Combat lifesaver course
The US Army Combat Lifesaver Course is an official medical training course conducted by the US Army, intended to provide an intermediate step between the buddy aid-style basic life support taught to every soldier and the advanced life support skills taught only to US Army Combat Medics (MOS 68W).
Providing at least one soldier in every squad with some ALS training and equipment (focusing on time-sensitive battlefield trauma such as arterial bleeding and blocked airways) creates a company-level organic reserve of trained auxiliary medical personnel, ensures the fastest response time to a wounded soldier on the battlefield and has been statistically proven to reduce the likelihood that a soldier will die while waiting for a battalion medic to arrive.[1]
Concept
US Army Combat Medics (MOS 68W) are trained up to and beyond the level of a civilian Advanced EMT, combat medics also train continuously at their profession, rather than splitting their duties. This makes them the definitive battlefield lifesaving resource for the US Army. However, in the absence of a 68W, the level of medical training available to the individual soldiers is quite low, basically equivalent to a civilian first aid course, and focuses on giving basic aid to a single other soldier (the buddy aid principle) until a medic arrives.
The CLS course is intended to bridge the gap between the minimally-trained average soldier and the highly trained Combat Medic (who may not be available in a trauma situation), by giving an intermediate level of ALS training and equipment to at least one soldier per 10-person squad. The idea is to ensure that in the absence of a combat medic, the CLS will be able to replicate some (though not all) of the full-fledged medic's ALS techniques for their squad until the patient(s) can be evacuated to definitive care (i.e. an aid station or field hospital) or a medic arrives to take over. It functionally extends the soldier's medical duties from just his or her battle buddy to his or her entire squad, and gives him or her the extra training to do it successfully. In times when there is many casualties and few medics (and presuming the soldier can be spared), the CLS can also serve as a competent assistant at an aid station.
Course outline
- 40 hours theory & practical instruction
- 40 question written exam (pass/fail), 70% minimum score
- 30 minute practical exam (pass/fail), 100% minimum score
While a CLS certification is technically permanent, soldiers in Priority 1 units (actively-deploying brigade combat teams, for example) must retake the course once a year to retain their certification.[2]
Scope of curriculum
Aside from basic first aid, Combat Lifesavers are also taught to identify and perform the correct pre-hospital treatment for:
- Tension pneumothorax produced by a penetrating (bullet/frag) or non-penetrating (explosive barotrauma) lung injury
- Vascular hypovolemia produced by uncontrolled external hemorrhage
- External arterial hemorrhage (especially from an extremity)
- Destabilized spinal cord injuries
- Sucking chest wound produced by a penetrating (bullet/frag) chest injury
- Respiratory failure produced by a non patent airway in an unconscious or semi-conscious casualty
Combat Lifesavers are not, however, trained or permitted to perform (among other things) laryngoscopy, single lumen tracheal intubation or any kind of surgery (such as emergency cricothyrotomy), since all involve a high risk of failure and serious additional injury to the patient when performed by a non-expert. Likewise, CLSs are not permitted to carry or dispense any medication (aside from the acetaminophen, meloxicam and moxifloxacin pills carried in every soldier's Combat Pill Pack) without specific orders from their Battalion Surgeon.