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Are there any Army Paramedics, or are they just EMT-B or EMT-I? I am in the Coast Guard and I am getting out to become a Paramedic. If I join the Army can I be a Paramedic or will I just have to be an EMT-B. Thanks
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You would be a 68W - Health Care Specialist, AKA Combat Medic. |
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If your a paramedic, it's a crap shoot if it will help or not. A good friend of mine in the RA is a paramedic, gets him no where. I'm a paramedic in the NG, I ended up with alot of added duties at my unit, especially for my rank. The only thing it is good for is theoretically you are supposed to be advanced to week 7 of training down at Fort Sam if you have NREMT. However, as was my case and about 10 others, the admin NCO for Echo company is a lazy POS completely dropped the ball getting our paperwork going. Ended up sitting on our butts for 4 weeks waiting to start training. "advanced" all of 3 weeks. You need to push them everyday to get you advanced. Don't take anyone's word for it that it's being taken care of. Do it yourself, and pester them everyday. That's how we finally got it done.
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As you probably already know, all of the medics in the Army are EMT-B. Some instillations teach the EMT-I (1985 standard). The medics in the special operations community have the opportunity to attend a six month paramedic course taught at Fort Bragg. You will usually hear this referred to as the ranger medic course, or W1. If you find that you like working with an advanced skill set, perhaps you should look into a special operations unit in the National Guard.
MIKE |
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No you will not be a paramedic in the Army as it is not a recognized skill set. Here is the cold hard facts. The military has what is known as it's "cannon fodder" medical personnel (PA's and all Enlisted Specialties, 2yr RN's who must work as enlisted etc) and then it has it's "professional" providers (RN's and Physicians and nurse practicioners). You see if the Army recognized your skills as a paramedic they might have to "gasp" pay you more. This is the same reason they allow combat medics to get away with all kinds of stuff on the battlefield in order to save a life (cause golly gee we don't want to have to send our more highly skilled folks to the battlefield they might have to gasp get shot at, then we won't be able to attract them in). But heaven forbid these highly trained "enlisted medics" so much as pick up an IV bag in a hospital and get that gleam in their eye. Hospitals you see are for the "skilled" priviledged "providers" to work in. This is why RN's and physicians in the Army tend to work on retirees and mommy's having babies and never get sent down range. It is why enlisted medics can't stand these clowns who think every damned front line aid station should run as a hospital ward in the states with superior trained personnel (again as long as it is not them). So no your medical skills will never be recognized by the Army, heaven forbid one of their "cannon fodder" medics have the same skill sets as do their "intellectual hospital staff". That would break the status quo. Better off getting a paramedic job on the outside where your skill sets are recognized, well publicized and known about (you would be surprised at how many Army doctors and nurses don't even have a friggin clue as to the skill sets of their enlisted "combat medics") and compensated for. Of course the Army will never admit to this little factoid publicly but ask nearly anyone it is the experience of many highly trained enlisted medics everywhere they go, when they have to constantly prove through CBR folders, CBO training, CMAST training, 6 week hospital "orientations" etc that they just might have some of the same skills as do their degreed hospital REMF counterparts.
