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Rules of organising courses and training at WCKMed.

The Military Medical Training Center in Lodz, hereinafter referred to as the ‘Organiser’, delivers training in the form of upgrading refresher and qualifying courses, specialist training, training for the needs of the National Reserve Forces, training for students – candidates to become professional soldiers of the medical corps, and training for the needs of NGOs and other social partners, pursuant to:

-     Decision No. 420/MON of 12 September 2008 on the introduction of the system of vocational enhancement of professional soldiers in the Polish Armed Forces;

-     ‘Annual plan of vocational enhancement of professional soldiers of the Polish Armed Forces for the year 2012’, approved by the Minister of National Defence on 1 June 2011;

-     National Medical Rescue Act of 8 September 2006 – Article 12(2) and Article 13(2)(3) (Dz. U. 2006 No. 191, item 1410);

-     Regulation of the Minister of Health of 19 March 2007 on the qualified first aid courses (Dz. U. No. 60, item 408);

-     Regulation of the Minister of Internal Affairs and Minister of National Defence of 23 December 2011 amending the regulation on the qualified first aid training (Dz. U. No. 299, item 1778).

1. On the first day of the course/training, Organiser provides the participants with the following information:

 - Course organisation and agenda,

 - Mandatory completion of theoretical modules,

 - Rules of procedure binding at the course/training which every participant should sign upon getting familiar with their content,

 - Method of completing the course/training.

2. Timetable of classes is displayed on the information board at the Teaching Department.

3. Course/training participants are obliged to take part in all the classes planned in the course/training programme.

4. Acquired knowledge and skills are verified based on the final exam passed before the Committee, which covers theoretical and practical exams. The average grade of the theoretical and practical parts is calculated as the arithmetic average. The scale of grades:

from 3,00 to 3,50    satisfactory (3);

from 3,51 to 4,50  – good (4);

from 4,51 to 5,00  – very good (5).

5. Upon completion of the course/training, Organiser issues a statement or a certificate which confirms completion of the course/training, as well as keeps a register of the issued statements and certificates. This documentation is stored for the period of 5 years.

6. Uniforms worn during the course/training – battle dress, adapted to the time of the year and conditions.

  • Combat Lifesaver (CLS) Training,

  • Combat Medic Training,

  • Course in the advanced life-saving procedures applied in injuries under pre-hospital care,

  • Specialist training under qualification course for candidates to the career Master Corporal (E5) rank addressed to NCOs without medical background,

  • Specialist training under preparatory service in the corps of privates,

  • CLS upgrading refresher course (Combat Lifesaver) for cadets of the Military Academy of Land Forces in Wroc³aw,

  • Upgrading refresher course in the field of epidemiology and military hygiene for medical personnel of the Polish Armed Forces, who implement missions abroad,

  • Upgrading refresher course in the field of rendering medical care to casualties in the environment contaminated with CBRN and toxic industrial agents,

  • Upgrading refresher course in the field of rendering medical care to casualties in the CBRN environment,

  • Training in the field of rendering first aid organised for Riffle Associations,

  • Upgrading refresher course in the field medical rescue and life-threatening conditions,

  • On-the-job training of the Polish Armed Forces medical personnel who implement missions abroad,

  • Upgrading refresher course for officers applying for senior job positions. Special functional level – 8351002 (Lieutenant Rank),

  • Upgrading refresher course for officers applying for senior job positions. Special functional level – 8351001 (Captain Rank),

  • Upgrading refresher course for candidates for job positions requiring special vocational qualifications at the major rank – of the medical corps – course code 1020003,


Combat Lifesaver (CLS) Training

The CLS key assumption is that every crew (e.g. KTO Rosomak vehicle) or team has at least one trained Combat Lifesaver. This person will act as a bridge between the combat casualty and medical services in a detachment or MEDEVAC team that will reach the patrol or convoy. Every participant of this training that passes the exam will receive a document which confirms the course completion. The document will be included into the graduate’s personal files. Combat Lifesaver must be recertified at least every 12 months, at the military unit level.

U.S. peers wish to ensure that the Polish units which serve in Afghanistan include CLS graduates, who, based on the acquired know-how, will be able to render care to their colleagues using U.S. Army equipment and procedures.

