Johca, I am moving this discussion from the SERE thread for obvious reasons.
I will answer your questions here.

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The IDMT was introduced into this thread as being a highly trained SERE-medical asset having purpose of participating in and performing high risk rescue operations and missions. The question (or rather confusion) of SERE and SERE-IDMT contribution to the non-aircraft weapon system GUARDIAN ANGEL was concurrently introduced. This was answered in my first response, the medics at the SERE school are NOT SERE instructors nor do they contribute to Guardian Angel. I never implied that, nor does the offending video. It's safe to say we agree on this.

In regards to Guardian Angel it is certainly clear few here understand the operations, support, and functional administrative aspects. Additional uniformed opinion providers failed to clarify the SERE-IDMT’s primary role is safety of the staff and students and not SAR. Wrong, they are duel hatted. They support medical operations for students and staff and they support SAR operations. I think this is pretty well established also.

The video was brought into the conversation, but no effort was made to clarify the inaccuracy of: (1) SERE IDMT MEDIC is hands down the highest trained Medic in the Military; So they think...I know PJ's who think the same. I take it all with a grain of salt.(2) They are SAR, Swift Water Rescue, Rope Rescue, Helo Rappel, Field medics who function in the woods or austere locations through a variety of conditions; and, True statement (3) IDMT's - the best the military has to offer. Again, I take statements like this with a grain of salt.

SERE eligibility for the parachutist qualifications (Static/FF/HALO) does not come from being assets employed to participate in operations and perform missions but rather from being trainers who train and doing equipment testing and evaluating. There is no implication on the video that they jump and I never implied they did...irrelevant. The IDMT has no duty performing eligibility for the training advertised in the video and more importantly they do not respond into the civilian jurisdiction as an operational military asset to perform physically difficult SARs in hardship or demanding environments. I think you have found this is untrue just by taking a look at others posts.

All AF IDMTs whether deployed independently or attached to a Squadron Medical Element (SME), or doing whatever expanded role they may think they have are first and foremost members of the medical community and are always leashed to a medical unit and a PHYSICAN PRECEPTOR Leashed? Meaning medical control? Yes to some extent, either in person or by comms (more often by comms) It's nice to have back-up advice when your in the middle of BFE. You do know PJ's are also afforded this if they are far forward and cannot get a patient back quickly. Someone on the team is going to have some sort of Comm In most situations and circumstances the IDMT is restricted to practice within the confines of the DOD Healthcare System and limited to providing treatment only to active duty members. Again, mostly true statement. At home (States) I operate as a Paramedic, as do the SERE Medics...excuse me...medics who work at the SERE school.
The scope of care parameters that the IDMT is expected and trained to work within is not the civilian emergency responder arena. The IDMT isn’t trained or identified as an asset to perform combat medic or combat life saver duties. This is a bit odd. I understand what you are getting at about "Combat Medics", we aren't shooters, never implied we were. But unable to perform CLC? Your kidding right? CLS is simply a little more hands on version of SABC with IV's thrown in. It's a better version of SABC that I wish the AF would adopt, and is taught to NON-MEDICs. Your saying an AF medic cannot perform CLS? I better turn in my CLS instructor card. The IDMTs purpose is to provide clinical medical support to include medical care according to established step-by-step protocols (THE AIR FORCE INDEPENDENT DUTY MEDICAL TECHNICIAN MEDICAL AND DENTAL TREATMENT PROTOCOLS)

All members of the enlisted 4N career field to include IDMTs are considered nursing assistants. Wrong, I will explain later. That’s the purpose of the “N”. In the hierarchy of military medical providers the 4N IDMT resides where?

The top of the feeding chain is the physician, all others are below the physician. Below the Physician in the AF military medical hierarchy are: PHYSICIAN ASSISTANT (Orthopedics/ Otolaryngology/ General Surgery/ Perfusionist/Emergency Medicine/ Oncology/Bone Marrow Transplant) and Nurse Practitioners (women’s health/pediatric/adult), Nurse (all other commissioned nurses), IDMT (Enlisted 4N) and all other enlisted nursing assistants Your just being condesending. A slick 4N is a hell of alot more than a nursing attendant.

