I’m a current 2nd year medical student. I’m being confronted with some decisions about how I want to orient the rest of my education and I’m deciding if joining the military makes sense for me.

TEMS and tactical medicine is what has maintained my interest in medicine for the last 6ish years. I’ve found some nitch interests within the larger scope of healthcare too but they mostly orient around fitness and performance. When people ask what kind of doctor I want to be I always say “the kind who helps people” because I think its a polite response to a fairly personal question about the rest of my life. Deep down I think I know I want to go into emergency medicine because I don't care for surgery “culture” and I think acute care is the only thing we do “well” in American healthcare.

I was pretty set on taking a scholarship from the Air Force or the Army, but being 33 already and married I am starting to count the cost to my life differently than I did when I started this path 6 years ago. Military medicine has remained sort of mysterious this entire time because after finding out about the jobs I’d be interested in (SOST, JMAU/JMU) the only details I could find about those were on here or podcasts.

I have legitimate sports interests that I’m still pursuing while I’m in school. I won't go into detail but military service would definitely crush any ambitions in that department. However it's something I’m willing to sacrifice if the juice is truly worth the squeeze.

I have friends serving in two significant conflict zones in a paramilitary capacity (tccc). I have already traveled to one and worked for an extended period in a hostile austere environment - I am surprised how much I appreciate being able to do it looking back now. If I never joined the military I could still serve in fulfilling roles in ways that most people join the military for because you basically can’t get them any other way.

Lastly, TEMS doesn't require that I have military experience, just that I’m eligible to serve a local police or fire department. My thing is that I think the military would benefit me as a provider. I think it could make me better. But can it make me better than I could be any other way? I kind of have a very unique set of opportunities already and I’m leaning towards taking them in lieu of military service.

I’m posting here because I know there's some real OGs that can speak definitively to the equation I’m describing. Military just seems like an unnecessary risk to get the skills I want. It could end up just like so many of these HPSP kids say: “I can’t wait to get out” - but I’ve always believed that you get out what you put in.

TLDR; I’m future Dr. Rambo and asking the tactical wizard council how to proceed on my quest for valor

Lots of responses are trying to swing at the proverbial- SWAT docs don't: (enter tacticool skill here)-nail. I’m highly aware of the misconceptions about TEMS tactical physician involvement, hence the TLDR; joke above. I think tactical physicians should be trained to handle firearms and complete SWAT training (like they do in many states as a requirement). The level of involvement in hot/warm/cold zones varies by state, department, and call out. This post isn’t about discussing what TEMS docs actually do, its about discussing what military service actually does to benefit a doctor with a TEMS career in mind

I’m 22 for reference and in decent shape. I’ve been a paramedic in a very busy city for a while and I’m looking for routes into tactical EMS. I’ve looked into the 68w route which seems the most promising but I’m not too familiar with how the army works or if i will get that MOS.

Are there other alternative routes? You’ve probably answered dozens of these questions before but any input helps, thank you.

I found a guy with a bunch of these for sale but I am trying to figure out what exactly they do. It says it retains body fluid but also wicks fluid away. That seems counter productive, but I am no medic, just some dude likes to be prepared. Sorry of this is a dumb question.

1) I selected PFC because none of the other flair categories fit. I have also posted this in r/EMS.

2) Studying for my AEMT and can’t get my head around this one. I asked my instruction, and he kinda said hypocalcemia causes vasoconstriction at first but looked more up and then kinda said “it makes sense” but to me it doesn’t.

So, my text says hypocalcemia has both vasoconstriction and hypotension as signs/symptoms. How are both of those possible? It doubles down by saying hypercalcemia causes vasodilation.

Anyway to easily help me with this?

Long shot but I'm wondering if anyone has experience with either of these bags and would be willing to give me your thoughts.

