Page 85 - Journal of Special Operations Medicine - Summer 2015

appears to be a general hesitation on the part of the pro- to compare differences in response to each question
vider and the military treatment facility (MTF) to allow by respondent group. Examples were provided in the
medics to function within the full scope of their skill survey, such as IV access, administration of IV/intra-
set. To overcome this resistance, a letter was sent out to muscular/nasal/oral medications, drainage of abscesses,
MTF leadership by MEDCOM in November 2012 and suturing wounds, splinting broken bones, placement
again in 2013 describing the MTFs as “. . . an extension of urinary catheters, measuring vital signs, wound care
of the battlefield,” and further emphasizing the goals of management, chest compression, and placement of basic
the MTF is for Soldier skills sustainment. Additionally, airway devices.
depending on the location, there may be competition
among provider trainees to obtain procedural volume, Results
thus limiting medic exposure. The exact reasons for the
lack of medic use are not clear, as there appears to be The study took place from July 2014 through August
no data on this topic. This study is intended to provide 2014. During this time, 287 surveys were completed.
leading data for future research. Seven were excluded because they were incomplete,
leaving 280 surveys for inclusion. The majority of those
At Bayne-Jones Army Community Hospital, Fort Polk, participating in the study were on active duty (51.1%),
Louisiana, where this study took place, the bulk of the followed by dependents (36.1%), other (7.5%), and re-
medic’s clinical time is spent obtaining vital signs, in- tirees (5.4%).
travenous (IV) catheter placement, administration of IV
and oral fluids, and assisting in room turnover. Table 1 lists the questions that were asked of patients.
Patients agreed that medic skill maintenance is impor-
tant for deployment (mean LS score = 1.4). Patients felt
Goals of This Study
medics should be allowed to perform procedures (mean
We wanted to determine how patients perceive medic LS score = 1.6). Patients felt medics should be allowed
use. To the best of our knowledge, this is the first study to administer medications (mean LS score = 1.6). Pa-
to survey patients’ perceptions of the use of Combat tients would allow medics to perform procedures on
medics in their care. their family members (mean LS score = 1.7). Patents
would allow medics to administer medications to their
family members (mean LS score = 1.7). Patients felt
Methods
that medic clinical activities should be a core mission at
This was study was reviewed and approved by the insti- MTFs (mean LS score = 1.6).
tutional review board at the San Antonio Military Med-
ical Center, which supervises all research occurring at Table 2 outlines the average responses overall and by
MTFs under the Southern Regional Medical Command. respondent group. The results suggest that average re-
The study was also approved by local command. A sponses to each question did not vary significantly by
waiver of informed consent was requested and obtained.
Table 1 Survey Questions
This cross-sectional design survey study took place at 1. Combat medic skills maintenance is important for when
Bayne-Jones Army Community Hospital, which is a they deploy.
small MTF in Ft. Polk, Louisiana, with approximately
23,000 visits per year. The patient population consists 2. I believe that Combat medics should be allowed to
perform procedures within their skillset in the emergency
mostly of active duty Soldiers, dependants, and a small department when a physician is supervising them.
volume of retirees. The hospital also provides medical 3. I believe that Combat medics should be allowed
support for all units performing operational training at to administer medications within their skillset in
the Joint-Readiness Training Center. the emergency department when a physician is
supervising them.
Surveys were offered to all adult patients and adults who 4. I would allow Combat medics to perform necessary
were accompanying minor patients upon checking into medical procedures on me or my family members
the ED. Patients were asked to complete the study and in the emergency department when a physician is
put it in a locked dropbox or to give it to a staff member. supervising them.
The study was completely anonymous. Patients were 5. I would allow Combat medics to administer medications
asked six questions that were answered using the Lik- to me or my family members in the emergency
ert scale (LS). They responded on a scale of 1 (strongly department when a physician is supervising them.
agree) to 5 (strongly disagree). They were placed into 6. I believe that allowing medics to do activities within
four groups: active duty, dependants, retirees, other. their skillset under physician supervision should be a
Nonparametric analysis of variance methods were used core mission value for military treatment facilities.

Combat Medics in Emergency Departments 75