Let me break it down for you. On completion of IDMT school the 4N071C is realligned under the hospital SGH (the head Doc). The SGH is in charge of all credentialed and non-credentialed (IDMT's) providers. The 4N071C is alligned under the medical corps and is interchangable with PA's on UTCs.

Pertinent to the military medical community hierarchy and autonomy to be an emergency responder are not IDMT’s: Where do you think the "Independent" of IDMT comes from? We are trained in our school to respond autonomously. Why else do you think we deploy by ourselves? Of course we are emergency responders. What, do you think we call PJ's if something happens on base/site/field?

1. members of the medical community at all times? Ummm? Yes.

2. aligned functionally as nursing assistant care providers even when attached to a Squadron Medical Element or performing duties independently? You have 44-103, read it. I shouldn't have to explain something you have actually posted.

3. limited to the confines of the DOD Healthcare System and specifically active duty patients under direct supervision of a Nurse or Physician unless given specific authority to practice independently? Only Physicians can precept IDMT's. Under no circumstances can nurses or PA's precept IDMT's.

4. are required to obtain and sustain civilian level of certification of EMT-B? Yes. Do you really think thats all basic 4N's and IDMT's are? The NREMT doesn't meen jack in a military setting. We are military medics, not civilian EMS. The Navy doesn't even bother with NREMT for their Corpsman. They have no "civilian" certification in regards to EMS. Are you going to tell me Corpsman are nothing more than "nursing assistants"? Navy produces some fine medics. Guess what, if you look at thier basic "A" school and compare it to the basic 4N school...they are very similar. Even SOCOM did away with the NREMT. They deemed it a waist of time for military medics.

To my knowledge no state has an IDMT license or certification. The civilan medical responders, other than licenced physicians and registered/certified nurses, scope of emergency responder practice all fall under EMT certifications.

The 4N IDMT is not required to hold EMT-P certifications and relevant to this how many AF IDMTs actually hold a current civilian certification higher than EMT-B (5%, 10%, 50%, 75%, 100%)? Higher than EMT-I? I would swag about 40%.

When participating in the expanded role of performing a civilian SAR is not the IDMT’s or any other enlisted 4N’s ability to provide care limited to the level of their civilian certification?
True, the SERE Me....sorry, IDMT's that work at SERE, are paramedics. They operate at that level during civilian rescure. Just like P....oh nevermind.

quote:

Originally posted by MorsGod:
This was answered in my first response, the medics at the SERE school are NOT SERE instructors nor do they contribute to Guardian Angel. I never implied that, nor does the offending video. It's safe to say we agree on this.

I never said you did. However, my response was pertinent to the Guardian Angel-SERE-IDMT connection made in the discussion and also the confusion about SERE-IDMT being an AFSC or a Special Experience Identifier duty and the training and qualifications the SERE-IDMT is required to get. The answer cannot be given without clarifying what IDMT duties is and isn’t. The answer regarding a medic being part of a non-aircraft weapon system (Guardian Angel) weapon system cannot be clarified without getting into discussion of the medics non-combatant military status which is directly connected to a protected status that hinders, limits, and restricts employment to directly participate in and directly contribute to the accomplishing certain types of military operations.

BTW- among other purposes non aircraft weapon system designation clarifies responsibilities for all using and supporting organizations, sustains force structure, and establishes higher priority for funding and training. It gives the strongest advocacy regarding capabilities-based planning, programming, and budgeting for designated system-wide unique equipment, upgrades/modifications, initial spares and other weapon system-unique logistics issues, and follow-on test and evaluation (follow the money and the mission ready qualification requirements).

The SERE-IDMT video is not offensive but it makes a false capabilities statement. Besides misinforming with half-truths it is very misleading to those who know very little about military job and missions and specifically Air Force jobs and missions. The boast “If you do not hear much from them it's because they are not screaming from the rooftops this is "What we Do" because they are too busy,” is a very strong comparison statement. There are very few military jobs the comparison is being made with.

The SERE-IDMT video does not directly state much, but the duties narrative published with the video is an exaggeration that when combined with the job title SERE-IDMT describes an inaccurate and untrue operational capability the 36th Rescue Flight is tasked to provide when AF RCC or local base authority gives unit a civilian SAR tasking to accomplish.

