medical proficiancy

[CosmicGamer]

Premise: Shouldn't most Traveller characters have basic medical skills?

To all real life people with military, law enforcement, and fire fighting backgrounds:

To anyone with experience working on a commercial cruise ship or passenger ship or even a commercial ship like a ferry boat:

Q#1) Were you required to have CPR and First Aid training?

Q#2) While actively employed in this profession, were you not required to take refresher courses?

I propose that all PCs that have a military or law enforcement background should have at least some medical knowledge.

I also propose that all crew of ships that carry passengers are required to have some medical knowledge.

In my experience

USNavy
Q#1) Yes
Q#2) Yes
I know I did and I believe all 5,000 people on the aircraft carrier did as well. Not just the combatant types like MPs, Marines, and Seals but the mechanics, pilots, and chefs in the galley (they probably needed it the most - you ever eat onboard a Navy ship when its deployed!)

 

[rust]

Here in Germany many schools offer First Aid courses, and you need a First
Aid training to get a driver's license, so almost every person has had at least
some basic First Aid training.

And of course everyone working in law enforcement, fire fighting, the milita-
ry plus quite a lot of other occupations receives some medical training, and
in most cases also is required to take refresher courses.

In my setting literally all persons know how to use a first aid kit to deal with
the most common medical problems, at least until more professional help ar-
rives on the scene.

 

[Magnus von Thornwood]

terms.

1. Its called First Responder Training and includes both.

2. In the world of Civilian Pukes that's called In-Service. And from my studies yes, most Jurisdictions require regular In-Services and Medics and Fire Fighters even more.

3. IMTU all PCs may elect if they are from a TL5 or so world to have Skill-0 in their TL's First Responder Skill.

 

[CosmicGamer]

3. IMTU all PCs may elect if they are from a TL5 or so world to have Skill-0 in their TL's First Responder Skill.

Sorry, I'm not familiar with all the versions of Traveller, and my book only lists a Medical skill. Where does First Responder come from?

 

[Magnus von Thornwood]

OOps.

That's a Real Life Term for the First-Aid and CPR, combo Basic Life Support Training for of course, First Responers, i.e. Fire Fighters, Medics, Cops.

 

[Border Reiver]

There is a world of difference between the basic first aid taught in the services and elsewhere and actual medic skill, I'd hesitate even to count it as skill zero but will.

The major area of difference is actually one of assessment, it is all very well knowing how to bandage or perform CPR but when to actually use the skill (you would not believe how many times I've come across someone performing CPR on a live patient) or what treatment is actually required.

Even in the military the skills taught were largely mechanical, pressure dressings and IV access etc., follow the drills. We have defibs which are largely automated in various public places and first responders across the country but this is a very narrow and basic skill set.

Present a squaddie with a Congestive Heart Failure patient and they wouldn't know where to start and give them a trauma induced tension pneumothorax and they probably wouldn't see it until it was too late to treat. The same would apply to most police and firefighters too.

 

[Magnus von Thornwood]

*bows*

Thank you, Baron Medic, and oh yeah I had a friend who was an MP and then a civ EMT and eventually got his Paramagic, so I can spot the indicators, and true cops can mess that up, but they're used to peeps being dead or hopefully living till the Medics get there....and I have spent more than my fair share of time in a hospital or two. *shrugs* Some serious mini/maxing of the genes, win some, lose some.

 

[CosmicGamer]

you would not believe how many times I've come across someone performing CPR on a live patient

Are you supposed to wait until they are clinically dead to start CPR?

Present a squaddie with a Congestive Heart Failure patient and they wouldn't know where to start and give them a trauma induced tension pneumothorax and they probably wouldn't see it until it was too late to treat.

My CPR training taught you to do the ABCs before performing CPR on someone. Why is this person lying on the ground unconscious and not breathing after you checked the airway? If someone knew the person I might quickly ask a question or 2 while doing the ABCs but yes, if Congestive Heart Failure has reduced your BP to <60 you may not get a pulse and without any other information to go on (checked airway, not breathing, no pulse) I would probably start CPR. (been over 10 years since I had training so I hope I'm not making a fool of myself here)

Enough of that, this about Traveller medical skill and not RL so...

Even in the military the skills taught were largely mechanical, pressure dressings and IV access etc., follow the drills. We have defibs which are largely automated in various public places and first responders across the country but this is a very narrow and basic skill set.

