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.