The extent of capability the flight surgeons and medic provides is more appropriate described as emergency air evacuation rather than rescue. The level of search and rescue abilities and capability the IDMT, flight surgeon, or any other enlisted medic that flies on the 36th Rescue Flight UH-1N helicopters is on-the-ground rescue capability and ability.

The UH-1N units have been a strange SAR/local base rescue management problem for the Air Force (previously HH-43s). At the draw down of the Vietnam War they were inherited by ARRS and suddenly in addition to Range Support/Missile Field Support picked up the MAST mission. Many suddenly had PJ teams assimilated into them. Fairchild was no exception. However, some units such as the one at Mt Home picked up deployable CSAR UTCs. Although the PJs at Fairchild did, the UH-1Ns didn’t. Some of these units also didn’t get PJ teams assimilated into them (examples: Ellsworth, FE Warren, Vandenberg, etc). At these units SARs were done by Flight Surgeons and Med techs. The PJs would go to these units and give the simple up and down the hoist training and the annual flight evaluations. There are plenty of SAR missions in the historical record all similar to what is done today by the IDMTs and Flight Surgeons at the 36th Rescue Flight. This is not the in dispute.

What is in dispute is SERE-IDMT being a duty qualification and the level of other than medical duties participated in by the IDMT on the missions they directly contribute to doing technical or difficult extrication of the patient or to provide site security. The difficult extraction is such situations as technical climbing to include high angle evacuation, river crossing, swift water rescue, High elevation mountain rescue, etceteras.

The search when done by the 36th Rescue Flight is an air search and in this capacity the scanner can be anybody. When arrive at point of incident or patient there is typically no scene control or additional gaining access to the patients being treated, the response provided is focused on injury, illness, and emotional problems of the patient. In this regard if the IDMT has Paramedic qualifications there is or shouldn’t be any difference in the medical care provided by the IDMT or the PJ. However, point of difference is all PJs are required to obtain and sustain EMT-P certifications and the IDMT other than the SEI 455 IDMT-Special Operations Command Medic has no mandatory requirement to obtain and sustain curent paramedic certification.

The SERE-IDMT video and accompanying statement of duties description makes claim to background, training, and experience that is not required to assigned duties of supporting SERE School training operations and providing clinic level medical care access to SERE staff and students at the location of the SERE school. The School and its billeting location is sufficiently separated from Fairchild and with the numbers of students going through it would be too much a disruption sending such a transient population to the main MTF at Fairchild AFB for sick call.

The SAR response supported by the medical element supporting the SERE course requires only knowledge of aircraft procedures and safety. This brings with it standard level of Aircrew SERE training given to all Air Force aircrew members. This certainly does not bring with it any of the additional training given to the PJ to deal with hostile environments and physical hardship situations and circumstances. Certainly not to the level to function in a one or two man team for extended duration away from the UH-1N in the way the PJ is required to be prepared to do and is also given the equipment to do.

The much of the training shown in the video is all informal and not required to perform assigned duties at the SERE School/Fairchild AFB location. More importantly once the informal training is completed, there are no qualification verification or mission ready proficiencies requirements. There is no mission ready standard, unit capability, or SERE-IDMT capability statement saying the IDMTs or flight surgeons will obtain, sustain, and provide such capabilities. There is nothing authorizing IDMTs to perform such operations and there are no risk management protocals put in place to ensure safety of IDMTs performing such operations when tasked to fly a SAR on 36th Rescue Flight aircraft. The only reason IDMTs and Flight Surgeons supporting the SERE school do civilian SAR is because of the existence of the 36th Rescue Flight to support SERE School training operations.

quote:

Originally posted by MorsGod:
Leashed? Meaning medical control? Yes to some extent, either in person or by comms (more often by comms) It's nice to have back-up advice when your in the middle of BFE. You do know PJ's are also afforded this if they are far forward and cannot get a patient back quickly. Someone on the team is going to have some sort of Comm

Yes, and its also true PJs may have communications with a flight surgeon, but it's also a flip of the coin on every mission and not such a protocol obligation as it is for the IDMT. However the leash is also the IDMT being non-combatant military and primary focus to provide clinic level health care to a military population at a encampment or more established and built-up operating location. As a noncombatant military, the privileged status of the medic cause significant legal complications for the medic and the United States when used to commit acts harmful the enemy outside of their humanitarian functions. In this regard the rescue of airmen downed on land is specifically identified a combatant activity. It follows the combat rescue or recovery of hostages and isolated personnel in enemy controlled or occupied areas is also a combatant activity. This is also one of the reasons Army Infantry are being trained as combat life savers and specifically with deliberate purpose not being classified as a medic. If you noticed the combat life saver is also not hampered with obligatory protocol to contact a physician while providing care.

