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Revamped Flight Medic Training


17 May 2012
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Good news. Enhanced Flight Medic Training Begins

After over a decade of urgent calls for upgraded training of Army flight medics, it has begun. This article provides some details of what is involved. As noted, Army statistics have long shown that wounded troops rescued by National Guard MEDEVAC crews have a 66% higher chance of survival than if they were rescued by Regular Army MEDEVAC crews. This difference is directly attributable to the level of training attained by the crews and prior trauma experience. Most National Guard flight medics are paramedics in their civilian life, so they have more extensive training as well as daily contact with trauma victims. Even civilian paramedics, however, need additional training to handle military war casualties.

The other area of good news is that flight medics also will be trained for en route critical care of stabilized patients. What most people don’t realize is that a huge percentage of MEDEVAC flights entail the transfer of wounded troops from one level medical treatment facility (MTF) to another. These patients often are hooked up to various types of medical/life sustaining equipment which the typical flight medic is not trained on or certified to use. As a result there is a substantial risk to many patients during the transfer flight that their condition may seriously deteriorate. The Army attempted to address this with the assignment of en route critical care nurses, but as was reported by Col. Robert Mabry in his after action report in 2011 – those nurses had not been properly trained (indeed, many were unaware that they would be assigned to helicopter rather than ground transfer duties) and suffered from weak leadership in the field.

These much delayed positive changes should be acknowledged and applauded. However, I was informed by someone close to the MEDEVAC program that no special program was in place to assure that Regular Army MEDEVAC flight medics scheduled to deploy to Afghanistan in the next year would be enrolled in the enhanced training program before deployment. It is interesting that the early enrollees appear to be among the National Guard crews already providing the higher level of care and achieving the higher survival rates for their patients. Wouldn’t have made sense initially to maximize the number of Regular Army flights medics getting this training – especially those going to the combat zone? [If someone can provide updated information about enrollment policies and timelines, I would appreciate it.]

Note the comment from Army Master Sgt. Kym Ricketts, chief medical non-commissioned officer with the Army National Guard, “It’s advanced, pre-hospital medical care.” The term pre-hospital care is relatively unknown but includes all the medical care provided to the wounded from the time of injury to the time the patient is in the hands of medical staff at a medical treatment facility. MEDEVAC is but one portion of the spectrum of pre-hospital care for the wounded. As discussed in How the Army is slow to meet MEDEVAC Challenges in the 21st Century this also covers Tactical Combat Casualty Care training and doctrine, as well as pre-hospital care trauma registries that track the wounded and their care discussed in US Army Report: 2011 After action report blasts MEDEVAC shortcomings.

The article follows:

Army National Guard medics among first to attend revamped flight medic program
National Guard Bureau
Story by Sgt. 1st Class Jon Soucy

Date: 05.15.2012
Posted: 05.15.2012 14:07
News ID: 88451

580614-1000Army National Guard medics among first to attend revamped flight medic program

By Army National Guard Sgt. 1st Class Jon Soucy
National Guard Bureau

ARLINGTON, Va. – Medics from the Army National Guard are among those taking part in a pilot program designed to revamp the training that flight medics throughout the Army will receive.

Taught at Fort Sam Houston, Texas, the program will provide flight medics with additional paramedic and critical care training and certifications.

“A paramedic provides a higher level of care,” said Army Master Sgt. Kym Ricketts, chief medical non-commissioned officer with the Army National Guard. “It’s advanced, pre-hospital medical care.”

Currently, to be a flight medic, a soldier must be a qualified combat medic and be in a flight medic slot, but since flight medics operate under different conditions those requirements are changing to reflect that.

“The medics need additional training as flight medics as they do a higher standard of care and in a different environment than a line medic on the ground,” Ricketts said.

The program is designed to emphasize that fact and focus on training soldiers on those additional skills needed as a flight medic.

As part of the pilot program and proposed changes, soldiers go through three phases of training specific to flight medic duty.

“The first one is the flight medic phase,” Ricketts said, adding that it can be waivered in lieu of on-the-job training. “Phase two is the nationally registered paramedic [course], which is the longest phase, and phase three is the critical care transport piece.”

The push for making changes to flight medic requirements came from a number of elements, including a study done on a California Army National Guard medical evacuation unit that deployed to Afghanistan with full-fledged paramedics in flight medic positions.