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What kind of special ops are in the NG? I will be to old (30) when I complete Paramdic school to try and become a SF in the regular army. Would Ranger be another way to try to go or will it be the same as a regular combat medic? As for ronald45's remarks, I have thought about getting a job on the outside, but I love the military. I am in the Coast Guard and its not very "military" if you know what I mean. I just hate to get out after I have been in 10 years. I am an E-6 now, but I have no problems starting over in the Army if I would have some good career choices. |
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SFC Ronald G Pritchett,
LOL, your post was rather entertaining, to say the least. You certainly have some built up animosity against the officer side of the AMEDD house. First of all, your "cannon fodder" medical personnel; PA's and 2yr RN's as enlisted specialties is just flat out WRONG. A PA [physician assistant, 65D] is an Army Medical Specialist Corps officer. A 2yr RN is most likely a commissioned Army Nurse Corps officer in the Reserve Component, and not an enlisted nurse. Then, you rant on how combat medics get away with all kinds of stuff on the battlefield, again your WRONG. Combat medics "on the battlefield" follow a scope of practice & standards of care, i.e. CMAST [TC-3]. Next, you complain about a medics limitations within a MedCen regards to IV administration. Even in the civilian setting you will not have EMT's hanging IV's, unless maybe working in an ER. However, Paramedics, per scope of practice on the streets, start peripheral/EJ IV access, as well as administer ACLS drugs. Yet, I'd venture to say a Paramedics scope of practice is different inside the hospital setting vs. on the streets. You mentioned AMEDD Docs & RNs "never get sent down range." Really? LOL, what the hell was I doing in Iraq for 15 months? I guess our Mass Cal with over 70 injured & 8 deaths was just my imagination. Yes, I've worked with both medics & M6 Soldiers while deployed to Iraq that had great clinical skills. I am well aware of the "skill sets" of an 68W. However, you fail to realize, or accept, each level of AMEDD health care member, whether that be a 68W [medic], 68WM6 [LVN], Army Nurse Corps officer [RN], or AMEDD MD each have a specific scope of practice to follow. This also holds true in the civilian health care sector. In fact, the AMEDD closely follows the applicable civilian health care standards of care & guidelines. I thought the AMEDD was one team, and not AMEDD enlisted vs. AMEDD officers? - Cary James Barrett, CPT, AN This message has been edited. Last edited by: ANCofficer_USMCvet, |
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[QUOTE]Originally posted by ANCofficer_USMCvet:
SFC Ronald G Pritchett, LOL, your post was rather entertaining, to say the least. You certainly have some built up animosity against the officer side of the AMEDD house. First of all, your "cannon fodder" medical personnel; PA's and 2yr RN's as enlisted specialties is just flat out WRONG. A PA [physician assistant, 65D] is an Army Medical Specialist Corps officer. A 2yr RN is most likely a commissioned Army Nurse Corps officer in the Reserve Component, and not an enlisted nurse. Right you are PA's are not enlisted, however they are about the ONLY officer you will find in front line aid stations outside the battalion surgeon (and they have 2 year programs unlike the physicians). 2 year RN's must join the Army as enlisted (not even Reserves take them now) cause the Army will not recognize their skill sets. Then, you rant on how combat medics get away with all kinds of stuff on the battlefield, again your WRONG. Combat medics "on the battlefield" follow a scope of practice & standards of care, i.e. CMAST [TC-3]. Granted, however their scope of practice on the battlefield is MUCH GREATER (IV push of narcotics such as morphine and antibiotics, needle decompression, airway insertion, suturing, surgical airway insertion etc) than what they will EVER be allowed to do in a hospital, such as start IV's. Why then does the Army Nurse Corps turn a blind eye to such practices in one set of circumstances (the battlefield) and holy hell breaks loose when they try to do the same in a hospital setting, never mind they have been trained and in both environments the standards are the same. Why is their scope of practice LIMITED in one environment and not the other (other than ANC Officers DO NOT accompany Infantry and Combat Arms Soldiers on the Battlefield) So if "only an RN" can do such things in a hospital why isn't it "only an RN" can do such things on the Battlefields, other than the ANC will not send them downrange (and as such I mean to a battlefield not a CSH or some other fixed