The role of today’s SAR Medic is a challenging one.
Today’s rescue environment demands the highest levels of prehospital care be delivered to patient side despite the technical environment that might present itself.
Whether it be reducing a shoulder on a multi pitch climb, pulling a lifeless body from a snowy hole and bringing her to a complete recovery with ECMO, giving pain meds to the multi trauma on a Combat SAR (CSAR) mission, or resuscitating a cardiac arrest on a HETS mission, today’s SAR Medic must deliver good medicine, in bad places.
The path to becoming a SAR Medic is long and complicated and involves much training and experience. An Advanced Life Support (ALS) SAR Medic requires, on average, 8,000 hours of training and practical experience just to become certified, licensed, proficient and safe. This involves classroom, clinical, operating room and emergency room practicum, and real life field experience.
Most ALS SAR Medics have resuscitated at least 10 cardiac arrests before they graduate to become an independent practitioner. 10 cardiac arrests. That’s a minimum of 10 life and death situations that rest solely on that medics shoulders, not to mention all the other life and death situations, before they are deemed safe and proficient enough to practice independently.
Then, take that training, and add it to the technical rescue training requirements necessary for the environment within which you are working, and the training tempo increases exponentially. In my situation, for example, I must maintain my ALS skill set, helicopter rescue/HETS, rope rescue, and Avalanche rescue. I’m lucky I have an understanding wife.
The CSAR Medic? Add even more training to their requirements. Add rescue intelligence support, in rescue self protection, airdrop of equipment and personnel, rescue swimming, SERE, and much more. The training tempo is constant.
But all that training is actually the easy part.
Next, you have to learn to put all of the pieces of that puzzle together and make it work fluidly.
You have to learn balance.
The balance to decide when the safety of your team and the patient means less patient care and more rescue, or when you have to be a staunch patient advocate and increase the complexity of the technical side of the mission to provide more patient care.
A good example, is the BASE jumper we rescued off the Stawamus Chief a short time ago. Although the mechanism of injury was huge, his situation demanded that we rescue him from the face of that massive monolith first, then, once in a safer location, provide patient care.
Conversely, the unconscious anaphylactic patient on the other side of that same monolith required aggressive medical intervention first, prior to launching the technical rescue component of the mission.
Maturity, self awareness, situational awareness, skill retention, certification, and many other things come into play for the SAR Medic. But most importantly the SAR Medic must be confident enough to know how to operate in the team environment to achieve that balance between patient care, and rescue effectiveness.
The world of a SAR Medic is dynamic, and no two situations can be treated exactly the same way. You have to think on your feet, plan ahead, and treat aggressively. The world of a SAR Medic has no room for minimalism.
Recent studies of CSAR outcomes in theatre in Afghanistan prove that aggressive prehospital care, combined with helicopter transport, improved outcomes by more than 6%. At first glance, that might seem like a small number, until you put it into perspective. Without aggressive CSAR Medic intervention, 6 more guys out of a hundred would not have come home. 6 more guys came home to their families as a direct result of skilled, self aware,aggressive SAR Medics.
That’s what it’s all about. That’s why I deliver good medicine, in bad places. To bring people home, that otherwise would not have survived.