When is the USCG going to adopt Combat Life Saver as an approved course. As a reservist who is about to go over the the big show, I was required to take the course. The USN requires 100% of all deploying members to take the course -- and that includes all USCG who fall under USN in any way going "over there" -- and don't think that is just fo rthe PSUs who may be part of future ops -- the MSSTs and anyone else carrying a weapoons should earn it too. The US Army is going to make it part of their Basic Training. The USAF requires it for security personnel and the USMC gets it through their USN Corpsman.
As a civillian LE and former firefighter who has treated the wounded, I found it to be the best medical training I have ever done. It certainly goes far beyond EMT skills to save a life. An EMT can do little more than ABCs, manage C-spine, and administer O2 (and module into IVs and other things as well). That's great, but airways, IVs, tourniquets, and tension pneumothorax decompression (Mark Wahlberg's chest injury in Three Kings) will save 15% of those who would otherwise die in the field. All of its skills are not designed to be used on civillians (liability for sticking needles in someone's chest) but is for fellow coasties or that person you just shot and now you need to keep alive (especially if it was an accidental shooting).
I hear that the USCG wants to review and create its own program. Why reinvent a system used daily by each of the other branches and one that is constantly being revised? It has saved many lives.
You will get far more practical training out of 4 days of CLS vs three weeks of EMT.
I don't want to post the link here -- but talented people can go to the Navy Knowledge Online, create a login, and go to tactical field medicine and find a US Army link that is a PDF of the program. Very useful in itself.
The Coast Guard may be at sea but it does not need to be an island floating off by itself.

imlivid,

As one of the few CG members who is qualified by the US Army to teach CLS/TCCC/CMAST, (and with over 30 years of EMS experience) I agree with you and share your concerns. I have been unable to get things moving as I'm not an HS as that seems to be the "sticking point" in many a conversation.

I do know that one or a few MSSTs on the East Coast do/did CLS/TCCC training, however I believe that they encorporated tactics also, making it a longer class. CLS is a stand alone training and should not be incorporated into a "tactical medicine program" as it precludes those who NEED it, EVERYONE going downrange, from those who think it's only for the HS/MSST groups.

It's a basic skill, taught in US Army BCT, and is not a "secret cool guy thing". It saves lives. Let's teach everyone who needs it, not keep it for a few.

I mean no offense to the HS community in this posting, so please don't take it that way.

My .02

I agree with you all 100%. When ramping up to go overseas in 2003, I was shocked that we did not even run people through so much as a basic first aid/CPR course. As far as I know, they still are not.

I feel that such a course being a part of Bootcamp would be the most efficient way to get the training out there. We are, after all, a lifesaving service.

Need I say more about the need to keep our medical training go beyond the simple ABC and CPR stuff --

More Marines receive basic medical training

By Gidget Fuentes - Staff writer
Posted : Tuesday Oct 16, 2007 18:55:12 EDT

CAMP PENDLETON, Calif. — The chuckles and sarcastic comments belied an underlying nervousness among the class of Marines.

They were about to stick each other in the arms with needles and catheters — if all went well, only once.

“What does a good vein look like? How does it feel?” asked Hospital Corpsman 2nd Class (FMF) Michael Bundenson during the second of a four-day Combat Lifesaver Course at Camp Pendleton’s Camp San Mateo.

Some fidgeted in their seats.

“Big,” said one, and many glanced down to look at their own arms. “Springy,” said another.

The prospect of needles and blood clearly was discomfiting. But 16 members of 5th Marine Regiment’s headquarters jotted notes and listened while Bundenson led them through the basic steps, equipment and procedures to administer an IV, used to hydrate and stabilize a wounded patient.

Bundenson, a certified combat lifesaver trainer with 5th Marines, is part of the Marine Corps’ effort to increase the number of front-line combat first responders.

In the past year, the Corps has been expanding its combat lifesaving capabilities with a revamped program designed to save more lives on the battlefield. They are building more certified combat lifesaver trainers within units, mandating combat-lifesaving refresher training and requiring commanders to integrate more first aid and lifesaving skills in their units.

According to Marine Administrative Message 363/06, issued last year, the overarching goal is to “eliminate preventable loss of life on the battlefield” by having more trained Marines to shorten the time needed to stabilize wounded troops and get them to proper medical care within the “golden hour” after an incident.

Marines learn about hemorrhage control, airway management and treating shock. At San Mateo, students also learned about combat evacuations and different types of wounds — such as penetrating chest wounds or burns — they may encounter in combat.

“Hopefully, we won’t have to use this,” said Staff Sgt. Steven Cheatham, an administrative chief and former KC-130 crewman, who believes the course is invaluable for Marines.

“Now they’re getting the experience of sticking a needle in somebody and maybe saving their life some day. It’s really opening up their confidence.”