facility in a war zone) Next, you complain about a medics limitations within a MedCen regards to IV administration. Even in the civilian setting you will not have EMT, Paramedics hanging IV's, unless maybe in the ER. Once again you are correct, but a warzone is not exactly a civilian setting is it?? So why can they get away with it in one area and not another?????? That is is the question??? Other than as stated if we let medics do in a Medcen what they can do on the Battlefield the Army might just find itself NOT needing as many of those ANC slots they have. You mentioned AMEDD Docs & RNs "never get sent down range." Really? LOL, what the hell was I doing in Iraq for 15 months? I guess our Mass Cal with over 70 injured & 8 deaths was just my imagination. Again when refering to downrange I meant on the battlefield with the combat arms Soldiers assigned to their Platoons, AMEDD Docs and RN's are sent downrange but not in this capacity as are the combat medics, who again find their scope of practice severly limited by those AMEDD Docs and Nurses when they leave the battlefields and return to the Medcens. Again that is the question why does their Scope of Practice change from one setting to the next?? Other than JACHO standards which again was placed in military healthcare facilities by those VERY SAME AMEDD Officers?? Yes, I've worked with both medics & M6 Soldiers while deployed to Iraq that had great clinical skills. I am well aware of the "skill sets" of an 68W. However, you fail to realize, or accept, each level of AMEDD health care member, whether that be a 68W [medic], 68WM6 [LVN], Army Nurse Corps officer [RN], or AMEDD MD each have a specific scope of practice to follow. This also holds true in the civilian health care sector. In fact, the AMEDD closely follows the applicable civilian health care standards of care & guidelines. Which is the problem under these civilian guidelines which are only in place in the US, but we know find ourselves having to adhere to in 3rd world countries where such guidelines don't exist, the combat medic finds his skills limited. If we are going to apply such standards why do we do so when it only BENEFITS the AMEDD?? We adhere to JACHO policies in hospitals and clinics but not battlefield medicine? So what happens is combat medics who are assigned to hospitals lose valuable skills when assigned in areas where they cannot practice those skills, find themselves on those battlefields where such skills are needed. As such the combat medic who hasn't been able to start IV's in the hospital because of JACHO standards, now must do so to save lives on the battlefield but can't. Why because those skills were allowed to atrophy whilst assigned to the hospital. It makes more sense to allow medics to practice and use these skills in fixed facilities UNDER the supervision of nurses and physicians, before they find themselves on the battlefield facing life and death situations where such skills are needed. I thought the AMEDD was one team, and not AMEDD enlisted vs. AMEDD officers? At one point I thought so to Sir, but that would no longer seem to be the case once the AMEDD Officers signed off to let CIVILIAN agencies tell us how to run our show. in MILITARY hospitals. Hopefully this helped explain my position a little bit. |
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SFC, you said "Paramedic skills will be WASTED in the military unless they were to attend a course and MOS such as 18D." So in your opinion would you suggest I not go to Paramedic school when I get out of the Coast Guard. Instead enlist in the Army and try and go SF? If I enlist when my Coast Guard time is up I will be within the age limit. My only problem with that is, I heard in SF you are picked out if your unit training to be SF. Meaning I can complete all the PT and everything else that is required and still not be picked. That would suck. I have 8 months left in the Guard and I know for a fact if I start training now I would have no problems. I have even bought Army books on land NAV and all that other soldier stuff (
 ) that us Coasties don't know; just to get ready for the Army if I go that route. Its just the unknown I don't like. If I passed everything and was guaranteed a spot that would be different, but from what I hear it is not like that. |
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It depends on what you want to do, if you want to join the Army as a medic and then use the medical skills learned there as a building block towards being a paramedic, then yes it would be a good move. However, if you want to become a paramedic FIRST then join the Army thinking those skills will be of use in the Army then forget it unless you try for a "higher grade" of medic like SF. Otherwise, you would have to try for PA.