Combat Lifesaver (CLS) Training includes the following elements:

- Rendering tactical medical combat casualty care and taking decisions on the types of care rendered under fire or during the tactical phase and during evacuation of the casualties from       danger zone;

- Assessing the casualty condition;

- Opening and maintaining the airway;

- ing nasopharyngeal airway in cases of facial injuries or severe unresponsiveness;

- Using large-bore needle in chest injuries to decompress tension pneumothorax;

- Treating penetrating wounds;

- Stopping bleeding using such aids as haemostatic dressing;

- Preventing development of hypovolemic shock;

- Using Combat Application Tourniquet - CAT (with one hand);

- Initiating field medical card;

- Medical evacuation (MEDEVAC) request;

- Casualty evacuation using SKED or improvised litter.


Equipment required for the CLS training participants

   1.   Battledress uniform (2 sets) – depending on the time of year,

   2.   Body armour or tactical vest,

   3.   Knee + arm pads,

   4.   Helmet,

   5.   Tactical gloves,

   6.   Goggles,

   7.   Headlight (torch),

   8.   Notebook + ballpoint pen + pencil.


Combat Medic Training

This training is dedicated to medical rescuers, to the personnel appointed to take part in foreign missions in particular. It is a 5-day course. Prior to the training, trainees are required to get familiar with TCCC Guidelines, which are displayed on the Center’s website.

Due to the form of this course, trainees must be very fit and resistant to stress.

Training activities are delivered in the Battlefield Medical Simulation Center and Jezewo Center. The key activities include lectures, practical activities and medical simulation. After each theoretical module, practical activities focused on a specific topic to ensure that the trainees accomplish training goals at the highest level are held. During the practical training the trainees have to be equipped with full gear (body armour, helmet, kbk AK rifle, rescuer’s backpack)

To prepare the trainees adequately to render medical care in difficult conditions, the activities are also held late in the afternoon and at night. If in the course of the training a trainee does not demonstrate that his/her knowledge is expanding or his/her skills turn insufficient to accomplish tasks requested by the instructors, the Course Manager in consultation with the instructors may decide to eliminate this trainee from the ongoing course. The trainee can make such a decision himself/herself if he/she considers that he/she is unable to learn the material and accomplish the tasks.

The final exam is held at the Jezewo Center, based on 3 simulated scenarios, which involve three phases of tactical medical care, i.e. CUF, TFC, and CASEVAC.

Examples of questions:

1. A 45 year old patient was riding a motorbike and hit a post. During assessment of his injuries you have established that your patient has an altered mental status, dyspnea, HR 140/min,     his neck veins are excessively swollen, diminished breath sounds on the right side, hyperresonant(drum) percussion. Your diagnosis is:

a.    Pneumothorax

b.    Cardiac tamponade

c.    Pneumonia

 

2. Adrenaline is recommended in the following circumstances:

a.    Sudden Cardiac Arrest 1mg i. v. every 3-5 minutes

b.    Treatment of anaphylaxis 0,3 mg/h i. v.

c.    Asystole and PEA, the first dose is administered after 5 minutes

 

3. Which of these parameters defines ‘shock’ best:

a.    Loss of 30% or more of circulating blood

b.    Systolic pressure is below 90 mm Hg

c.    Inadequate tissue perfusion

 

4. Femur fracture may lead to the following blood losses:

a.    500-1000 ml

b.    1000-2000 ml

c.    1500-3000 ml

 

5. You are rendering care to a casualty, and you are under fire.  Which of the following actions will you perform before you move the casualty to a safe location?

a.   Restore the airway.

b.   Perform needle chest decompression.

c.   Place a tourniquet (CAT) on the extremity with the wounds which bleed severely.


The course on the advanced life saving procedures performed in case of injuries to the body under pre-hospital care phase

This course is to prepare medical rescuers, nurses and physicians for the needs of the Ministry for National Defence to deliver tasks in terms of the advanced life saving procedures, which are rendered to individuals who have suffered injuries which pose an immediate threat to health status at the site of the incident, during their evacuation, until they are passed to personnel of the medical treatment facilities. The course curriculum is in line with the International Trauma Life Support guidelines. A special emphasis is placed on the practical aspect of the activities and on preparing the trainees to work in military units as well as taking part in foreign missions. Practical training during which iStan Mobile Patient Simulator is used is particularly interesting.


Specialist training under qualification course for candidates to the career Master Corporal rank dedicated to NCOs without medical background

A specialist training whose objective is to award NCOs of the military health service with specialist qualifications to assume higher positions  This training participants enhance their skills in the field of rendering medical care on the modern battlefield, including the procedures binding during foreign military missions. They also learn how to perform basic life support procedures in adults (BLS) in accordance with the binding guidelines of the Polish and European Resuscitation Council, assess the casualty’s condition in terms of risks to vital functions, perform trauma survey (initial assessment, focused examination, rapid trauma survey) and qualify trauma patient for evacuation from the site of the incident using available rescue equipment. The trainees also learn how to cope with stress and provide basic psychological support to victims of the accident and their relatives. They also learn about treatment and evacuation options available at Role 1 and Role 2 of the medical support, as well as improve their English language skills to submit 9-line MEDEVAC request. The participants also get familiar with the topics of ethics and medical law.


