Letter Re: Advanced Medical Training and Facilities for Retreat Groups

I have been enjoying and appreciating the letters and replies throughout the blog, and I am compelled to respond to “Advanced Medical Training and Facilities for Retreat Groups”. The letter contained very accurate and useful information, but I must comment on medical skills available to survivalists.
First of all, need to say that I am a professional Emergency Medical Technician – and have been for 25 years. I have treated dozens of real-life gunshot wounds, hundreds of knife wounds, and thousands of other cases of trauma that I would prefer to not remember.

As a 911 responder, I appreciate the faith that the general public has in my knowledge and skills. The word of an EMT or Paramedic is trusted – and we don’t take that trust lightly. This is a part of the reason for this letter. In our existing EMS system, EMTs are very good at arriving as quickly as possible and providing life-saving treatment until definitive care can be provided. In a TEOTWAWKI event, the shortcomings of EMT skills will be readily apparent. My crew and I are as good or better than anyone at stopping bleeding, splinting, providing IV support, protecting airways, and rapid transport. However, final treatment of a gunshot (or fracture, or chainsaw laceration, or what have you) is completely out of the realm of experience for any EMT or Paramedic.

A gunshot requires the cessation of bleeding – often requiring surgery. Usually gunshots also involve bone fractures or organ damage – and require surgery. An antibiotic regimen is also required – of which EMTs have little to no experience. All of this is typical for the most simple of gunshots. My fear is that in TEOTWAWKI, people too readily equate a physician’s knowledge and skills with that of an EMT. To put a number on it, Physicians attend medical training for 12 years or so. EMTs typically have two months of medical training.

Now – before I begin to get hate mail from other EMTs – let me say this: For the treatment of traumatic injuries in the pre-hospital setting, no one does our job better. I promise you I can do more effective CPR than most any doctor. I can intubate in the field better than most any respiratory technician. But my training and skills are limited to pre-hospital care. Of course, an EMT will have basic useful skills in a hospital or clinic setting but they pale in comparison to those of a physician. To state otherwise is foolish.

So, as a professional EMT for 25 years, the plan for my retreat is as follows:
1. Have a good relationship with a physician (preferably a surgeon) at the retreat
2. Have a RN, Veterinarian, or Physician’s Assistant at the retreat.
3. Know where other surrounding physicians are located
4. Have a method for transporting severely injured people to the physician,
5. Have adequate, in-depth barter stock to pay for surgery
6. Lastly – and I mean very last – would be to use a scalpel to open up a family member.

Barter stock would be best that is applicable to the physician’s skills: surgical tools, antibiotics, rubbing alcohol, sterile bandages, pain killers, sutures, and so forth. Also beneficial for barter would be other high value items from gold or silver coins, firearms, or even a fifth of whiskey.

The short of it is this: EMT skills are extremely valuable in the niche that they are designed. However, they are not designed for long term care. For my family, I will be providing life-sustaining care to include cessation of bleeding, splinting, IV, treatment of shock, pain management, and antibiotics – and they I will do whatever I can to get them to a surgeon. Anything else is second best. Yes, I have several great books that provide great information, such as “Emergency War Surgery” and “Where There Is No Doctor”. But to plan on performing these techniques without adequately exploring all options to get my wounded to a physician, is foolish. – BES in Washington