Medics read this.

Here's some food for thought.

Statistically, you or your client are significantly more likely to have a heart attack than get wounded during a firefight. Now look at the amount of resources given over to range days, weapons and tactics training and compare that to the amount of resources given over to supply and support of med provision and training. There's an absolute inbalance of risk -v- skill.

If I were to suggest that any tom, dick or knobjockey, that's done a 3 day weapons training package could then deploy as part of a team, there'd be outrage. However, exactly that standard applies to med provision, in that people with little or no knowledge of the subject, attend some invented all singing, all dancing, super course which is in fact a sexed up FPOSi, and hey presto, another 'medic' is created - and they're deployable as a medic.
 
The other side of that once seen and experienced whilst working for a well known PSC, no names..oh alright, Olive, actually employing well qualified experienced Paramedics/OSM and then sending them out on the ground as such in support of clients; with no kit! apart from the odd bandage and plaster they managed to find lurking at the back of a very unhygienic iso container, and all because they hadn't done any prior planning and preparation (pppp) when a new contract started...Outstanding!...

Starlight said:
Thanks Med1c999, very enlightening.

@ stewmac91. Yes, that's my experience of it. However, it's a smoke and mirrors thingy, in that if you call an FPOSi something else, usually but not exclusively named after some sort of slithery reptile or similar, then in the eyes of the client, they're getting the real deal.

And I've commented on this before many times......It's not in the interests of the PMC company to employ Paramedics, OSMs etc. To them, we're hard work, what with our requirements for kit, demands for safe and correct practice etc etc. Better they have an FPOSi that they can fook off at the high port, than someone who will or at least should have some real clout when it comes to medical stuff.

We're just an expensive problem.
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sparkymedic said:
The other side of that once seen and experienced whilst working for a well known PSC, no names..oh alright, Olive, actually employing well qualified experienced Paramedics/OSM and then sending them out on the ground as such in support of clients; with no kit! apart from the odd bandage and plaster they managed to find lurking at the back of a very unhygienic iso container, and all because they hadn't done any prior planning and preparation (pppp) when a new contract started...Outstanding!...
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I've been in that exact same position. The ONLY Paramedic in country for one of the big players, but no kit, equipment or facilities. I should say, that I was employed for governance and teaching, however, once in country, it was very apparent that there was an expectation placed upon me by the in country bosses and everybody else for that matter, that I would intervene at a clinical level if it all went tits up. I only had the small amount of kit I'd taken in with me. Shocking.
 
Im deployed as a PSD operator and what I find poor is that medics are running around and trying to act as if they are Dr but also there is a lot of medic quals out there but no one is checking the certs for dates of issue and run out dates. even down to the basic FPOS and MIRA there are still run out dates
 
UK registered paramedics routinely cover Dr OOH services, with an emphasis on none conveyance and discharge at home. We will soon have prescribing rights.
Similarly, OSM will also find themselves as the sole med provider for an organisation, and also work in professional isolation.
Both are the prime decision maker in all things med. Both professions are therefore well placed to replace Drs who wouldn't or couldn't work in hostile environments.

Q. What do you call a highly trained emergency medicine consultant, who has no access to kit, assistance or med facilities?
 
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Ans: A first aider.

The lesson to be learned here, is that it's absolutely no good what-so-ever having highly trained, experienced health care professionals supporting who ever where ever, if they have no kit of facilities.
 
There are a great number and variety of explanations in this modern world for the use of the term "medic." Some of them are traced to centuries old. Confusion and miscommunication occurs when someone thinks that their definition of medic is the same definition that everyone else is using. I've been on contracts buggered by the dog because the desk jockey didn't get a subject-matter expert to advise them on terminology and compatibility. I've had naval corpsmen tell me they were doctors to try and get me to do something inappropriate. I met a guy who professed to be a Russian special forces medic and couldn't coherently describe bleeding control. St. Maarten (Caribbean island) "medics" are basically stretcher van drivers, but called medics. In my own country, there are thousands of certified paramedics working for fire departments who haven't touched a patient in years and whom I wouldn't trust to touch anyone but my worst enemy. Some of the confusion is from mis-interpretation of skillsets, some is from misapplication of the word, and some is just plain outright lying.

I've asked before, in this forum, why PSD companies advertise for a medic, but don't really want one. Mis-interpretation of skillsets in the advertisement by a third-world company might be an explanation, but not so for an American/European company. yet most of the advertisements are from American/Europeans. Why does the government or contractor put in the requirement for paramedic when they know the contractee is only going to pencil-whip the check-box with a certificate? Why does the contractee agree with the contractor when both know they don't really care about extensive medical skill and knowledge?

If some company hired someone as a (USA) National Registry Paramedic and didn't require proof of certification AND demonstration of skills/knowledge, then that company deserves what it gets. In the US, unless the prosecutor could prove malicious intent, then almost certainly no one would go to jail for a certified paramedic to act as PSD guy did. Lots of license taking, lots of lawyer money, sure, but no jail time. However, falsifying documentation IS a criminal offense, and with the lack of education to go with the falsification, I'm sure the offender could be charged with practicing medicine without a license and the company could be charged with wanton negligence resulting in permanent harm or death.

So, in CPParamedic's story, the first breakdown was the PSD guy misrepresenting himself as a TRUE medic. The second breakdown is the company's recruiter not knowing the difference. The third breakdown is the company's lack of due diligence in researching the applicant. The fourth breakdown is the company's lack of training and deployment protocol regarding demonstration of knowledge and skill (does anyone think the company took his word on weapons and tactics capability?), and the final breakdown goes back to the PSD guy in not admitting at the time of patient contact that he couldn't handle the situation and thus endangered a life.