The Army currently has no enlisted medical program that would use your skills as a paramedic outside the 18D route. You can enlist for an SF MOS but if you do not meet the training requirements then I think you are pretty much "as needs of the Army dictate".. My suggestion is find out what you want to do, if you want to be a paramedic, then when leaving the Coast Guard I would go that route only. If you want to join the Army I would do that. However it is when trying to do BOTH that you will be dissapointed, unless you use the Army (combat medic, 68W) as a stepping stone towards a paramedic as many have. The Army really has no program on the enlisted side other than again SF higher than probably EMT-I. Anything higher than this (EMT-P) in the Army and you are better off as a Physician Assistant or a degreed program. Hope that makes sense to ya. Good luck whatever route you decide to embark on. Have you looked into the Navy?? They have what is known as an "independent corpsman" that is more along the lines I think of a paramedic in the enlisted side of the house. But that is outside my area. |
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My wife is a GS-10 [civilian RN] at an Army MedCen. Even she does not like how some things are done. I can see your points, skewed as they may be. At any rate, your gripe should not be against ANC officers. BTW, I'm positive ADN RN's can be commissioned into the USAR ANC. True, an ANC officer w/o a masters degree will not be eligible for Major. Yes, I as an ANC officer would most likely never be assigned to an infantry unit. The combat medics primary role is with a line unit to stabilize an injured Soldier for transport to a higher echelon of care. You make it sound as if a medic can perform surgeries on the battlefield, which is far from accurate. Even at a BAS you have PA's, which are now graduate level programs, btw. The medic is trained in immediate first responder type medical care, but the goal is to stabilze for transport. You did not mention about FST's which have RN's. You did not mention RN's that work in ER or ICU that are also trained in immediate life saving skills, as well as a scope of practice that extends from immediate to acute to long term care. When a medic is placed outside the role of the "battlefield" the applied skill set no longer is black & white. This is the same as a Paramedic on civilian streets, i.e. your not going to see Paramedics working on a hospital Floor. However, in a civilian ER hospital setting you will see RN's doing triage, etc. IMHO, your frustration of the medics scope of practice in the hospital setting is being transferred inappropriately towards ANC officers. This message has been edited. Last edited by: ANCofficer_USMCvet, |
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Highly Experienced Member Ex-Moderator, Fired For Cause Highly Experienced Member |
Several points of order:
1. As mentioned briefly above, a PA is not merely a "2 year program," implying that someone could conceivably go from high school to PA in two years. A PA is a post-graduate level degree (in many cases granting a Masters as well as the PA credentials) - that requires a four-year degree prior to commencing study. 2. ADN RNs may be commissioned in both the Reserves and Guard. In order to be promoted to field grade, they must have at least a Bachelor's degree - optimally, a Master's. Active Duty direct commissions require a baccalaureate degree; promotion to field grade requires a Master's. 3. Most ANC officers are female, not male. As such, they are prohibited from assignment to combat arms units. However, there are currently a few male ANC Adult Nurse Practitioners who are being attached to these units in traditionally MD/PA slots - because they are male and have the skill sets (as you call it) and credentials to do the job. You sound as if you expect to be able to do everything from sticking on a band-aid to full thoracotomies, regardless of environment. If you want to do that, go to medical school and spend four to eight years or more of your life in studies and residencies, and lay out a couple of hundred grand to do it. Speaking from a strictly dollars-and-sense standpoint, your "cannon fodder medics" is not totally wrong. If I were a bean counter (and I'm not), mentally I'd be adding up, "Hmm ... how many medics can be trained for the cost of a single surgeon? Which one is a higher fiduciary risk if he/she is lost?" No contest. The medics hop in the humvee or go out on patrol ... not the doc. |
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 I was hoping you would chime in  |
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You sound as if you expect to be able to do everything from sticking on a band-aid to full thoracotomies, regardless of environment. If you want to do that, go to medical school and spend four to eight years or more of your life in studies and residencies, and lay out a couple of hundred grand to do it.
