Premedical Training?

[Kballdc93]

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

 

[TLDR20]

Take Anatomy and Physiology 1&2, Maybe a pathology class if they will allow you at the community college near you. I might even take a microbiology class. Those are all things that would have helped me in SOCM, which is a more academically challenging version of the PJ course.

 

[CBTech]

Not being a PJ Iwill give my advice as a first responder with a federal agency. A&P 1 and 2 as previously mentioned is a great idea and I would say your willingness to take EMT-B is a great idea but you need to go further and get a job on a rig, work as an EMT-B, and get patient contacts. I am pretty sure you can't get into paramedic school without requisite time working as an EMT-Basic or EMT-Intermediate. At least you can't in any state I'm familiar with.

I know that some civilian training is written off with some military schools as procedure and protocol is totally different between the two, ie. recreational skydiving vs. jump school / PADI cert vs. cive school. They just don't do anything for you except possibly give you bad habits before you get to your military training of the same discipline but medicine is medicine and if anything it will be more liberal when you get to military medical training. I intubated in live tissue training in the military and could very well have done the same in the field as I had practiced in training. 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.

So, yes. I would suggest you take EMT-B at the very least. The junior college I went to made you take First Responder and Anatomy and Physiology as a pre-requisite to the EMT-B course. Do that and start getting experience. It will only help you.

 

[TLDR20]

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.

 

[TLDR20]

To be honest though you will probably fail out before the medical training even happens, so maybe some EMT-B stuff might help you out somewhere else in life. Nothing personal, just those pesky odds.

 

[CBTech]

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.

I stand corrected and assumed incorrectly that medicine is medicine and I should have stated that while TTP's may be different medicine is medicine (anatomy, dosages, ...).
I know about the bad habits that you can pick up through civilian dive and jump training but I would hope, in regards to medical, that one would only have to unlearn good civilian emergency medicine habits to learn tactically good emergency medicine habits. We all strive to not pick up bad habits in the medical field. If someone has bad habits they brought to SOCM/Pj then they were bad in the civilian sector as well.

 

[pardus]

I stand corrected and assumed incorrectly that medicine is medicine and I should have stated that while TTP's may be different medicine is medicine (anatomy, dosages, ...).
I know about the bad habits that you can pick up through civilian dive and jump training but I would hope, in regards to medical, that one would only have to unlearn good civilian emergency medicine habits to learn tactically good emergency medicine habits. We all strive to not pick up bad habits in the medical field. If someone has bad habits they brought to SOCM/Pj then they were bad in the civilian sector as well.

It's not so much a matter of "Medicine" we (and I'll say right now, that I'm the most junior Military medic there is) just have a different set of priorities and a different mindset. For example, as per our training, If a person on the battlefield is found with no heartbeat or breathing, case closed. The first thing we were told once we left EMT-B school and went into the Military phase was to forget all of what were learned. The most important part of EMT-B for Military medics is A&P IMHO. The rest is mostly baggage.
An EMT-B who is the lone medical professional for 30 odd guys, hours from help, who is required to be the Dr (of all specialties), the mortician, the pharmacist, sanitary health, veterinarian, mental health specialist, physical therapist etc... simply doesn't have the same mindset or restrictions as a civilian medical professional.
How many EMT-B's on the civilian side can do crics and chest tubes!?

 

[lushooter]

I am pretty sure you can't get into paramedic school without requisite time working as an EMT-Basic or EMT-Intermediate. At least you can't in any state I'm familiar with.

With the program through my school you can. Finish EMT-B one semester, begin EMT-P the next. However, I know and talked to people who got a job as an EMT or with a fire department between the Spring and Fall semesters and work as an EMT/FF during school if that makes much of a difference. I understand it isn't a long time comparatively, though some do come in with prior experience. Paramedic certification is part of the major here, so the school has something worked out with the county to give Fire/Paramedic majors priority for acceptance into the Paramedic program (priority, but by no means guaranteed).

After talking to EMT's and Paramedics from other services, they say that the director of the training program is very good, well known and set it up to teach/test to a higher standard than most places. I know a couple students in the Paramedic portion of the program and they seem to be doing very well, so it appears to be working for the county even without requisite time. This is all based on my observations though, I am still learning.

 

[medicchick]

I stand corrected and assumed incorrectly that medicine is medicine and I should have stated that while TTP's may be different medicine is medicine (anatomy, dosages, ...).
I know about the bad habits that you can pick up through civilian dive and jump training but I would hope, in regards to medical, that one would only have to unlearn good civilian emergency medicine habits to learn tactically good emergency medicine habits. We all strive to not pick up bad habits in the medical field. If someone has bad habits they brought to SOCM/Pj then they were bad in the civilian sector as well.

My civilian Paramedic training and my husbands Ranger Medic training are very different. If it's trauma I turn to him, peds, geriatrics or more medical side he turns to me. We can both do IV's, tube and bandage but reading a quick rhythm isn't really his thing (most drugs or ACLS at all really) just as I can't to do a chest tube or sutures. That's not to say he was a bad medic he just had different areas of focus.

I am pretty sure you can't get into paramedic school without requisite time working as an EMT-Basic or EMT-Intermediate. At least you can't in any state I'm familiar with.

Wrong. I know plenty (myself included) who never worked as an EMT-B, only EMT-P. School from off the street knowing nothing to being a newly minted Paramedic was straight through 2 years, as long as you had your required ride times in you were good. There is no state that I know of that requires you to have WORKED as a basic first, you just have to have your hours done in rides or an internship.

