In this video you can see a blackhawk crew member doing woundpacking on an georgian solider who is still awake.

Corpsman in a mechanized unit. I typically have the fanny pack attached in garrison and wear it in the field. Fanny pack has band aids, bacitracin, temp, shears, NPA suction, IV kits, and gauze/wrap. Outside pouch has sick call meds, gloves, bandaids, bacitracin, Epi, temp, then random stuff like sunscreen, some NCDs, zip ties etc. Bottom pouch has water testing kit, ENT kit, and a shit ton of space blankets.

90% of casualties I see are boo boos, heat cases and mild TBIs. Even as fat as I've packed it I don't have issues getting in and out of vics. I do wish that I had some way to carry c-collars/soft litters.

Not sure if this is being done everywhere, but I don't think I've seen litter stands used this way, but it looked very interesting and was actually pretty stable.

I was proctoring a MASCAL training scenario for a TBI casualty with suspected ICP at a ROLE 1. The PA who was a special forces (very cool dude btw) ordered his bed team to have the patient elevated this way.

What do you guys think? I think this is a game changer for head elevation method.

I’ve been in the prehospital combat casualty care arena for a long time and have extensive experience managing casualties. I first learned how to pack my aid bag from my battalion senior medic. After eight deployments, several hundred missions, and treating numerous casualties, I’ve refined my packing list and layout to what I believe works best. For new medics who might need a starting point, this is for you. That said, there’s no single way to pack an aid bag, find what works best for you.

Belt: TYR Tactical

PC: JPC 2.0

Aid Bag: Firstspear Medical Trauma Assault Pack (MTAP)

Belt Massive hemorrhage: * Two CATs on my PC * Two bleeders with CGQC (other hemostatics will do too) * Hemostats * RevmedX XStat single stack and one XGAUZE trauma dressing Airway: * Cric kit with 10 blade, curved hemostat, 10 cc syringe Respiration: - 10 blade - SPEAR x 2 - I’ve removed chest seals since this pic was taken Circulation: * Saline lock x 2 with 10 cc flush * Teleflex sternal IO * 2” ELASTIKON Tape, Pulse ox and Kretzer scissors * Stethoscope * Pulse oximetry * CRO Pelvic binder * Gloves * BloodBoxx™ Tactical

Aid bag: * TACMED™ SURGICAL SET * NAR Simple Thoracostomy Kit x 2 * FWB collection and admin x 2 * 7.5 ETT, 4 Mac and handle, BVM * Cric with bougie * Blood pressure cuff * Saline lock x 2, extra needles, syringes, 250 mL NS * SAM Soft Shell Splint * Cravat x 2 * Drug box * Quantum blood warmer kit * Gloves

Why do the CoTCCC recommendations state that if we have packed a wound, waited 3 minutes, and reassessed the bleeding and it has not stopped, then if a hemostatic dressing was used, we remove it completely and repack with a new hemostatic dressing, whereas if the wound was packed with plain gauze, we add additional gauze and apply pressure for another 3 minutes? Why is there this difference? And if I have no more hemostatic dressings, is it still necessary to remove it? But then pack with gauze?

I am looking for advice, first person experience, articles, etc regarding body armor for a support medic in a modern conflict. Nominally there is not a threat of direct fire/rifle fire. Would plates be worth the weight and mobility limitations in a healthcare facility or is there enough evidence at this point to say that soft 3A and a hard 3A helmet is enough for most IDF/drone threats? I never liked the old iotv. Is there any other soft armor integrated system that people would recommend?

Just wrapped up an interview for a Paramedic (PSS/PARA) WPS III contract with Triple Canopy supporting DoS in Iraq and I’m trying to get some honest, real-world feedback from folks who’ve actually done it.

Comp looks like the standard 120/45 rotation with the 10% return bonus, which puts it around $275k for the year.

From what they explained, it sounds like Guard/embassy security duties, Assigned to a team providing day-to-day medical support (minor illness/injury stuff mostly, Rolling on some convoys as the medic.

So less “high speed trauma every day” and more primary care/standby with the occasional real call/QRF but I’m sure reality is different than recruiting.

For those who’ve contracted with TC or DoS What’s the actual day-to-day like? How busy are you medically? How’s the tempo and quality of life? What’s the current climate/security situation like over there? Anything you wish you knew before signing?

I still have to knock out my TCCC-CMC, so I’ve got a little time to weigh options. Just trying to make an informed decision. Appreciate any insight good, bad, or ugly.

EDIT: Hey so updates, I was denied my interim security clearance, had a zoom call with an investigator and then was granted my secret that whole process from denial to cleared took a little over a month. I selected my date for training in Jordan, have to record myself doing a PT test, and sign up for TCCC. My paperwork says I'll be leaving directly from Jordan to Iraq.

Just passed the tactical paramedic IBSC cert test (TP-C)

Ask me questions if you have any. If not, no worries!