My goal is being able to carry my med gear in addition to some minor sustainment and ropes gear. I work in a service that is semi-rural but full spectrum from SAR to tacmed. At present my setup is multiple bags that are stuffed in various locations on the truck with my main "house bag" being what I operate out of for 95% or more of the calls. No issues with it, but it just doesn't interface well with any other bags when we have to get out in the woods. There's always the option of just building out a different bag that would interface better, and I'm not fully opposed to that.

As the title states though, I've come across these two bags that I'm thinking would fit the bill. My logic being with the TT some equipment can be relocated to the outer bag for dedicated entry work while having less immediate, sustainment, and other gear in the main. Reverse for the CTOMS by using the main bag as full medical, and buying the secondary accessory pack that attaches as sustainment and other gear. By the time it's done, price is roughly equivalent.

Thoughts, comments, concerns? Fully open to other suggestions as well for arrangement of things.

WWII First aid manual for troops who might have days before medical care.

Surprisingly up-to-date advice. Huge emphasis on taking their 4 antibiotic pills as soon as the injury happens.

What are your thoughts about perfusing the limb in a scenario where your days away from definitive care? (provided the patient is not in shock)

The Ukrainians are painfully learning that 75% of the 100,000 amputations performed have been on limbs that did not require a tourniquet.

https://youtu.be/IyDlB5MDOKY?si=XhDORae-yEZ9YT3-

Hi guys,

UK medic here.

Just got some surplus gear from a family friend and it’s some serious kit. A Medical Bergen and Piggot IRR field hospital.

Looking to what to put into it to have as an emergency bag for car travel/ travel in general.

I’m going to base it off of the sandpiper prehospital bags with stuff like a whole airway ladder, cat haem etc etc. Any other suggestions would be perfect thanks.

I’d like it if any of yous could point me in the direction of places to buy equipment in the UK.

Cheers guys.

Did anyone else notice that the most recent official version of the DD1380 TCCC card made two changes? In order to company with the president’s executive orders the word “gender” on the top of the card was changed to “sex”, the options male and female remained unchanged. This update is also reflected in most other DHA training material.

The other change that I can’t seem to wrap my head around was removing the Rule of 9s numbers on the body drawing on the front. No rationale given, no reason to replace it as rule of 9s is still taught. Do we think this was an oversight/unintentional? Or is DHA waging war on the rule of 9s or just plan overestimate my mental math skills lol.

https://www.esd.whs.mil/Portals/54/Documents/DD/forms/dd/dd1380.pdf

Does anyone have stats / thoughts on improvised pelvic binders/splints? What are y’all’s thoughts on them?

So I'm an Israeli combat medic with a lot of experience and deployment time in the field (I have all the credentials for this) and I'm thinking about moving to poland. Im interested in doing instructor gigs for military organizations and civilians as a side job. So here are few questions for you wise redditors of r/TacticalMedicine:

1. How relevant is my experience to the polish field?

2. Who do you think would be interested in this and who should I contact?

3. Are there a lot of organizations in poland teaching tacmed?

4. Where can I look for polish studying resources about tacmed, so I can understand the main doctarines taught in polish military and organizations?

Which tourniquet from Snakestaff Systems do you recommend? The regular or the wide one? I'm torn.

Hello,

I am my contract with the Guard will be up in April and, I want to return to active duty, in talks with a recruiter who will push me through MEPS come time.

I want reclass as a 68W with airborne and Rasp in contract or just ranger school

1. How possible is to get a 68W slot?

2. Also if possible instead drop a packet with 160th SOAR anyone know how that process is? I've seen, read, heard different things across the board.

Medical has always been my passion I've neglected for too long, ready to pursue it fully immerse myself. In medicine and tactical medicine world.

Multiple Guard deployments, Primary and secondary MOS' I hate. I have language (Arabic).

Tired of my own sandbagging. Any information will help.

A long time ago I came across a brilliant video of some sort of SWAT team being taught about blood loss and what blood looks like on the ground to estimate loss. Pouring out a litre at a time and explaining what will be happening to the casualty as each litre is lost, does anyone have any links to it or something similar?? Thanks!!

