Next Generation Combat Medic

Next Generation Combat Medic We provide a forum of perpetual learning, discussion, and camaraderie for "Doc", because knowledge we Fully understand the principle and master the basics.

Remember, We PRACTICE medicine so there is typically "A way" and not "The way". Only then can you apply or adapt to solve the problem and execute.

**Individuals that post in this group will post as private individuals and not as a representative of their organization or official position**

03/08/2026

Lethal Triad or Diamond?

As long as we can agree to not push Calcium BEFORE blood. Blood first, and slow push calcium.

Pushing before blood, in the absence of blood, or slamming it quickly should be addressed in training simulations.

1.) How do you teach blood sweeps? Vote below 👇🏻 2.) If you noticed that students were doing different methods, how woul...
02/08/2026

1.) How do you teach blood sweeps? Vote below 👇🏻

2.) If you noticed that students were doing different methods, how would you standardize? Would you fail a student who did not blood sweep at all or as much as you wanted, even if they “caught” all the bleeds?

3.) Do blood sweeps differ from all service members (ASM, Tier 1), to CLS, (Tier 2), to Combat medic/Corpsman (Tier 3), to Combat Paramedic (Tier 4)? Should they? …what additional info does chest and back give you, and do you need it that early?

4.) Are some nuances such as “raking” the back necessary?

You notice 1,500mL+ blood coming out of your chest tube in a trauma patient you performed a tubal Thoracostomy on. Do yo...
02/02/2026

You notice 1,500mL+ blood coming out of your chest tube in a trauma patient you performed a tubal Thoracostomy on. Do you clamp or no? Where did you learn that?

What is the thought process behind clamping?

Regarding of team clamp vs no clamp, think about what this patient really needs.

How do you check where to put your lower junctional wounds in training? Do you palpate the pulse and place it over? Do y...
02/01/2026

How do you check where to put your lower junctional wounds in training? Do you palpate the pulse and place it over? Do you estimate with landmarks? Eyeball it? Directly on skin or above pants? Vote below 👇🏻

Yesterday most guessed correctly on our photo, but in training we are often seeing too high or too low, especially when placed over clothes. Sometimes they are placed correctly on clothes and shift lower during movement or packing/wrapping.

Does 2-4 inches matter in this context? As long as it’s above where a TQ goes, is it junctional? Look at the first slide. Note the difference in angle the ACE wrap has to go depending on where the wound is. The lower angle (black arrow) is inherently easier and slides down less. The wrap necessary for a true junctional is a little higher and will likely require you to go through a belt (or make one), and can be a more difficult angle to perform and maintain.

I don’t know if a medic that cant place a moulage wound accurately knows how to use indirect pressure to stop a life threatening bleed. 🚨 200+ lbs of pressure just an inch to the side of an artery will barely slow the bleeding, if at all. You need to find it every time, and quickly. Learn the femoral triangle. Put your moulage in the right spot.

Instructors can also consider a distal palpate pulse with one hand while medic is attempting proximal pressure over artery. If you can still feel it, you can still spray blood from spray bottle/wound with opposite hand. You can even practice this as a skill outside of trauma lanes for axillary and femoral artery occlusion with hands.

How do you decide where to put moulage for your junctional wounds? Vote which is closest to where you would (2nd slide) ...
01/31/2026

How do you decide where to put moulage for your junctional wounds? Vote which is closest to where you would (2nd slide) and how you decide where to put the wounds on a role-player or other medium.

We sometimes see training scars of choosing an area to place it at random. Can we accurately place this for our TCCC lanes while maintaining comfortability of the role-player?

What is the risk of placing in a different area? I mean technically our patients can get shot/shrapnel anywhere… so can we just put wounds wherever we want?

The anatomy in this region is highly important to know for good instructors, and patient care.

How do you handle students doing poor hypothermia management? Let’s say you’re a senior medic and you see multiple medic...
01/28/2026

How do you handle students doing poor hypothermia management?

Let’s say you’re a senior medic and you see multiple medics who aren’t necessarily forgetting HPMK, beanie and all but putting it on very late, leaving open constantly, exposing whole patient for a procedure on one limb, etc. They “check the block” but don’t really crush it or take seriously.

Let’s discuss quality feedback and how to drive this home as leaders and instructors to deliver higher quality patient care.

Reminder on our website we have a guide on running TCCC lanes and grading them:
https://nextgencombatmedic.com/2025/08/19/teaching-better-tccc/

Which is better and why? Looking for less of a popularity contest and more reasons why initial training and culture of l...
01/27/2026

Which is better and why?

Looking for less of a popularity contest and more reasons why initial training and culture of line units and the providers over them may more consistently lead to a better product l.

Our discussion yesterday had heated opinions on Paramedic school for Medics. But not all Corpsman get even EMT in school… does that make them weaker providers? Or is EMT not as applicable for providers?

Consider the same logic on back when SOF medics were all EMT and not NRP.

All Army medics are at least EMT, but don’t have NPI numbers.

At the root of this discussion is what we want with initial training and on the job training at our units through leaders and providers.

(Anecdotal cases of your worst experience with the other side may still be applicable. đź‘€ )

Do you ever wonder how much blood was used in WW2?This article covers how ~26,000 casualties on Iwo Jima were supported ...
01/26/2026

Do you ever wonder how much blood was used in WW2?

This article covers how ~26,000 casualties on Iwo Jima were supported with ~12,600 units of LTOWB across ~7,000 miles.

There are a lot of cool historical facts in here, as well as applicability to those concerned with blood and logistics in LSCO. Also, thinking about how they used LTOWB in 1944 but we used Hextend in 2010 is not lost on me.

Check out the paper and let us know what you think.
https://doi.org/10.1111/trf.70073

“Amateurs talk about tactics, but professionals study logistics.”
– General Robert H. Barrow

Who uses Diclofenac Gel as a topical NSAID? Which joints do you consider, versus which do you avoid? Should it be paired...
01/25/2026

Who uses Diclofenac Gel as a topical NSAID? Which joints do you consider, versus which do you avoid?

Should it be paired or avoided with an oral NSAID?

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