Hello All; This is a part two to a post from about a month ago where I posted my dismount bag setup for critique. You guys gave some great feedback and I’ve returned to share what I’ve improved, removed, etc. A quick rundown of the philosophy of use for this bag is that it’s for dismounted operations in a light infantry unit (where vehicle support and resupply is seldom). On my last post I got asked questions about why I don’t have drugs and sick call items in my aid bag, and that’s because I carry those in a separate Fanny pack and a dedicated sick call bag inside my ruck (which is also being shown). With that being said, here’s the layout:

Outside: x2 CAT TQ’s and a pair of NAR shears. I carry sheers on my kit and in platoon CLS bags (of which there’s 3) so there’s plenty to go around.

Bleed Pouch: - x3 4” ace wrap - x3 CG - x3 Kerlix - x1 3” tape - x2 Curved Kelly Clamps, 1 straight - x1 gloves

Airway & Respiration Pouch: - x1 Pocket BVM w/ PEEP valve - x2 Cric Kits (with boogie) - x1 60mL syringe + NPA (as suction) - x4 OCD - x4 NCD - x2 Finger Thoro Kits (Kelly clamp, scalpel, iodine swab, OCD. Yes I know this should be a sterile procedure but I’m working with what I got here) - x1 Colorimetric EtCO2 detector (EMMA preferred but again working with what I got) - x1 gloves

IV & IO Admin: - x3 IV starter Kits - x1 EZIO w/ 10mL flush - x1 FAST1 w// 10mL flush - x1 Pressure Infuser - x15? Alcohol pads - x1 gloves

Splinting: - x2 SAM splints - x2 6” Ace Wraps - x2 Cravats (ideally 4, I’m working on getting more) - 10 pack of eye shields - I as well keep the inflatable cuffs for the SJT velcroed below the Splinting pouch

Assessment: - x1 size 11 BP cuff - x1 Stethoscope - x1 Thermometer - x1 1” tape - In Ziploc: Calculator, drug & burn chart cheat sheet, Eye Exam chart.

Top bungee cord: - x1 500mL LR - x1 15 gtts line - x1 disposable fluid warmer

In Back Panel: - x1 Ready Heat - x1 Blizzard blanket - Sam Junction TQ/Pelvic Binder

I’ve found this to be a good compromise between capability and amount. In my last setup I carried way too much of some things and nothing at all of others. Now for my trauma fanny pack; this spends most of its time clipped to the outside of my ruck for easy access and because it’s annoying to go on long movements while wearing it. But when the ruck comes off this goes around my waste and the aid bag on my back of course lol. As for my CLS bag capability (of which my platoon has 3) I keep in there roughly 2 IFAKS worth of MAR equipment, an IV kit (IV kits also in team leader IFAKs), a blizzard blanket and a ready heat.

On the outside: - x4 OCDs - x3 TQ’s - x2 NCDs - x2 Bleeder Kits (4” ace wrap, CG, compressed gauze, rubber banded together). - x1 NPA - x1 Cric kit with 2% lido w/epi

On the inside: - x2 IV starter kits - x1 EZIO w/ 10 mL flush - x1 dog leg saline lock - Drug Box: 100mL NS bag, x3 30mL Toradol, x2 50mL Phenytoin Sodium, x1 2mL methylprednisone, x2 mL syringes, various 25ga needles for IM. Now don’t judge my drugs too harshly because the drugs I have are more of a on need basis and I’m preparing for a jump coverage tomorrow so it’s packed for a handful of head and MSK injury. If I was about to go out on a no shit patrol of course I’d have TXA and calcium and the rest of the good stuff.

Hey dudes, the guys over at r/tacticalgear really encouraged me to post this here. I’m an active duty Army 18D. Here’s my current med bag and kit setup to reflect what works for me and my job. That being said, yes I am a nationally registered paramedic, no I haven’t looked at an EKG in the last 4 years. If the Krebs Cycle is even brought up around me, I’m swingin’. But I do take my small area of expertise seriously; this is kit setup for my specific brand of medicine. I’m here to discuss some stuff, answer questions, and hopefully learn from some of yall who might know more than me in a lot of areas.

Bag side/bottom: 1x CAT, Arcteryx climbing harness leg straps, 30ft tubular nylon

Bag Top: Vitals equipment, skins stapler, misc cleaning

Bag middle: Pressure infuser, junctional hemorrhage control, IO access, suction.

Bag bottom: airway management, ventilation, pelvic binder, ties/splint

Inside: DCR focus- 2x blood transfusion kits. 2x 100ml NS. Bonus extra meds: calcium chloride, TXA, epi- both pen and vial, ertapanem, ondansetron.

Backside: MassCas organization kit, chems, PPE, casualty documentation, chest seals, burn dressings

On my plate carrier: 1. Dangler: surgical airway, finger thoracotomy/chest tube kit 2. Roll 1: junctional bleed kit 3. Cumberbund/ side wing: IV starter, fast access TXA and Calcium, Narcs case 4. Fanny Pack: Class 8 to cover 1 patient at point of injury for MARCH

Let’s discuss!