Hey all, new to the TEMS world (Kinda). My agency is starting an SRT team from the ground up and would like help with a medical "threat assessment" or TEMS report for incidents / events. Any ideas? Any standards or templates?

Thanks!

What does your work out look like? I’ll do 100 floors on the stair machine in 30 mins, then a couple of weight exercises. I’ll do the weights just below the threshold of being sore. I’m trying to loose weight and get in shape to carry a stretcher an extended distance. I’m spending about 45min in the gym 3-4x a week.

New to the contracting world and looking like I’m going to get this offer. Was wondering if anyone has experience in this line of work at one of the many embassies. What your role as the medic looks like, what gear you have access to, what the day to day looks like, and what the training prior to deployment looks like. PT test looks easy enough for my age group, 5 years in the 82nd 5 years in fire/ems. Thanks in advance.

Alright, I had my fun in the monthly bitch fest but I think we can find a solution with dilution! If more people post about real Tactical Medicine, the “which Amazon IFAK should I buy?” posts will seem less dominating of the conversation here.

To that end, it sounds like the CoTCCC is considering changing the MARCH algorithm to emphasize resuscitation over needle decompressions, based largely on evidence that Txpneumo is happening later on in patient care(if at all) and those patients deserve blood before we start fucking around listening to lung sounds.

What do you think? How do you think this adapts to the civilian TECCC? I think there is an interesting difference with TECCC due to the delay from point of wounding generally and the availability to get on the road, meaning, are you really going to start blood(or whatever gatorade you’ve got in your bag) on scene before finishing your exam?

https://prolongedfieldcare.wordpress.com/2025/01/27/214-tccc-updates-with-john/

I've heard a lot of talk about lactate recently- any conventional units using it or see a bright future for it at the BAS/Role 1 level, and what are you using it for?

Hi there,

Has anyone done the above course recently? What did you think? Would you recommend it? I found a few posts using the search function, but they were quite old.

I honestly just need to do a course with enough hours for my NREMT and my IBSC quals and want to do something interesting.

Thanks!

I have heard recommendations for both so what are the pros and cons of each?

In what contexts is one better than the other?

EDIT: by occlusive I am not necessarily referring to adhesive occlusive dressings like chest seals, just Impermeable membrane dressings in general.

Been working as a paramedic for over 2 years. I’m interested in joining the army reserves as a 68w and trying out for f2. Does anybody have experience with this? Or can anybody enlighten me on if I need to retake medic school/what would the training be? Thanks in advance.

Had anyone heard of Medresq? A friend just asked me about them, and I had no clue. Never seen their stuff before. They're on Amazon, but it gives off rebranded Rhino Rescue vibes...

Apparently they have a site.

https://medresqstore.com

Not sure where else I can ask this, but I’m a neurophysiologist with an NPI number, who enjoys TCCC training and education.

I have a stupid FSA with 1.5k in it I’m gonna lose if I don’t spend it. What would you recommend I buy medical supply wise?

I already have two IFAKs some misc supplies like SAM II splints TQ’s etc. thank you in advance for your time and consideration.

Hello all - this is an interesting resource that I imagine many are already aware of - but I have found it very good reading for the tactical medical kit-minded. (I’m an American trauma surgeon and emergency medical practice in austere environments is a subject of interest to me.)

The Royal Flying Doctor Services is an Australian medical service designed to provide lifesaving care to people outside of the major population centers. My understanding is that is that this is essentially a flight medicine team that can provide high-level emergency care and med-evac ill patients from rural areas that would otherwise not have access to a hospital. Forgive my very brief and inadequate description but the service seems quite amazing.

Among the resources available are medical chests that are left in rural areas to allow treatment to be initiated in conjunction with telemedicine consultation. To me, the chests represent an extremely well-thought-out supply list for dealing with unexpected emergencies. As we build our own kits, perhaps some might find this resource to be a useful point of reference. I’ve included the Queensland link because they have the contents list on their website.