Insurance isn't going to help anyone in this case. In the insurance cases I've testified for and against, all of them would be putting up the sign that reads, "Not a covered activity, policy not in effect."
 
Mikey7065 said:
I met a guy who professed to be a Russian special forces medic and couldn't coherently describe bleeding control.
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Hahahahahahahahahahahaha !

Soooo typical.

The French Foreign Legion has an expression for these guys : the... here you go...."Spetznaz", which in Legion vernacular means Walter Mitty.

:-D
 
Mikey .. great input there and very educational ... All of which I agree with ... But at some point some has to pay the medical bill !!!!
Now I can see each argument , but in this case the Medic , who has little time served and to be honest quals which mean diddly squat fits the exact requirement set before him in the recruiting phase. And to me the industry is in some cases totally ignorant as to the capabilities of some of these "off the street and in 4 weeks a medic courses" And to some extent training providers jumping on the band wagon cashing in on medic courses need to be looked at and regulated.
End of the day in this case the pt made a full recovery . this time ... but someone still needs to fund that medical treatment and hospitalization.
Who, the medics liability insurance ? The PSC ? or the active insurance held by the PSC ?
INTERESTING !
 
Lads lets face it, now days you are running one expat team...therefore you have to tick all the boxes , being TL, PPO and EMT/FPOS guy. Who ever did the cuts is to blame, but the "CLIENT" as well is aware that if you are EMT/FPOS trained that you are NOT a PARAMEDIC or an DOCTOR. Correct me if I'm wrong. If they want a Dr. they should pay for it.

To brake it down, you are there to stop bleeding, deal with shit on the ground and to get him possible safe and alive over to medical facility...well if you have one, right ???!!!

Ppl are running cross country details not knowing a basic thing..its general thing now days. how many don't have comms or maps sorted ext.

You do the best you can or some one els will do it..he might do it worse cos he don't give a toss...


Me 0.5 cents.


Para
 
Hi Guys,

The initial post is now 6 weeks old, does anyone know if the insurance company did kick up a fuss, or if the PSD company decided to review medic post standards. Near misses are not about whos to blame but what we can all learn from the incident.
 
All very interesting, especially if you are HCPC registered. I know of sooooooo many companies that are now hiring US or UK qualified Paramedics only (many with incredibly limited tactical experience!) and getting the guys to carry out procedures that are not within their remit (some of the sick call / prescribing is more akin to an ECP's line of work) and, in addition, how realistic is it to carry out many of extended skills whilst effectively flying solo and dealing with a roadside IED and multiple blast injuries. Use of equipment / consumbales that they are not trained in - the list goes on....

You will see physical evidence of tactical incompetence (quite often on the part of the employer / operational management) who will often stipulate the medic as a PSD team 2i/c. Not hard to look at that one going wrong is it? The TL gets whacked and then the medic is supposed to both supervise the the remainding TM's AND deal with the casualty. Same still happens on a daily basis in CP teams by getting the team medic to drive; BOOM! An IED and then keystone cops as, for example, the medic has to drive past his casualty as part of the team IA drills and then the pure Keystone cops scenario as the team try to work out who will drive (once the medic has finally got to his casualty) whilst the medic takes care of his casualty or MEDEVAC arrives.

There is an old saying that should always be remembered: "Shooter first, medic second...."

It would seem that some lads taking up these posts will certainly be putting their registrations on the line...
 
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It would if there was an insurance issue mate; the first thing that would happen is the insurers would look at how they can circumnavigate a payout. One of the first ports of call would be validating the quals of whoever rendered aid.
 
you mention a few valid points there ! Firstly NO WAY should the medic be a driver!! and shouldnt really be 2ic. But with regards to carrying out a virtual ECP role ...well thats where a good current HCPC Paramedic who is registered and can prove he is trained in the use of certain drugs advanced assessment skills AND has the permission of his medical overwatch, can go past what is classed past his normal remit. Just needs to back it up!!
I personally see this as job security and the practice of carrying out fresh cases / sick call should be encouraged. Obviously with guys that demonstrate the qualifications to do so. This keeps the Paramedic role fresh and hopefully worthy of a higher pay scale.
The HCPC will not jump down someones throat if a Paramedic uses Ketamine for example ...As long as he can prove adequate training. As Paramedics now we HAVE to push for this. Drugs given by non prescribers on PGD'S or similar are the way around this.
Because in a remote / hostile environment you are still more likely to be dishing out Cypro than Morphine!
But I must stress that you need proof of training to back you up. Modern Paramedic Practice has to move towards ECP roles. And in a HE/Remote setting its without doubt the way ahead.
 
One of the ways to enhance 'standard' HCPC Paramedic practice, and meet the somewhat unusual requirements of the environment/client, is to do the OSM course. This is particularly useful to ex-mil CMT's that become Paramedics as it can be used as a refresher of basic skills not neccessarily covered in any great depth during paramedic trg.

Some time ago I had this discussion with the CoP's and they agreed that a Paramedic that is also an OSM, can legitimately describe themselves as a Para Prac. This is much more in keeping with the needs of the wider industry.

It's not all about trauma - in fact, it's rarely to do with trauma.
 
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How much in terms of education and training does the OSM course provide in reality though ? For an experienced Paramedic or CMT 1, with an already substantial amount of primary care experience, how much can be gained from four weeks ? I know some courses offer PHTLS and ACLS certification as part of the course, but these skills and knowledge should already be very familiar to the experienced medic. Then there is the clinical placement element of the course, one week of primary care in a GP surgery and one week in an emergency department, again experiences that many Paramedics and CMT 1's will already be familiar with.

Is there a set syllabus for this course or does it vary from provider to provider ?

I haven't completed the OSM course and would like to hear opinions on what it has to offer, especially for Paramedics. Off topic I know, but seen as you brought it up Starlight.
 
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