“[The study found that with] having flight paramedics in the back of an aircraft there was a 66 percent higher survivability rate than with a straight [combat medic] that wasn’t paramedic trained,” Ricketts said.

Additionally, proposed changes to the flight medic requirements also mean that graduates of the program walk away with national certifications as paramedics. That provides additional benefits including a greater flexibility with integrating with local, state and other agencies in a disaster situation, she said.

“A citizen-soldier can do their wartime mission as well as their peacetime mission of taking care of their community,” Ricketts said, adding that those certifications are the same received by civilian paramedics.

But the important part, she said, is simply providing the best care possible.

“The benefit is the best battlefield medicine and care that a soldier can get,” she said.

“With the forward surgical teams that are out there casualties are actually having surgical intervention on the ground at the point of injury,” Ricketts said. “Combined with these medics that are able to have this training … the [casualty] will be getting the best standard of care.”

The pilot program wraps up later in the year and will then go through a review process.

“It’s still a pilot program and once the pilot program is through we’ll do an analysis to see what works best,” she said.

Ricketts remains positive about the results of the program.

“These medics are going to affect so many people,” she said. “Not just American forces, but coalition forces as well, and that’s amazing.”

The original story can be found at

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  • This commment is unpublished.
    robin yates · 9 years ago
    I am surprised that this is a new proceedure.I always thought the wounded had medical treatment the second they were loaded.
    • This commment is unpublished.
      AK NG Medic CHAP · 7 years ago
      They have medical TX within minutes of being hit or injured by a line medic or a combat life saver(CLS). Everyone deploying is CLS certified for one year(They have to go through the training annually to claim to be CLS). Line medics are at least EMT-B and taught TC (Tactical Combat Casualty Care) at AIT and undergo more intensive training predeployment. The change is that the Flight Medics are now being taught up to EMT-P with Advanced medical training afterwards. I've been selected to attend next year by my unit and look forward to being getting my Paramedic certification. I've been in the National Guard now for 7 years and have worked in healthcare for around 10 years, including a couple working in an Emergency Room as an ER Tech. I now work in a clinic, as a Community Health Aide(Look it up, unique to Alaska and a very good fit for any soldier looking for a job while serving in the AK NG or after ETS'ing and there are always openings).
  • This commment is unpublished.
    Terri Soave · 9 years ago
    I have been following this chain of events. I was surprised to see Sgt. Ricketts interview. I supported her and the medical unit she was with her last deployment.
  • This commment is unpublished.
    Heywood Jablomi · 9 years ago
    It is a travesty that it has taken this long for these upgrades to finally occur. The training of flight medics has been a joke for decades. Not years. Decades.

    The recalcitrant, parochial, lazy bureaucrats who were content to put combat medics on helicopters and then call them "flight medics" for so many years should be prosecuted for ineptitude.

    And why is it that this training is apparently limited to the National Guard?

    It appears that AMEDD is simply incapable of managing the forces assigned to it. This may not be so surprising, when you realize that leadership and management are not core skills taught in the military medical curriculum. Likewise, the strongest combat warrior leaders in the US Army are not assigned to AMEDD units.

    AMEDD is in need of a total overhaul. Merely improving the training received by flight medics is not enough. It has not been enough for decades. This is no mystery. It is a debacle, and it has been going on for so long that it became the status quo.

    I am not confident that anything positive will happen. After all, both the Army Chief of Staff and the Sergeant Major of the Army never attended Ranger school, the core leadership laboratory for junior officers and managers.

    If the highest leadership of the US Army is questionable and political, how can we expect anything better from lesser levels of command?
  • This commment is unpublished.
    karen · 9 years ago
  • This commment is unpublished.
    Dang · 9 years ago
    OK - let's get one thing straight - the paramedic training currently underway is NOT only for National Guard or Reservists. AND, NO, the NG and Reservists do NOT show up already paramedic qualified - NOR are ALL NG and Reservists already paramedic when they deploy. Currently the class in session now has 28 in it - There are 18 NG and RC; they are from California, Texas, Colorado, New York, Ohio, Oklahoma NG/Reserve. They are either LPNs,Firefighters,EMT-A in their states. Not all are flight medics or have deployed. That means they are currently training to become a flight medic. There is only one EMT-P. There 10 Regular Army.