Not at all but I would think that if I can give an IV on the battlefield I would be able to do so in a hospital (in many instances not the case). The same holds true for passing out tylenol, motrin, OTC medications. Draw blood, give immunizations, insert oral/nasal airways and combitubes, and analgesic narcotics such as morphine. You both know that such life saving skills are taught combat medics, you also are well aware that it is by and large the ANC that limits medics from performing such skill set in the hospital. Wish I could say otherwise, but it would be nice if most ANC Officers knew just what the skill sets of most combat medics are, instead of regulating them to nothing more than vital sign takers and b*ttwipers in medical centers. Let me give an example if a combat medic was to insert a combitube on a patient on the battlefield and save their life, they would receive all types of accolades for doing the right thing. If that same combat medic was to be the first responder in a hospital dining hall for instance and attempt the same thing they would more than likely be railroaded out the Army. When in reality what changed?? Both lives were in danger and in both instances the medic responded AS TRAINED to the situation. This is my issue, it would seem because the medic is the only person on the battlefield, such actions would not be an issue (because the AMEDD would never place an RN or physician on a platoon level) but let the medic do the same in a hospital where RN's and doctors are and see what happens. The skill sets change when RNs and Physicians are around for the medic, but they are the only ones where this occurs a Physician's skill set stays the same regardless as does the RN, only the medics change depending on location. In addition it is not even a STANDARD location as in some hospitals medics can do more than in others. Again it is only the medic who's skill set changes by virtue of "who's in charge" than by knowledge base or some other measurable factor (degree, skill set, priviledges etc). If an RN in Tripler says start the IV the medic can, if an RN in MAMC says they can't, then they can't. Even though they did not lose that skill when they changed location. This results in an RN being able to do the same job no matter where they work. Yet a combat medic must have a CBO folder, a test, etc, etc, etc. to PROVE they can do the same thing they have been trained in every time they move to a new duty location. I guess it boils down to most combat medics worry about saving a life first then the legal consequences. The same can pretty much no longer be said for the ANC,who are more concerned with meeting JACHO standards and who is licensed to do what. Instead of who has the skill set (licensed or not) to perform the lifesaving measures needed to be performed. What we have instead is combat medics relagated to performing the "menial jobs" in the hospitals while their medical skills suffer, simply because someone is misinformed as to what it is then men and women can do. I could care less about being a physician. What I do care strongly about are my skill sets changing simply because the environment I find myself in changes. And the fact that we now seemingly apply American hospital JACHO standards to 3rd world COMBAT operations. (. This message has been edited. Last edited by: ronald45, |
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Highly Experienced Member Ex-Moderator, Fired For Cause Highly Experienced Member |
Your hospital dining room scenario doesn't hold up, because the first person on the scene with the training to intervene gets to do so. If that's a medic, then fine with me.
However, in a hospital/clinic environment, where there ARE standards to be met and licenses are on the line, then you're right - he/she who holds the highest license generally calls the shots (no pun intended). I would not let a medic administer IV narcotic analgesics because once a person is hospitalized, many more variables are at play. In the field, some guy wounded by an IED usually doesn't have any medications on board that might interfere with their action, positively or negatively. In the hospital, what's in that IV? What meds is he on? Does he require vasopressors to keep his BP up? And you want to just pop in and push some morphine? Not on MY patient you won't! And not under my license! It's my patient's welvare, my azz, my license and mycareer (in that order) on the line if you screw up - as well as yours. Even in the field, you know there are limits to what you can do - drama from Black Hawk Downnotwithstanding. Stuff like that happens, I know, but even that's a rarity. You may be able to administer morphine, but are you giving it IV? When you "pass out Motrin," do you tell people about the side effects of prolonged use, especially at higher doses? I doubt it. An RN can delegate tasks to LPNs, CNAs, medics and even unlicensed personnel (depending on the task), BUT ... the RN better be damn sure the person has the skills, training and experience to carry them out. Performing a task may be delegated, but responsibility for it is not; it stays right here with MY license. This may come as a shock to you, but competency testing is done to RNs all the time, too. Just because a 2LT was certified to start IVs at WRAMC doesn't mean he/she can walk right in and do the same at BAMC or anywhere else. Any self-respecting head nurse (or whatever the current inflated title is) will evaluate a newbie's skill level at specific tasks, and that goes for all personnel under his/her supervision. If you don't measure up, back to Nursing Ed you go for remedial training; if you do, then carry on. And for the record, the acronym is JCAHO, not JACHO. |
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What I would like to see is the combat medic finish AIT with an EMT-I certification, instead of EMT-B this would be more on par with what they are truly taught. However I also understand that with today's immaturity level just getting them EMT-B qualified is an issue in itself. Then factor in it is the 2nd largest MOS and the Army needs to churn em out in droves just to keep up now days. I also would like to see two seperate distinctions, one a combat medic assigned to the front lines, and two a "healthcare specialist" working the CNA route most combat medics are assigned in the hospitals. Of course that would cost $$$$ require more training and all the other naughty words AMEDD doesn't like to hear.