quote:

Originally posted by MorsGod:

This is a bit odd. I understand what you are getting at about "Combat Medics", we aren't shooters, never implied we were. But unable to perform CLC? Your kidding right? CLS is simply a little more hands on version of SABC with IV's thrown in. It's a better version of SABC that I wish the AF would adopt, and is taught to NON-MEDICs. Your saying an AF medic cannot perform CLS? I better turn in my CLS instructor card?

Not at all, you are so emotionally unhinged about my focus on the SERE-IDMT being a fabricate duty title and the claimed other than medical required qualifications it is causing you to make yourself look foolish.

The discussion began with focus on civilian SAR capability. I’m more than capable of getting into aspects of tactical causality care at the point and time of WIA during the fire fight to include the care provided to the patient while still under effective hostile fire. I ‘m both willing and knowledgeable of being able to discuss differences between care under fire, tactical field care, and combat casualty evacuation care and the AF IDMT’s typical involvement compared to the PJ.

“Care Under Fire” is the care rendered by the medic at the scene of the injury while the combat life saver or medic and the casualty are still under effective hostile fire. Available medical equipment is limited to that carried by the individual soldier or the medic in his aid bag.

“Tactical Field Care” is the care rendered by the medic once he and the casualty are no longer under effective hostile fire. It also applies to situations in which an injury has occurred on a mission, but there has been no hostile fire. Available medical equipment is still limited to that carried into the field by medical personnel. Time to evacuation to an MTF may vary considerably.

“Combat Casualty Evacuation Care” is the care rendered once the casualty has been picked up by an aircraft, vehicle, or boat. Additional medical personnel and equipment that has been pre-staged in these assets should be available at this stage of casualty management.

quote:

Originally posted by MorsGod:

Why else do you think we deploy by ourselves? Of course we are emergency responders. What, do you think we call PJ's if something happens on base/site/field?

Nope, not the IDMT's authority to make such a call. If the IDMT is there it was decided by competent authority the PJ is not needed. Who and capability responds to an off-base incident depends on what happened off base. There is no military jurisdiction off base domestically unless it is put in place and authorized by National Command Authority. There is no military jurisdiction or authority off base on lands and territory claims of other sovereign countries unless certain declarations or agreement are put in place, typically at specific request--such as disaster relief, humanitarian request or emergency response--by a requesting foreign government. In this regard I’m aware of military support obligations to domestic civil authorities to make available MTF and other medical assets and capabilities to local EMS. The IDMT is not a rescue specialist and in this regard the military on-scene incident commander is typically never the IDMT or even a member of the medical community. The PJ however has been the on-the-ground on-scene commander until relieved by arrival of other responding assts. (one of the reasons I mention Line NCO authority all the time. The NCO medic as a member of the noncombatant military has no NCO line authority when participating in a operations mission). BTW-you are aware The Civil Engineer (HQ USAF/ILE) is responsible for all policy, resource advocacy, and oversight of Air Force DP emergency management planning, operations, and response to: natural disasters; radiological emergencies; major accidents (including HAZMAT); shelters and personnel protection; camouflage, concealment, and deception program; and NBCC defense programs?

This message has been edited. Last edited by: johca,

quote:

Originally posted by MorsGod:
4. are required to obtain and sustain civilian level of certification of EMT-B? Yes. Do you really think thats all basic 4N's and IDMT's are? The NREMT doesn't meen jack in a military setting. We are military medics, not civilian EMS. The Navy doesn't even bother with NREMT for their Corpsman. They have no "civilian" certification in regards to EMS. Are you going to tell me Corpsman are nothing more than "nursing assistants"? Navy produces some fine medics. Guess what, if you look at thier basic "A" school and compare it to the basic 4N school...they are very similar. Even SOCOM did away with the NREMT. They deemed it a waist of time for military medics.

What bunch of false analogy and argument without substance you are resorting to.