    Maybe some of those who post with such passion and fervor about firing everyone and "revampting" everything ought to get ALL of the story - spend some time working through the issues to make things happen in Combat Developments and/or the School House - it's not perfect - but there are a lot of hard working patriotic people who work to make it safe and efficient to save lives.

    Currently our survival rates are amazingly high - despite what Mike Yon might say - they are defensible and produced from actual data.

    And the "golden hour" is actually trumped by the "platinum 10-minutes" - that time between "boom" and "call for nine-line." Two Soldiers were saved last week with FOUR amputations - one lost his entire body below the groin - yet he survived - WHY - good medics on the ground who knew how and where to put on tourniquets - and they ARE NOT PARAMEDICS.
    • This commment is unpublished.
      MEDEVACmatters · 9 years ago
      Dang - the article does not say that only NG or Reservists will be trained in the new curriculum. In fact, I have seen a report that stated that it was a 5 year transition plan and intended to primarily train NEW flight medics from scratch. Your description about the members of the new class would seem to reinforce that. It would be interesting to see the actual statistics about the percentage of NG and Reserve flight medics that are paramedics and compare it with Regular Army flight medics. The comment that "Most National Guard flight medics are paramedics in their civilian life" has been written in several publications but without a citation to the source of the statistic. Do you have access to that information? Would you be willing to share it?

      You mention that "there are a lot of hard working patriotic people who work to make it safe and efficient to save lives". I have no argument with that statement. Just as there are patriotic people in positions of leadership that have taken at least a decade to introduce this much needed improvement in training. Nobody is questioning their patriotism or their work ethic. What is being questioned is the delay in reacting to solid evidence that the change has been needed for over a decade.

      Not sure who is posting about "firing everyone and revamping everything". Why is it illegitimate to raise questions about specific patterns of decision-making? Doing so does not denigrate the people executing the missions or their immediate superiors. It merely points out that some decisions are hard to understand in any context.

      You talk about the Platinum 10 Minutes. Indeed that is a concept strongly pushed by the Brits even at a time that AMEDD concluded the benefits of the Golden Hour were a myth. Can you explain why Tactical Combat Casualty Care took over a decade to become a standard of training in the Army when survival statistics and report after report proved it to be superior to then current life saving skills training? If the Army didn't want to jump in feet first, it could have phased it in to non-Special Forces/non-Ranger units and do a "champion-challenger" assessment based on outcomes.

      Related to your last paragraph, between WWII and the mid-2000's the Army policy was tourniquets were the cause of loss of limbs. Then an AMEDD physician did the research that proved the opposite was the case and that led to the development of a better tourniquet and training techniques. Great outcome, but why wasn't this regularly researched in the prior decades? Given the role that hemorrhage plays in battlefield deaths, shouldn't that have been a topic of intense interest? The development of new clotting materials in the past 10 years has been terrific. From a report I read, the Army initially restricted the availability of the agent to medics, while the Marines issued it to every combat Marine. Have the results been studied and policies reviewed?
      • This commment is unpublished.
        Dang · 9 years ago
        My posting was in response to some of the postings directly above it by Jablomi. I can't answer the "why" for delays in changes regarding tourniquets nor blood clotting agents. I'm not privy to those decisions of the past - and I'm not sure your comment about the AMEDD Concluding that the golden hour was a myth is accurate either. I was proud to have served with those that ensured that the operational testing of the CATs was expedited and the best product fielded once the clinical research was finished that specified the designs parameters. You know improvements in surgical techniques often dictate what can be fielded forward to the troops on the ground - yet, medicine has its "do-loops" and those can often be very frustrating. Funding is always a "reason" (not an excuse) for many changes or "non-changes" - and it is always difficult to determine "who" or "what agency" delayed decisions. I've seen some stupid ones over my 40 years, too.
  • This commment is unpublished.
    Heath · 9 years ago
    That is a good step in the right direction. Still needs a lot more work. Hopefully the presidential candidates are paying attention to this issue because one of them could become the next CinC.
  • This commment is unpublished.
    Louann · 3 years ago
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    It appears as if some of the written text within your content are running off the screen. Can somebody else please comment
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  • This commment is unpublished.
    Adan · 3 years ago
    Why viewers still make use of to read news papers when in this technological globe the whole thing is existing on web?

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