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Okay, but these suggestions are out of the hands of Army Nurse Corps officers, especially company grade. Again, I appreciate the 68W & M6. However, as Cider33Alpha posted RNs have there license to protect. Some, maybe most, whiskeys & M6's have great battlefield, as well as clinical skills. However, the 68W training is not focused on critical care thinking past the first responder mode. This is NOT a put down. The RN is tasked with overshadowing a M6 in the MedCen, i.e. sign-off assessments, start blood product admin for first 15 mins., push IV meds, etc. Plus, the RN has there own assigned patient's. While I was in theater deployed with a CSH [yes, not w/Line Unit] the M6 did not have to have there assessment's co-signed but still the bld prod admin, IV push rules were in place. HOWEVER, these rules of standards of care & scope of practice are not in place because RNs want to belittle the M6. A lot has to with the formal education received, and degree/license which accompanies such. IMHO, even though the M6 has the same scope of practice as there civilian counterparts they are afforded way more health care experience opportunities. In a civilian acute care setting [not VA or military MedCen] you will see very few LVNs. MOst civilian LVNs work in LTC settings. Yes, LVNs with experience can have great clinical skills. Yet, the critical thinking aspect usually [NOT ALWAYS] is subpar to RNs. SFC, I do wish you would hate the game & not the player. In otherwords, don't hate the AMEDD officers. I can only speak for myself, but to me health care is all about team work & collaboration. Some of the duty levels are defined in black & white, some mesh together, and some are gray areas. BTW, I've noticed that some states [civilian nurse] are very rigid, while others a little more broad as to the scope of practice for LVN's, as well as RN's. I mention the civilian nursing d/t health care is health care regards to standards of care. True, the military as it's unique environment but still, for the most part the civilian & military health care guidelines run parallel. |
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You can not be serious. I can not comment on military medicine as I was not a medic in my service time. With that said I am a firefighter/paramedic in the civilian world. I have worked in a very busy county fire/rescue with heavy inner city time. Saying "Even in the civilian setting you will not have EMT, Paramedics hanging IV's, unless maybe in the ER." is insanely wrong. No your not going to see an EMT-B start IVs or give meds but as a paramedic starting IVs and giving meds is our bread and butter. I start IVs and external jugular IVs and administer meds, and I'm not talking about NS bags, but the full scope from anti-dysrythmics to narcotics....Hanging nitro drips on STEMI patients to cordarone and lidocaine infusions for wide complex v-tachs and maintenance drips following conversion from a VF or pulseless VT...Dopamine drips @5mg/kg/min at 3am to that heart failure patient with a BP of 50/p... I also work part time in the ER of a level I trauma center/burn center/pedi trauma center as a PRN medic. On the streets I work withing the protocols outlined by my medical director but I am still a clinician and an extension of that physician. |
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_______________ My apologies, my error in wording. I meant to say... Even in the civilian setting you will not have EMT's hanging IV's, unless maybe in the ER. However, on the streets a Paramedic will start peripheral/EJ IV access, as well as administer ACLS drugs. Yet, I'd venture to say a Paramedics scope of practice is different inside the hospital setting vs. on the streets. BTW, you are not saying in the ER of a Level I Trauma Center as a PRN medic you perform the same clinical skills as you do on the streets as a paramedic, correct? This message has been edited. Last edited by: ANCofficer_USMCvet, |
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