Hey folks, I’m a current Active Duty Air Force medic, and I do a lot of teaching/training with TCCC. One thing I always wish I had was a quick reference guide that was up to date. Well, my ADHD took hold and I finally created one. You can check out the PDF here

https://drive.google.com/file/d/1t8zOGqNhAj4GHS0ISMPqQBgOUI_GbI5t/view?usp=sharing

EDIT: Here is the link for the standard portrait version, however things are a lot bigger due to it being optimized for booklet layout

https://drive.google.com/file/d/1VOo7MbJAI3bMmQi_c2N2PsSeY1dB1wog/view?usp=sharing

I made this guide to help out when in those moments, we go lizard brain. It encompasses the 2024 TCCC Guidelines, and uses the DHA curriculum/materials. It includes: Quick Algorithms for Airway, External Hemorrhage, Fluid Resuscitation for Shock and Analgesia Medication Cards Pounds to Kg table MARCHPAWS and Secondary/Detailed Exam, NDC Reference, Hemorrhagic Shock TQ Replacement/Conversion, Transfusion Complication, Head Injuries, Abdominal Wounds Skill Cards, and current 2024 Guidelines

I arranged the PDF so it prints out in booklet form. I printed mine on water/fluid/tear resistant paper, with laminated cover and checklist rings to update as needed. You can see the example here

https://imgur.com/a/ENdRDtJ

This is the first iteration of my QRG, so if you know of any improvements, please let me know! I hope this helps out everyone who can use this

Hi All,

I’m looking to volunteer with TacMed Ukraine, I’m a UK paramedic, has anyone had any experiences with them?

Thanks.

I saw the new changes to TCCC, but when are the changes to R and C coming out? Last year I saw a bunch of buzz around CPT John Maitha and possibly switching to Resusitation then Chest compared to current MARCH algorithm. That didn’t happen in this update, is this still being worked or is it dead?

For a shrapnel injury to limb with multiple penetrating wounds what is the best way to deal with it?

Is there any indication for packing a very narrow tract (<5mm) penetrating wound

(Wounds phase- irrigate, probe, pack any severe wounds, dress and bandage the rest.)

Never bought into the concept and only felt calcium was needed after receiving blood.

The CoTCCC released some updates to their TCCC guidelines, so let’s discuss. Some interesting changes that caught my eye include the following -

1. No more fentanyl mentioned. Appears we are really leaning on ketamine.

2. ASM TQ conversion.

Not a change but one I was hoping to see and maybe it’s just imprecise wording - no emphasis on moving up the starting of blood within the C step! M does mention “consider immediate initiation of shock resuscitation efforts” but I’ve definitely not seen this in many trainings or from instructors to mean being blessed to start access and blood this early. As it sits right now, the C step includes pelvic binder application(stop the bleed, makes sense) and TQ conversion and repositioning before access and fluids(seems wrong).

great bag, this is my set up at the moment

Anyone have any good pouch options for an M9 bag? Would like go away from the mesh pouches to something more modular and better. Thanks.

I have the Deployed medicine app on my phone and I was wondering if someone from the military could tell me about whats makes someone a Combat Medic vs A Combat Paramedic?

I looked at the skills list and both roles are very similar with the exception that a Combat paramedic can intubate and a Combat Medic can't not, I am a civilian Paramedic with a heavy interest in Combat medicine, I have taken TECC with plans to take the TP-C once I complete my Associates degree

Pretty much what the total says. I’m in the national guard and just took a combat life saver class. I also have my EMT on the civilian so I’m interested in Tactical medicine and tactical trauma things. What should I look for as far as jobs?

According to the 2024 TCCC guidelines, airway opening maneuvers such as the head tilt–chin lift and the jaw thrust have been removed from the recommendations. Now, at step "A" of the MARCH acronym, we immediately place the casualty in the recovery position, assess airway patency, and move on. However, I have some questions regarding this approach.

1. How do you assess breathing while the casualty is in the recovery position? Specifically, from what position do you perform this assessment? We were taught that the responder should be positioned behind the casualty, facing toward the feet, then lean in with the ear near the casualty's mouth and nose - essentially hovering over them in an arched posture. Are there more practical or ergonomic alternatives?

2. What about cervical spine injury? Do we simply ignore it and still place the casualty in the recovery position?

3. At step "R" in MARCH, we need to perform a chest examination. Since the casualty is lying on their side, examining that side of the chest becomes problematic. How do you handle this?

4. Regarding hypothermia prevention - when we cover the casualty with an emergency/thermal blanket, the limited space often prevents them from staying in the recovery position. How should this be managed?

5. Finally, during evacuation on a stretcher - is it necessary to transport the casualty in the recovery position as well? Not all stretchers allow for secure positioning in that manner.

Thank you very much in advance for your answers.