In combat, if bullets are flying and the platoon corpsman goes down, “to be able to stabilize that patient and get him into the rear for that golden hour will increase their survival rate,” Cheatham said.

Practical application at this CLS class is as real as it gets. A day earlier, Bundenson had the Marines stick breathing tubes up each other’s noses and down their throats to learn how to get a wounded patient breathing again.

“I notice that more people learn by doing it,” he said.

Inserting an IV — pricking the skin with a needle and then pushing a flexible catheter into a vein — isn’t always perfect the first time.

Sgt. Estraisand DaSilva trained his eyes on the right arm of Staff Sgt. John Trias while DaSilva’s finger felt for a vein ripe for the pricking. He punched the needle through the skin, but the catheter didn’t take hold, and the site swelled a blackish-red. DaSilva, with Bundenson at his side, tried again. The second try worked, but the site also swelled. Doc reassured him as he secured the tubing with tape.

“You’re getting the vein,” Bundenson told him. “That’s a good thing,”

Trias, 27, didn’t flinch. “It felt weird at first,” said the personnel administrative clerk, preparing for his first deployment to Iraq. “It didn’t hurt at all.”

DaSilva, a 27-year-old field wireman, realized the first error in placing the catheter.

“You actually have to push it down and follow it into the vein,” he said. “You definitely have to follow the procedures.”

Preaching to the choir... I've been saying this for the last 5 years.

In response to the question on why the CG does not provide CLS/TC# training before deploying to the "Big Sandbox" so to speak. I run one of the finest Combat Casualty First Aid training courses for CG personnel deploying with PATFORSWA (and other places). This has been said to be some the very best tactical medicine courses available to non-medical members. It is part of the pre-deployment training for CG members heading "Over There".
This training has been in place for over four years and is improving with each session due to updates tecniques and research. Former Navy Corpsmen, Marines, and US Army personnel have attended and hail it as the best medical training they have ever been through. So. if your heading to the "Hot Zone" for PATFORSWA or other CG operations in the Mid East TAOR, you will more than likely go through this training. Other tactical medicine courses are being developed for other operational situations but are not yet in place.
Thank you all for serving and your interestin our rate. HSCS dgs

Senior, let me ask you this and it's a bit off the subject, but I've been out of the loop for a while. At what level are non-corpsman boat-crew members trained to? The reason I ask is that I was perusing the details of the reports on PO3 Gill's tragic death, and I found it odd that they had to get an EMT from one of the other boats operating in the area to assist. When a boat goes out I guess they are not required to have at least an EMT-B on board, but rather someone who has been only trained in basic life saving? Perhaps I'm remembering incorrectly but I remember back in the 80-90's each boat crew had to have at least one NREMT EMT-B on board? -Jeff

rx, PO Gills tragedy/injuries was not fixable or correctable at even the EMT level. We are developing plans to have MSST's, PSU's, LEDET, TACLET and members up to speed on the current Tactical Medicine training that is being developed. We recently (3 yr ago) got rid of the Lifesaver Program at the HS/EMT school because there was no tracking it and no recert available. We put online a new National Registry First Responder program to be taught by HS's that have graduated from the new Independent Duty Health Services (IDHS) School. This programs has registry tracking recirtification can be conducted by a qualified IDHS. Once this First Responder training begins spread into our fleet (ashore and afloat) we will be better trained and equiped to handle basic emergencies in the field/afloat. The Tactical Battlefield First Aid (name may change)is coming and is aimed at specific operational areas up front. Hope this helps.

Senior Chief, thanks again for the info. I did not mean to insinuate that in the case of PO Gill that it would have changed anything, and I apoligize if it sounded that way. I just find it hard to imagine that a USCG smallboat would be out available to the public with only a "first Aid" level responder aboard, but it sounds like yourself and others at the schoolhouse are working hard to improve the situation and bring a higher level of training to the field! BZ! On a side note your name looks familiar, did you spend any time at the academy medical clinic in the early 90's? Happy Holidaze! -Jeff

Sr,

Where do you hold the training? What is the schedule? What unit are you with that hosts it?
Thanks.

BTDT,
The Tactical Lifesaver Course (CLS) should be similiar to the Army's course. To get ahead of the game, I would suggest going onto the Army Distant Learning Website (Army Institute for Professional Developement). As a member of USCG, you can register for the Self Aid/Buddy Aid Course (Subcourse ISO0877). Just remember that you must still follow USCG policy with whatever first aid you may provide.
Also, the USCG self aid/buddy aid course is out there. There are a handful of IDHS's that teach it (Most with MSST units). And of course one PS1 at SECNY .
Like HSCS mentioned, those who have participated in the Pre-deployment combat first aid training have praised what has been done over the last few years. This feedback will help the program grow.
If your are interested in the Army CLS course, go to http://www.cs.amedd.army.mil/clsp/index.htm

psdiv,

Thanks. I'm already a certified US Army Instructor and can teach: CLS/TCCC/CMAST. I have been teaching CLS/TCCC to the Army Reserve/NG for predeployment for the past 6 years since we don't have it in the CG (yet), gotta keep the skills up.