Examples of exam questions:

1.   Which of the following kits contains infusion fluids:

a.   IPMed

b.   Prevention and treatment kit

c.   CLS bag

d.   Medical rescuer’s bag

 

2. Which of the following documents is the document that contains personal details necessary to establish whether its holder is entitled to use protection envisaged under the Geneva Convention and which complies with the requirements of the ID card envisaged in the Agreement of the North Atlantic Treaty:

a.   ID card

b.   Identification plate (ID)

c.   Professional soldier’s ID card

d.   A white band with a red cross symbol

 

3. Swollen neck veins may suggest the following:

a.   Tension pneumothorax

b.   Cardiac tamponade

c.   Blood clotting disorders

d.   A & B are the right answers

 

4. In accordance with TCCC guidelines, which of the following actions performed on the battlefield should provide the best results in terms of preventing deaths on the battlefield?

a.   Perform chest decompression

b.   Restore airway

c.   Control of massive haemorrhages from extremities

d.   Preventing minor wounds from infections

 

5. Which of the following words should you use in MEDEVAC request to specify the code marked with letter "C"?

a.   COMBAT

b.   CELOFANE

c.   CHARLIE

d.   CREDIT

 


Specialist training under preparatory service in the corps of privates

A training dedicated to militaries of the preparatory service, candidates to the National Reserve Forces (NSR) for the needs of the corps of privates to perform duties in the posts in accordance with the military specialisation held in the medical personnel corps.

All classes are delivered by qualified medical rescuers who work in the units of the National Medical Rescue Service system, using state-of-the-art equipment and based on the binding guidelines. The groups consist of 6 trainees, which ensures that each trainee is able to take an active part in the practical activities and benefit from individual approach of the instructor. They learn the rules on how to proceed with trauma casualties and casualties in the state of immediate threat to life, perform CPR (including the use of AED - automated external defibrillator), and ensure psychological support to victims of accidents. During exercises, which are held at the Practical Training Center, the trainees acquire know-how on triage of mass incident casualties and their evacuation from vehicles. These skills are later practised during practical activities at the Jezewo Training Center. The activities are delivered in cooperation with instructors of the National Fire Service. The training is additionally complemented with English classes in the field of basic military-medical terminology, NATO alphabet and 9-line MEDEVAC request. Soldiers of the preparatory service also get familiar with the principles of recruitment to the National Reserve Forces as well as with characteristics of this service.

Intensity of the classes and the scope of knowledge delivered to the trainees prepare them to render first aid on the incident site until the casualty is passed to medical personnel. The training is delivered pursuant to provisions of the Regulation of Minister of Health of 19 March 2007 concerning the course in the field of the qualified first aid (Journal of Laws (Dz. U.) of 2007 No 60, item 408 with subsequent amendments) and its graduates are eligible to obtain the title of rescuer.

 

Examples of exam questions

1.  Assessment of the casualty’s respiration is performed for:

a.  15 seconds

b.  10 seconds

c.  25 seconds

d.  1 minute

e.  None of these answers is right

 

2.  A cause of hypovolemic shock:

a.  Rapid reduction of sugar level in blood

b.  Rapid increase of sugar level in blood

c.  Temporary unconsciousness

d.  Reduced volume of circulating blood

e.  All these answers are wrong

 

3.  AED electrodes are placed in the following way:

a. One under the right collarbone along sternum, and the other above the tip of the casualty’s heart

b. The electrodes may be placed on the casualty’s chest in any location on both sides of the sternum

c. One under the left collarbone along sternum, and the other above the tip of the casualty’s heart

d. The electrodes should be placed ‘2 fingers’ above the casualty’s intercostal angle

e. Place them to ensure that their endings do not touch each other above the sternum which  will facilitate energy flow

 

4.  In order to press the chest during the closed chest cardiac massage you should place your hands in the following way:

a.  In the middle of the casualty’s sternum

b.  In the bottom 1/3 ending of the casualty’s sternum

c.  To the left from the center above the casualty’s heart

d.  1cm above the casualty’s intercostals arch

e.  In the upper 1/3 section of the casualty’s sternum

 

5.  Restoring respiration, circulation and consciousness means:

a.  Defibrillation

b.  Resuscitation

c.  Reanimation

d.  Decontamination

e.  Decompression

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