 

[TLDR20]

I stand corrected and assumed incorrectly that medicine is medicine and I should have stated that while TTP's may be different medicine is medicine (anatomy, dosages, ...).
I know about the bad habits that you can pick up through civilian dive and jump training but I would hope, in regards to medical, that one would only have to unlearn good civilian emergency medicine habits to learn tactically good emergency medicine habits. We all strive to not pick up bad habits in the medical field. If someone has bad habits they brought to SOCM/Pj then they were bad in the civilian sector as well.

The difference is in being the sole provider. As an EMT-B you work as a member of a team, and have your slice of the pie. As a SOCM/PJ you are it. You are in charge of a patient from point of injury, till they are in a higher care providers hands, on the case of a SOCM/PJ that could be days.

Our EMT/Paramedic students learn shitty HEMCON techniques and then when the shit hits the fan they revert to their most basic skills, if those skills are EMT-B techniques rather than the techniques that we have that are time tested and well engrained, the dude will fail(either in training or in combat)

 

[CBTech]

when the shit hits the fan they revert to their most basic skills, if those skills are EMT-B techniques rather than the techniques that we have that are time tested and well engrained, the dude will fail(either in training or in combat)

Heuristics. I understand. Mental shortcuts, when SHTF, steers them down the wrong path. The mental slides they refer back to are not the new ones they learned in the pipeline but their first mental slides they built when they were an EMT-B/I/P or nurse?

Heuristics can be a great thing but it can introduce bias.
http://psychology.about.com/od/hindex/g/heuristic.htm

A heuristic is a mental shortcut that allows people to solve problems and make judgments quickly and efficiently. These rule-of-thumb strategies shorten decision-making time and allow people to function without constantly stopping to think about their next course of action. Heuristics are helpful in many situations, but they can also lead to biases.

 

[CBTech]

Wrong. I know plenty (myself included) who never worked as an EMT-B, only EMT-P.

Not so in CA. California is quite different. Not only do you have to be nationally registered but you have to have a county specific protocols test. Not every county is the same and they do not recognize other counties licenses. Same way with Firefighter I. California doesn't accept any FF I training from any other state. It's so fucked up here.

 

[Ranger Psych]

A protocols test you can walk in with NREMT-whatever and take for your corresponding qualification level, though. Every department, anywhere, worth a shit, has a protocols test for the practitioners in that area.

Hell, I know we specifically had them for our Ranger Medics, and while I wasn't a SOCM grad I still went through it as an Infantryman turned "homeschooled" BN level medic. I did it 2 weeks prior to all the MOSQ'ed medics, then did all the logistics in support of them getting theirs done.. both written and practicals.

You can go to a college or school, spend 2 years in school doing all that jazz and walk out with your national registry paramedic certification. No "work" involved. Will you have some ride experience as part of the program? It's a requirement to do X amount of hours both ER/Ambulance, increasing, for each level of qualification. Is that work? no, because you're a student in the course and not being paid.

The good thing about our EMT course is that while the NREMT "crap" the EMS trained us on, at the same time we were using a large portion of what WE normally would be using for casualty care. We didn't have truck bags, we had aidbags packed to the RSOP for what medics carried and also had company/Bn senior medics do continued training with us expanding our scope/knowledge with how we did things tactically vs what we got taught for ambulance/er operations due to NREMT requirements.

 

[medicchick]

Not so in CA. California is quite different. Not only do you have to be nationally registered but you have to have a county specific protocols test. Not every county is the same and they do not recognize other counties licenses. Same way with Firefighter I. California doesn't accept any FF I training from any other state. It's so fucked up here.

Why would you have to do a protocols test to go to school though?

 

[Ranger Psych]

Also, CBTech, you gain demerit points for bringing up California in any discussion that didn't start off with

how it sucks and doesn't relate to any other state of the union
how it is a thorn in the side of respectable american conduct and behavior
why the san andreas fault just needs to become a shear point
why individuals that export california mindsets and politics outside of the borders of that state should be donated to North Korea

 

[TLDR20]

Also, CBTech, you gain demerit points for bringing up California in any discussion that didn't start off with

how it sucks and doesn't relate to any other state of the union
how it is a thorn in the side of respectable american conduct and behavior
why the san andreas fault just needs to become a shear point
why individuals that export california mindsets and politics outside of the borders of that state should be donated to North Korea

I love California.

 

[Ranger Psych]

Why am I not surprised?

 

[policemedic]

I love California.

I love most things about California, but the politics are why I will never live there.

 

[CBTech]

Why would you have to do a protocols test to go to school though?

Not sure I understand the question because you don't have to pass a County Protocols test to go to school. You pass the course, take the protocols test in a lab tacked on to the end of the course, go to the National Registry testing with your paperwork from the school and the passing grade from the County protocols test. Take the NREMT test. No protocols test to gain entry into a school.

You would have to do a county protocols test to work as an EMT-B in your particular county in California. I have looked at many Paramedic programs in San Diego County and you have to have a various number of hours worked as an EMT-B and, often, pass a board to be accepted into a program.
I am not on the side that determines the "why's" and the reasons but I would bet that you have to pass a county protocols test, going above and beyond National Registry, due to litigation.

Back to topic a little bit. I took several TCCC courses to include two live tissue courses. I looked back on that training after I posted the link about Heuristics and thought how my mental slides could be skewed if I had taken any kind of civilian medical training beforehand. I would like to think nothing would have negatively affected the building of my new "tactical mental slides" but I can't be sure. I can say, with certainty, that having taken the live tissue course has made me a better civilian first responder. This discussion has provided for great reflection and a renewed appreciation for TCCC and live tissue courses.

 

[CBTech]

I love most things about California, but the politics are why I will never live there.

It's a struggle to live here but what a beautiful state. My suggestion to people would be to visit not move here. I've grown roots here but been looking at Northern AZ, CO, and OR recently.