My question for the HSCS was where on the West Coast he is teaching and what unit he is with so I can coordinate some needed classes out here.

ONTOS/HMCS DGS
Meaning no disrespect to you if there really is a program that has been established for four years but...
How Come:
This was never offered (cerrtainly no knowledge of it) when I was at an MSST 3.5 years ago.
This was never offered when I was at a PSU one year ago.
This was never offered as part of my pre-deployment for my current job forward in the sandbox
The DOG has never heard of any advanced CLS type of training offered by the USCG.

This almost seems to be some sort of free lance single unit activity and not mainstream. CLS is mainstream for EVERYONE else. Why does the USCG have to be so different all the time?

Whatever it is you do, it needs to be published so it can be exported to other units, not just held in some unit's or district's pocket

The US Army does not recognize anything in the AOR besides USA/USN Medic/Corpsman, and CLS certifed. Any unit deploying under the USN umbrellas is supposed to be 100% CLS qualified so we went through the course. We need Medic/Corpsman and CLS certifed for the range and for convoys. Not first responder or EMTs. The USCG needs CLS. It is required for the job over here.

CLS covers what you need to know. It goes way beyond what an EMT can do to save a life -- EMTs are glorified Paramedic assistants who initially do well when told what to do but can't offer much more that O2, C-spine, CPR, and direct pressure. They learn a lot from the medics they work with, and that is where they learn how to save lives. Only active EMTs who practice their craft with regularity will make a difference in s atressful situation. The EMT course does little to teach you how to save a life in a critical setting without ALS nearby. The EMT course does little to teach you how to save your own life: CLS does.

A CLS, EMT, Corpsman, or Parmedic could have done nothing to save PO Gill. Perhaps only a trauma center with a neurosurgeon right there in the hold could've helped, but not much more could have.

The USN Corpsman learns a whole different skill set than a USCG Corpsman does. USCG is clinical. USN is clinical and field work. IDHS for USCG is 4 months -- the USN is 12 months. No criticism for the USCG Corpsman again, just not quite prepared for combat injuries like the other services that are doing it every day. Why not follow the USN model and not create our own. If its good enough for the USMC, it certainly is good enough for us. And it only takes 3-4 days to take the course -- and you can go to that link lsited in that previous posting for self update.

If you have info on this wonderful mystery program, send it to BTDT. He seems to have the training and ability to make it happen in a unit that is gonna go do it for real some day.

Check out ask.com or google and type in TC3 this is the Tactical Combat program the CG is supposed to move suit to. My supervising MO went to the conference a while back and brought us back some cool tools that will be tools of the trade.
The idea behind it is to qual all the HS's to be able to teach their crews TC3. They will all don a self saver kit that fits in a small pack on their side.
That is all I have heard. THis medical officer is a DMOA for MSST 9111 Anchorage. Not sure where we are at in developing policy in it perhaps there is an HS out there attached to an MSST, ect unit that can elaborate, there was a message that directed the HS to purchase the TC3 kits for the units so that sounded pretty forward motion to me???
Perhaps some of that helps.

That's great news. I looked online and some of the searched links did not work but one lead to a Navy Times article about the program and it seems to be right in line with what the USCG needs. As long as it covers what it needs to cover in 2 days and is compatible with other DOD units that sounds like it will work. It probably works with the kits we carry on our gear -- tourniquets, quik-clot, bandages, decompression catheter, and nasal airway. Hopefully the TCCC covers IVs as well -- essential to save the somewhat stabilized wounded soldier.
Hopefully the HS community can make this happen and get it out to the DOG units ASAP.

quote:

Originally posted by BTDT:

My question for the HSCS was where on the West Coast he is teaching and what unit he is with so I can coordinate some needed classes out here.

He is teaching it on the East Coast in Norfolk. It is combat first aid training for folks going to the sandbox. Training is a few day. HSCS Swanger is stationed at MLCPAC KOM. Hope this helps.

HSC Kulbeth

Bob,
What in the world is that avitar picture????
Chris

So George does not get confussed anymore. He will now know when CGBoatDocTrainer makes a post.

Big Bob

Someday I will be that huge. NOT!!

HSC K,

Thank you.

Runsprocket,

That would be/should be the IFAK kit that is standard issue. I do know that the CG has taken out some of the items and training that TC3 covers.