I agree that this would be true even in Traveller. The training isn't the greatest but they should be trained for what is the most common things they would have to respond to - hence my thought that they should be at Medical - 0 and not be getting a -3 DM.

There is a world of difference between the basic first aid taught in the services and elsewhere and actual medic skill, I'd hesitate even to count it as skill zero but will.

Good, we agree again. I'd like to add: In CT, I believe you are considered a professional at Medical - 3. That leaves Skill 0,1, and 2. IMO, it seams very plausible that someone with Medical - 0 just has a very minimal amount of first aid training. This is the point I was making and wanting to discuss when I started this thread so I'm glad we agree.

In the far future of Traveler the simple training people get should include the use of simple medical diagnostic and treatment equipment that even a novice could use (I think of Star Treks Medical Tricorder).

If Traveller had a separate First Aid, or First Responder skill we wouldn't even need to discuss this.

 

[aramis]

I just recerted in First Aid/CPR through American Heart Assn. ...

You merely assess for breathing, and if not breathing, begin compressions protocol. Breathing is now optional on the provider's part.

 

[deniable]

My last (2006) CPR recert had the same things. The ARC (Australian Resuscitation Council) supposedly changed it to keep in line with the Americans, and had brought in the new standards after my 2005 recert.

Check D and R then if no A and B (there is no longer a C) begin CPR. They don't teach simple breathing any more, but do insist on breathing as part of CPR. They've changed the rates too.

The changes were to make the whole thing easier, because too many people were fuzzy on the details so wouldn't do anything.

This is all part of the Senior First Aid required on pretty much any mine site in the north-west. (Of course, I was always in the office and got made a designated first aider, so I got the training too.) Full recertification (the two day course again) is every three years and CPR refresh is annual.

 

[Magnus von Thornwood]

Say What?!

I just recerted in First Aid/CPR through American Heart Assn. ...

You merely assess for breathing, and if not breathing, begin compressions protocol. Breathing is now optional on the provider's part.

Breathing is optional and no ABC, wow what a crappy class, shit I got more from Tommy Trauma in the Security Suite at several cons, before I even hit a class.

 

[aramis]

Checking for breathing as taught will open the airway, and if you have breathing, you don't check for circ... you still activate EMS.

 

[Magnus von Thornwood]

oh yes.

Yep. Always call the Pros to handle possibly soon to be dead people! I love having the conveniences of modern life, like Medics.

 

[deniable]

This is all second hand from my instructor:

A lot of people have trouble finding a pulse in any conditions and will waste a lot of time trying to check circulation. Somebody checked the stats and chest compressions will move some air in the lungs and any attention is better than nothing. The chances of survival are low enough that inaction was seen as the most efficient thing to fix. It's better to have people able to perform basic CPR than have them stand around doing nothing.

 

[Icosahedron]

In my (meagre) experience, the vast majority of people in the UK wouldn't have a clue about anything beyond CPR, and even that is only what they might have picked up off TV. It might be different for the military and the emergency services, but military service over here is much less prevalent than over there - you only have to look at the 'military service' question on the Who are We thread.

The problem with the Medic skill is that it will be (ab)used in all sorts of conditions, and personally, I don't think that someone who has done a few hours of CPR 11 months ago should be classed as 3 points better than Joe Public when called upon to stop the bleeding from a gunshot wound until the medics arrive, or administer the correct antidote to a fast-acting venom - and let's face it, that's what they will be using their 'Medic-0' for in a game.

I might give all ex-servicemen a house-ruled 'CPR' skill, and say that its effect is simply to prevent death from occuring until the real medics arrive, but I wouldn't give them the 3 point (5 point CT) advantage that Medic-0 confers unless they are special forces or have some form of medical experience written into their backstory (maybe their father was a surgeon?)

 

[rust]

I agree, Medic-0 seems to be a bit too good for the average person's first
aid skill.
If a doctor is Medic-3, you need the Medic-2 for a nurse and the Medic-1
for a trained medic. This leaves Medic-0 for those people who had some
real medical training beyond a normal first aid course, for example a poli-
ce officer or a fire fighter, but not the average soldier.

 

[CosmicGamer]

I wouldn't give them the 3 point (5 point CT) advantage that Medic-0 confers

Could you explain how it is a 5 point advantage? I'm only familiar with if Medic-0 no DM and if no skill at all DM -3 for the 3 point difference.

I am not familiar with all of the versions of Traveller so if people could say how they differ on this I would appreciate it.