All NREMT certification does is provide public information verification an individual has successfully completed all educational and testing requirements that included demonstrated the ability to perform their medical qualifications competently to a nationally standardized measurement of a scope of practice. The NREMT certification has no bearing in the scope of practice of military medicine, but is does in the civilian EMS and the civilian trauma center practice of medicine. Within the Air Force enlisted career fields it is the AFSC Career Field Education and Training Plan that defines, describes and authorizes what medical tasks the enlisted military member must at all times be qualified to legally perform when holding qualification to do the duties of the AFSC.

I’m aware of the training given to Navy corpsmen and to SOCOM medics. SOCOM may have done away with NREMT but the PJ is a primary National SAR response asset and none of the military medics have such a military to civil SAR response role and mission. There is also the matter of getting access to getting the degree of emergency trauma surgical and other abilities in civilian trauma centers and civilian EMS systems that requires current Paramedic certification, not to mention the liability of providing the level of medical treatment the PJ is expected to provide in the treatment of the civilian trauma patient.

Trying to complicate the discussion in hopes of getting other military medics of the other military services into the discussion is not going to work. It is you that has taken affront in a PJ commenting on AF IDMTS and also took unintended insult that my comments was a comparison of who is the better medic. My comparison concerned rescue specialist qualifications and the required minimum core skills and proficiencies regardless of duty position, regardless of SEI and regardless of skill level commensurate with rank and grade. The comparison showing the accuracy of that opinion can be easily demonstrated.

It is not a matter of what all basic 4Bs and IDMTs are or what other military medics are, it is a matter of the required core tasks for award of 3-skill level, 5-skill level and 7-skill level 4N AFSC. The 4N career field has several specialty standards, but all have a common specialty wide NREMT-B core task requirement. No more, no less.

It is the required core tasks that established the comparison measurement. For IDMT it is the required core tasks in attachments 2 and 10 (to include Special Operations Command Medics (SEI 455) STS of the CFETP 4N0X1/B/C. Please also note the Wartime tasks are the tasks to be taught in the 3-level course when the wartime courses have been activated. Note also lack of clear identification of what qualification or proficiency is required to successfully complete any of the 3-level AFSC awarding courses.

The comparison is the CFETP 1T2XX Parts I and II.

Please note (1) The Parescue Apprentice Course (the 3-skill level awarding training) does not change for wartime; (2) % indicates task accomplished at Pararescue Emergency Medical Technician – Basic and Paramedic Courses, as a prerequisite to the Pararescue Apprentice Course; and (3) all required 3-skill level qualifications obtained in training as either a prerequisites to the Pararescue Apprentice course or for successfully completing the Pararescue Apprentice course are clearly identified.

The require medical core skills are identified on pages 37 thru 40. Do the comparison, the scope emergency medical core tasks and care all PJs regardless of duty position or rank and grade are required to be ready to provide and perform are clearly indicated.

What counts is what do the required core competencies of these two enlisted career fields substantiate? One substantiates nursing assistant standards of care and the other substantiates emergency medicine standards of care.

This message has been edited. Last edited by: johca,

quote:

