Critical Care Flight Medic?

The more “we” sweat in peace, the less “they” bleed in war.
                                   ….variation of a Chinese Proverb

     There are many lessons learned from our current and recent military conflicts. For MEDEVAC, we have recognized that the needs of the trauma patient require an expanded knowledge base and skill set for the Flight Medic to achieve a high degree of patient survival. The training and experience standards must improve for this to occur. It is not acceptable to expect the Flight Medic to attend a school or two without exposure to critical patients. Completing ACLS, PPEP or PALS, and a pre-hospital advanced trauma course do not provide the abilities or knowledge demanded by the patients needs. These deficiencies are unfair to the medic, to the patient, and all other stakeholders.
     The nature of the injuries and illnesses, that the flight medic will encounter, demand a higher level of performance than is currently provided. While there are exceptions to this performance level, there are also special circumstances that make the difference. One example of exceptional performance is the recent deployment of a National Guard MEDEVAC unit (California) to Afghanistan. The specific conditions that caused a significant improvement in the overall patient survival rates was the Commands understanding and support for the recruitment of experienced Paramedics for  Flight Medic positions. The benefits of this decision are the refined skills, experience related medical knowledge, and the relative comfort with critical patients. Contrasting these benefits with the abilities that most Flight Medics achieve following the military training program exposes a significant disparity.
     Civilian Paramedic Training Programs are often one year in duration and require considerable patient exposure before graduation. Military Flight Medic training does not approach these expectations...but it should. Unless there is a good reason not to improve the military Flight Medics abilities that emulate the civilian sector training, it is time to progress. Although there was a recent (2009) push for improving injury-to-surgery transport times, there was not recognition of the quality of the care needs. Surgery is definitive, but without the proper care enroute, there will definitely be fewer patients for the surgeon.

Afghanistan combat medics

Fly Along With MEDEVAC On The Frontlines In Afghanistan

What motivates you?

Nothing great was ever achieved without enthusiasm.
                                        ....Ralph Waldo Emerson

     Because this is the first posting, it seems appropriate to consider why we have chosen this path as a Flight Medic. The title of this post is a simple inquiry into our motivation and some may ask why this is worth discussion.  In response, consider that everything from the quality of our effort to the degree of our satisfaction and sustainability in the Flight Medic role hinge on our motivation. Following this inquiry further, we would probably agree that MEDEVAC transport is a difficult, sometimes gruelling, often risky, and deeply challenging profession (to offer a few descriptive terms...no doubt you have a few of your own). Why do we invest our time, energy, and emotion when there are easier paths to follow?  The answers are personal. That is, each of us can probably provide a unique answer that derive from our individual experiences and personalities. Because of this, a couple of thoughts come to mind.
     The first revolves around the concept of motivation as it pertains to the difficulties of the profession. Bringing this idea into a more tangible and recognizable picture, why do you scramble using so much energy, sweat, and intensity in the face of task overload, discomfort, and distraction. Consider an all too common scenario involving a deteriorating patient with traumatic amputations, penetrating wounds to the abdomen, chemically paralyzed, sedated, and intubated with blood products infusing and no partner to help you (or, you can insert your own "tough transport" here...no doubt you have one of these too). In other professions, you can just stop and get some coffee, before regrouping to complete the job, but that's not an option for us. So, why do we choose such demanding roles?
     Each of us will have our own explanations, but there are some common elements to consider. What draws us into these roles? Is there a common thread of compassion for the sick and injured? How about respect for those who depend on your abilities? Does the challenge alone spark your desire for success? Are there more personal reasons for the way you perform? Most likely, there are several similar motivators that influence us in various combinations. Questions such as these are useful for introspection. To be comfortable in our demanding profession, we need to know the answers. It is not enough to do something just because we can. There must be an element of passion for true success to occur. At the risk of sounding like a compromise, we may not always have the desired outcome, but we can always provide our best effort.
     The second thought is a consideration for those motivational elements that we share. MEDEVAC teams  are small and depend on each other for many reasons, especially in (the all too common) difficult situations where lives are often on the line. Cooperation, communication, and collaboration are unspoken rules to survive by.  Crewing a Blackhawk can be a great source of pride. While you have good reason and the right to be proud of your role, there is an even greater reward in the positive influence you have in the patients lives during the rescue or transport. No one can take take away the satisfaction and pride you have from saving (or sustaining) a life on a MEDEVAC Transport.
     You have probably noticed that no answers have been offered for the original question. The simple reason for this is that the answers can only come from you. These are merely some thoughts intended to provoke curiosity and a better understanding of our motivations. Motivation is important and worth consideration.  With that in mind, what is your motivation?