I don't think that someone who has done a few hours of CPR 11 months ago should be classed as 3 points better than Joe Public when called upon to stop the bleeding from a gunshot wound until the medics arrive, or administer the correct antidote to a fast-acting venom - and let's face it, that's what they will be using their 'Medic-0' for in a game.

I totally agree that with just CPR training you should not get the bonus. In my proposal for Military to get Medical-0, it is based on the military (in my experience) having First Aid, or as some have called it, First Responder training which would definitely include bleeding from a gunshot wound. I'd also like to add now that troops would probably get additional training based on their current mission, for example soldiers in iraq are trained in heat stroke so troops that might me exposed to dangerous flora and fauna would get the appropriate training. Also consider what I said here:

In the far future of Traveler the simple training people get should include the use of simple medical diagnostic and treatment equipment that even a novice could use (I think of Star Treks Medical Tricorder).

So if you think this could be true, they would know the correct antidote.. In RL I believe most doctors would have trouble making that diagnosis without getting a description of how the patient got poisoned unless they were familiar with the local sources where the occurrence took place. Also I think they would not have anti venom in their med kits unless it was a common thing.

In my (meagre) experience, the vast majority of people in the UK wouldn't have a clue about anything beyond CPR, and even that is only what they might have picked up off TV. It might be different for the military and the emergency services, but military service over here is much less prevalent than over there

Too bad you don't know how your military is trained. My purpose in starting this thread was to compare the training received in RL Military and also civilians that work in a job where passengers are transported to determine if their Traveller counterparts should start with Medic-0.

I might give all ex-servicemen a house-ruled 'CPR' skill

Agree with you there. I did make the comment myself:

If Traveller had a separate First Aid, or First Responder skill we wouldn't even need to discuss this.

I'm trying to stay within the rules and I know there is a rule about GMs handing out Level-0 skills if they think its appropriate. As it says in the book

Level-0 indicates an orientation to the skill by an experienced person

and they give a list of skills that are "appropriate for level-0" and unfortunately medic is not listed so before I "break" the rules I wanted to see what people here thought (maybe different versions treat the handing out of L-0 skills differently?). Perhaps creating a new skill, which the rules also allow, such as CPR, First Responder, or First Aid as Icosahedron and I have mentioned is the answer. Unfortunately that info is on one of the pages I'm missing in my book. Maybe someone could shed some light....

Thanks Icosahedron, and again, could you or someone else, explain the 5 pt difference?

 

[CosmicGamer]

If a doctor is Medic-3, you need the Medic-2 for a nurse and the Medic-1 for a trained medic. This leaves Medic-0 for those people who had some real medical training beyond a normal first aid course, for example a police officer or a fire fighter, but not the average soldier.

Thank you for your input but I'm looking for a little more detail though. Why do you say yes for a police man or a fireman but not a soldier? Can you tell us the training these RL people get - not just your impression? I only can speak for one branch of military from one country (and even then it could be different for my brothers and sisters that are in positions that might not put them in harms way). I don't want to be limited by my own knowledge, which could be biased by my own experiences and not have a clear picture of how things happen in a wider scope.

 

[aramis]

In MT, the difference between unskilled and skill 0 is 4 points of DM. (A difficulty shift is a DM ±4.)

In CT, weapons exhibit a DM-5 for unskilled useage (TTB p37). This can be inferred to be the default CT unskilled penalty.

 

[rust]

"Level-0 indicates an orientation to the skill by an experienced person."

I highlighted the word where I see the problem with Medic-0.

During my short military career I was trained as a combat medic, and one of
my tasks was to give first aid courses for soldiers from non-medical units. So,
these soldiers did receive training and refresher courses, but they usually had
no real practical experience at all. And even those few who had used their
first aid skills now and then could hardly be described as "experienced".

Frankly, I would not even have described myself as "experienced". While we
had to solve some serious medical problems from time to time, this was no-
thing compared to what a civilian ambulance team was doing on a daily ba-
sis. The youngest voluntary Red Cross guy on an urban ambulance team had
more real practical experience than we did.

Edit.:
It is similar with police officers and fire fighters over here. They usually are the
ones who arrive on the scene first, and who are rightly expected to be able to
give at least sufficient first aid. They also do this almost daily (at least those
who serve with the highway police or the emergency teams of the firefighters),
and no theoretical training can only remotely come close to the skills they got
from experience "on the job".