One substantiates nursing assistant standards of care

That's not true John, those are the requirements of a Med Tech, not an IDMT.
First and formost an IDMT is an "unlicenced military PROVIDER" Whick has the duties of a doctor, not a nurse. This has always been the source of the confusion of just what an IDMT actually is and does.
DEPARTMENT OF THE AIR FORCE
UNITED STATES AIR FORCE MEDICAL OPERATIONS AGENCY
LACKLAND - KELLY
SAN ANTONIO TEXAS, 78226
April 13, 2009
MEMORANDUM FOR ALL MAJCOM 4N0X1X FUNCTIONALS
FROM: AFMOA/SGN
SUBJECT: National Provider Identifier for Independent Duty Medical Technicians, 4N0X1C
1. I’m pleased to announce that as a result of our continued joint effort with Independent Duty Corpsman and
Independent Duty Medical Technician Associations under the Armed Forces Operational Medical Symposium, our
IDMTs are now able to acquire their National Provider Identifier; Type I as “Military Health Care
Provider/Independent Duty Medical Technician.”
2. This is an important milestone for the IDMT career field, this will further help gain recognition/solidify our role
as a recognized non-licensed healthcare provider in the civilian sector.
3. All IDMTs are required to go to https://nppes.cms.hhs.gov and register to get their National Provider Identifier
(NPI), Type I NLT 31 July 2009. MAJCOM Functional Managers will need to provide oversight/tracking to ensure
100% IDMT application completion. This is a no-fee process and is permanent unless the identifier number is
reported as tampered with via fraudulent claims or something of a similar nature. It takes approximately 20 minutes
to register and fill out the application for a NPI. Please see attachment for helpful guidance.
4. To ensure all new graduates of the IDMT course are compliant, course instructors will help them complete this
process on their final day of the class prior to graduation with the following instructions applicable to all IDMTs:
Provide a scanned copy/e-mail of their NPI to the Career Field Manager (joseph.potts@lackland.af.mil), local IDMT
Program Coordinator and your MTF credentialing office.
5. IDMTs who fail to meet this required mandate will be placed in a temporary decertification status. They will be
entered in to a training Status Code “T”; individuals in this code are ineligible for reassignment, promotion or
reenlistment. The commander will evaluate members at 90 days and take appropriate administrative action and make
recommendation to the Career Field Manager for removal of Air Force Specialty Code, reclassified or separation.
6. As a reminder you will need to remember your user ID and password in order to update records, require another
copy or check on your NPI for any reason. Additionally, every time you PCS you’ll be required to update your new
address within 30 days.
JOSEPH L. POTTS, CMSgt, USAF
4N Career Field Manager
Office of the Surgeon General

You should also notice that many IDMT's are also a "-P" (as MorisGod is)
What the IDMT lacks are the military skills that PJ's are required to have.
So what it really amounts to is that if I do a Humty-Dumpty and brake my fool neck I will want a PJ to stabalize me and get me out of harms way. But if my liver decides to turn inside out I will want the IDMT diagnosing the problem. Of course having a doctor in the house would be nice in either case. When it's impossible for the doctors to be there is when both of your services are required.

No one expects a PJ to learn all about internal medicine, dentestry, optimoligy and on and on like an IDMT is suppose to do (15 different AFSC's in all). But then again no one expects an IDMT to jump out of a plane, find and stabalize a patient and then swim out to a ship with that patient like a PJ might just have to do.

Quite frankly, I'll take my hat of to either one of ya. Thank God people like you are around.

This message has been edited. Last edited by: blunder1,

quote:

Originally posted by blunder1:

First and formost an IDMT is an unlicenced military PROVIDER, which has the duties of a doctor, not a nurse.

But at a lesser level than both the Nurse Practitioner (commissioned NURSE UTILIZATION FIELD) and the Physician Assistant (commissioned BIOMEDICAL CLINICIAN UTILIZATION FIELD) You exaggerate the level of the IDMTs authority to practice.

AFI 44-103 describes the IDMT’s preceptor supervised unlicensed scope of practice as: “Performs patient examination and renders medical/dental treatment and emergency care to active duty personnel within the scope of practice established by the 4N0X1 CFETP part II, MAJCOM Supplements to this AFI and AFMAN 44-158. The IDMT provides care in preceptor supervised settings in USAF MTFs and deployed settings. The IDMT can provide care in the absence of a licensed health care provider at remote/deployed settings or in alternate care locations approved by MAJCOM SG (i.e., BMT, OTS)."

The current standard is- EMT-B and paramedic is optional. Scope of practice is more limited than the Nurse Practioner or physician assistant.

For comparison:

AFSC 46N1A/B/C/H, Nurse Practitioners. Specifically Women’s Health Care Nurse Practitioner, Pediatric Nurse Practitioner, Adult Nurse Practitioner, Family Nurse Practitioner, and emergency. Privileged health care providers who use critical judgment to perform comprehensive health assessments, differential diagnosis, and prescribe pharmacologic and non-pharmacologic treatments in direct management of acute and chronic illness and disease. Promotes wellness and prevents illness and injury.

AFSC 42G Performs primary medical care and clinical duties with the direction of a physician. Specifically Orthopedics, Otolaryngology, General Surgery, Perfusionist, Emergency Medicine, and Oncology/Bone Marrow Transplant.

