual providers also can use tourniquets as a temporary solution while other measures are put in place to control bleeding. TQ by caregiver and/or injured individual, apply bandages/etc, back off TQ to see if your interventions worked. It all depends on the situation.... but civilian side, you throw one on and you don't take it off and it's a BIG DEAL that you put it on.

Even though there's plenty of studies shown that all the other various things like tissue ischemia and repurfusion injury aren't nearly as bad as once thought as well as not nearly as bad as the alternatives to.. well, dying for one.

Some places are recognizing that TQ application really should be a first-line measure for certain types of wounds, but even those places are uncomfortable with a provider converting the TQ to a different hemorrhage control method. That's annoying, particularly if there is a long transport time or a delay in transport. At this point though, I'm just happy to see TQs formally approved in my state.
 
Back to the OP.
Get an anatomy book and study that Grey's Anatomy IIRC.
Also look at specialtactics.com as they probably are your best source for AF Special Operations Careerfields.
 
Back to the OP.
Get an anatomy book and study that Grey's Anatomy IIRC.
Also look at specialtactics.com as they probably are your best source for AF Special Operations Careerfields.

This may sound like I'm breaking it down Barney-style, but get an anatomy coloring book if you're buying books. No, I'm not kidding.
 
My FD just went to DP then TQ. NREMT is also teaching this.

The NR doesn't teach anything. They publish standards and conduct testing against those standards.

The bleeding control skill sheet uses that progression so that the examiner can test more than one skill in the station, not because they are advocating direct pressure when a TQ is the appropriate treatment modality.
 
Hello, I was doing research on the types of medical training that Pararescueman receive. If I have learned anything from what I read it is that the training is rigorous and challenging. Would any PJ's recommend to anyone interested in becoming a Pararescueman to have any premedical training such as EMT-B or Paramedic before entering the pipeline? Or no?

Thank You

Just figured a PJ should chime in on this:

If you have the ability to get your NREMT - Paramedic before you enter the pipeline, I would say go for it. I knew a couple dudes who did this and it cut 8-12 months out of their pipeline. All good dudes and competent operators. Idiots tend to remain idiots and self eliminate. In PJ school there is also a lengthy dirt medicine/ TCCC phase which is intended to create that bridge from street medicine. After this phase is over, your medical skills will be tested in every subsequent remaining phase, and if you are not performing to standard, you will be recycled. Students have been recycled on the very last day of training before graduation, or even eliminated from the pipeline completely, because of complacent or substandard performance. Bridging street medicine to dirt medicine well is a function of motivation and discipline. The instructors there will give you all the tools you need to be a good combat medic. It's totally up to you how you receive that training, and how you perform.

Additionally, when PJ's are not deployed, (esp at some units AK, Portland, AZ, Vegas in particular) sometimes you will be called on to practice Para-medicine in non-combat environments on normal civilians. So ultimately, you have know the difference and be good at both.

And remember, whether you operate for 20 years as a PJ, Ranger, SEAL, SpecialForcesRangerSapperSniperAirbornewhatthefuckever... nobody gives a fuck what you did yesterday. Stay humble, never complacent, and always be the hardest working dude in the room.
 
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