Until there is a change in the CFETP 4N0X1/B/C Parts I and II to include the Independent Duty Medical Technician (4N0X1C) STS there is no requirement to hold and sustain current EMT-P cerification for award and retention of AFSC 4N0X1C and except of a few SOF positions there is no requirement for paramedic either. An SEI is only a special experience identifier and is not a requirement for award and retention of qualified to perform AFSC 4N0X1C core skill level duties.

Pertinent to claim please disclose how many AFSC 4N0X1C the Air Force has and how many the Air Force requires to obtain and sustain current EMT-P certification for retention of AFSC or for qualification to perform duties in current perform duty position, and more importantly how many Air Force IDMTs have current EMT-P certification with a mandatory requirement to sustain it?

quote:

Originally posted by blunder1:
When it's impossible for the doctors to be there is when both of your services are required.

This is the accurate bottom line.

quote:

But at a lesser level than both the Nurse Practitioner (commissioned NURSE UTILIZATION FIELD) and the Physician Assistant (commissioned BIOMEDICAL CLINICIAN UTILIZATION FIELD) .

Oh absolutly! and that is as it should be for both IDMT's and PJ's. Neither of the carrier fields even come close to the medical education level of a Dr or a Nurse. That is why both IDMTs and PJs have stripes on their sleeves instead of bars on their collar.
I would point out however that the "-P" is not, nor was it ever intended to be the end all-cure all of the medical professions. It is a very important plug in the dam, but it isn't the only one. The same is also true of IDMTs

I'm just damn glad that I didn't have to do either one of your jobs, mine was tough enough.

quote:

Pertinent to claim please disclose how many AFSC 4N0X1C the Air Force has and how many the Air Force requires to obtain and sustain current EMT-P certification for retention of AFSC

You would have to post that Q to CMSgt Potts
I do know that they can apply for -I certification upon completion of IDMT school.

(Leaving in the AM for Sheppard AFB and daughters graduation from IDMT school)

This message has been edited. Last edited by: blunder1,

quote:

Pertinent to claim please disclose how many AFSC 4N0X1C the Air Force has and how many the Air Force requires to obtain and sustain current EMT-P certification for retention of AFSC

John
I had the oppertunity to ask that Q while at Sheppard, and the response I got was that CMSgt Potts's desire is that ALL IDMT's will be required to be -P certified in the near future.
However the Med-Group school is schedualed to be moved to Ft Sam Huston next year (the new school is already being built), and it will be a joint school with both the Army & Navy. So the whole thing could easly become a Part-A & Part-B sort of thing like the Navy is using now. As you know the Navy isn't using any EMT certifications at all.

Oh, and my kid is now one of those IDMT thingies

I personally believe the AF IDMTs should have a required EMT-P requirement. My divergence on the subject is desire is not policy and my initial engagement on the subject was a SERE-IDMT exaggeration of duties that didn’t even have a special experience identifier for the day-today duties and operations being claimed.

The SOF-IDMT does have a SEI and the operational tasking are bit more than typical clinic support at a deployed location. The AF IDMT has always been the cream of the crop of enlisted medics in the Air Force; I do not dispute this at all.

Where I do butt in my opinion is operational utilization, especially combat. Unless certain things change there is a demarcation between defensive combat participation and offensive combat operations that was put in-place by the Geneva Conventions and other international agreements after WWII that impose limitations on using Physicians, Nurses, and enlisted medics of the medical service to participate in military operations harmful to the enemy as a combatant. The simple result is this is why the Pararescue AFSC has not been and will never be a medical AFSC. Performing Pararescue duties is the only military classification with in DOD tasked to perform SERE versus teaching SERE techniques and skills. This is why I disclosed SERE-IDMT is nothing more than being a Squadron Medical Element having primary purpose of providing clinical medical care for the SERE cadre and students. The SME supporting the SERE school at Fairchild differs no different from the SME attached to the combat rescue squadrons at Nellis or Moody.

Regarding Paramedic certification and development of Squadron Medical Elements.

There was significant opposition from the commissioned medical professions during 1993-1996 to even require enlisted AF medics to have EMT-B certification. There was even stronger opposition against the PJs (a non-medical service classificion) having more than buddy-care level medical training. Fortunately there were several flight surgeons (Captains, Majors, Lt Colonels) that flushed their military careers down the toilet to ensure PJs retained having such level of medical training to include a required EMT-P certification to get initial award of AFSC and to retain AFSC. It was a significant political war that lasted 4-6 years.

About the same time an initiative emerged to strengthen what has become known as the Squadron Medical Element. Initially it was to become the empire domain of the Aerospace medical Technician AFSC (4F flight surgeon clinic medics) which was subsequently merged (4N-4F-4E) ca. 2002 into the 4N career field (which also includes IDMT). The merger was primarily implemented to reduce the total numbers of enlisted force structure (manpower) in the Air Force Medical Service. Unfortunately at the same time deployments were increasing and it was discovered (as it was found during the Southeast Asia Conflicts and Desert Storm) the 4Fs were significantly lacking clinical skills and that there were more requirements than the Air Force had IDMTs to fill (IDMTs have always sustained an impressive level of care providing skills and the historical records have it documented).

This is what broke through the political opposition preventing EMT-B being a requirement for award of the 4N AFSCs. It also resulted in all enlisted SME positions being converted to 4N positions with goal of “norming” all the enlisted operational public health/deployed operational care providers in the SME to be IDMTs. This norming process is a still in transformation work in progress. I’m not sure however if a functional requirement for all IDMTs to hold EMT-P certification can overcome funding and other difficulties of SME being military clinic health care providers at austere locations rather than “off-base response to civilian emergencies” (not the best wording-the off base/civilian has a demarcation that is difficult to explain in a few words). However, my bottom-line is AF IDMTs are the top of and the best qualified of the enlisted medic classifications in the Air Force.

Also congrats on your daughter becoming an IDMT.

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This is why I disclosed SERE-IDMT is nothing more than being a Squadron Medical Element having primary purpose of providing clinical medical care for the SERE cadre and students.

That is absolutly correct, and ANY medical involvement in a local serch or rescue is done in a CIVILIAN certified Paramedic capasity. The IDMT position was never designed for combat medic types of duty, with SERE or anyone else. Their job is to insure a squadrons operational readyness regardles of where it is deployed to. This can mean insuring that the water supply is acceptible, that the mice/rats aren't the source of a virus, to just seeing that the air crews get the proper amount of sleep. They can treat your blisters, burns, broken bones, and even perform minor surgeries. So an IDMT just might be the 'best friend' a guy ever had.
But IDMT's are not the guys to call when you need someone to shoot their way across the burning desert and get your azz out of the sling. (just a tiny bit of dramatization there)

Sort of off topic, but many of my posts have comments concerning unit readiness and individual personal readiness and pertinent to this is one reason why the Air Force has a Medical Service. Below is an extract from an article published in The American Society of Tropical Medicine and Hygiene.

quote:

IMPACT OF ILLNESS AND NON-COMBAT INJURY DURING OPERATIONS IRAQI FREEDOM AND ENDURING FREEDOM (AFGHANISTAN);JOHN W. SANDERS,* SHANNON D. PUTNAM, CARLA FRANKART, ROBERT W. FRENCK,
MARSHALL R. MONTEVILLE, MARK S. RIDDLE, DAVID M. ROCKABRAND; 2005.

Historically, non-combat injuries and illnesses have had a significant impact on military missions. We conducted an anonymous cross-sectional survey to assess the prevalence and impact of common ailments among U.S.
military personnel deployed to Iraq or Afghanistan during 2003–2004. Among 15,459 persons surveyed, diarrhea (76.8% in Iraq and 54.4% in Afghanistan), respiratory illness (69.1%), non-combat injuries (34.7%), and leishmaniasis (2.1%) were commonly reported. For all causes, 25.2% reported that they required intravenous fluids, 10.4% required hospitalization, and 5.2% required medical evacuation. Among ground units, 12.7% reported that they missed a patrol because of illness, and among air units, 11.7% were grounded because of illness. The incidence of diarrhea and respiratory infections doubled from the pre-combat to combat phases, and the perceived adverse impact of these illnesses on the unit increased significantly during the combat phase. Despite technologic advances in warfare and preventive medicine, illness and non-combat injuries have been common during operations in Iraq and Afghanistan, resulting in frequent transient decreases in operational efficiency.

The historical abstract gives significant insight to purpose of the Squadron Medical Element and the “norming” process of operational care providers in the SME to be IDMTs.