Friday 17 April 2015

SAF's faster response to injuries in the field

Civilian paramedics to reach casualties anywhere in the field within 11 minutes
By Jermyn Chow, Defence Correspondent, The Straits Times, 16 Apr 2015

SOLDIERS who are critically injured during small-scale training exercises are now being seen and treated by civilian paramedics in the field, in a move to sharpen the military's emergency response.

The change is a result of the Singapore Armed Forces (SAF) outsourcing its emergency ambulance services, which allows the activation of civilian-run ambulances to military training areas during medical emergencies.

The new emergency procedure will see a team of three civilian first responders, led by a paramedic, reaching casualties anywhere in the field within 11 minutes.

Emergency doctors said that the move will boost the emergency care of injured army troops, who train very often in the western part of Singapore that stretches from Lim Chu Kang to Jurong, where they usually practise battle manoeuvres in the forests or conduct live-firing exercises.

Previously, only SAF medics, who may not be as seasoned or skilled as civilian paramedics, were stationed on site to deal with emergencies during training drills such as field camps, route marches and navigation exercises.

Another improvement is that casualties will now be taken straight to the hospital to get medical help from emergency doctors.

No longer is it necessary to first take casualties to the nearest SAF medical centre to be seen by the military doctors.

Since the new ambulance service was launched on Jan 19, two injured servicemen have been evacuated in civilian ambulances from the training areas to the hospital.

Chief army medical officer Poon Beng Hoong told The Straits Times that the latest move has sped up the SAF's emergency response, although he did not want to say by how much.

"It is a dedicated, 24/7 system that projects care outfield to servicemen... That's an important change," said Colonel (Dr) Poon.

Six ambulances are stationed at six SAF medical centres across the island. When activated, they rush to 16 designated medical posts in the training areas to attend to casualties, who typically suffer heat and trauma injuries, and respiratory distress.

The new ambulance service is being launched ahead of the opening of the Ng Teng Fong Hospital in Jurong in July, which will allow soldiers in the western part of Singapore to get to the hospital in 15 minutes - half the 30-minute journey to the National University Hospital, where most SAF casualties in the west are rushed to.

Describing the civilian-run ambulance service as a "game changer", Associate Professor Eillyne Seow said that having the "clinical acumen" of civilian paramedics will boost the quality of care of injured servicemen in the field.

"It is critical that paramedics are able to identify signs and symptoms very quickly to decide how best to manage the casualty," said the senior consultant at Tan Tock Seng Hospital's emergency department.

Shore up SAF medics

I AM glad the Singapore Armed Forces (SAF) is taking active steps to ensure training injuries are attended to in a timely manner ("SAF's faster response to injuries in the field"; last Thursday).

However, I have a few concerns about the development.

When I served my active and reservist national service, the medics who served along with me were of very high quality, and were passionate people.

Bringing in civilian medics will cause the SAF medics to lose precious real-life clinical experiences, and deprive them of good lessons and learning material.

Combat medics are front-line soldiers. They know the terrain and military operations well, and are trained for that role and function.

Civilian medical equipment and vehicles are not suitable for use during military operations, as they are not manufactured to military grade.

Involving unscreened civilians in sensitive military operations may also be a breach of security.

There are some ways to counter these problems.
- Use the civilian paramedics and nurses to enhance combat medic training. They can do the training of trainers. This will be more cost-effective than having civilians be on standby during exercises.
- Attach our active and reservist medics to the Singapore Civil Defence Force ambulance service and to hospital emergency departments for training, service and refresher courses.
- Have regular exchanges between the SAF medical corps and medics of other armies.
- Send out our SAF medics as first responders in disaster relief work. This will not only enable them to serve others, but also give them the chance to hone their skills in real life.
- Hire more senior medics in each unit to supplement SAF medical officers and share the wide range of duties.
- Enlist more medically trained volunteers under the new volunteer corps.
Many of my doctor friends have volunteered to extend their reservist duty under the SAF's roving scheme. This should continue, and the SAF should deploy them accordingly.

Leong Choon Kit (Dr)
ST Forum, 22 Apr 2015

SAF medics well-trained for operational duties

WE THANK Dr Leong Choon Kit for his feedback and support for national service ("Shore up SAF medics"; last Wednesday).

The Singapore Armed Forces (SAF) Emergency Ambulance Service (EAS) enhances the medical evacuation support system to provide more comprehensive medical coverage for our training activities. When a serviceman suffers injury in the field, the SAF medic will stabilise him and evacuate him to the casualty collection point, where the EAS crew will take over the management of the casualty, all the way to the hospital.

The SAF medics, paramedics and medical officers continue to remain central in providing medical support

for SAF operations and training. Besides maintaining the operational readiness of all SAF medical centres, they also participate in various local and overseas exercises. Many of them served in overseas operations, including the SAF's six-year deployment in Afghanistan, the 2004 tsunami-relief efforts in Aceh, and various United Nations missions.

We are glad that Dr Leong attests to the quality and passion of the medics who served with him during national service. The medic training curriculum is reviewed regularly by medical specialists and is updated to keep pace with the latest medical evidence and best practices.

As part of their training, medics have to undergo a rigorous curriculum where they are taught critical life-saving skills, such as cardiopulmonary resuscitation, the use of an oxygen resuscitator and the use of an automated external defibrillator. Their skills are honed as they provide medical treatment in their units and, when required, emergency medical response to SAF servicemen.

Both the SAF and Singapore Civil Defence Force paramedics receive further training at the SAF Medical Training Institute. They can provide advanced pre-hospital emergency care independently, such as the administration of life-saving drugs.

The SAF paramedics provide medical support for training, perform operational duties, and instruct trainee medics. Working as a team, they are assisted by the medics when they are deployed to support training activities.

We assure Dr Leong that the EAS ambulances meet the SAF's stringent medical evacuation requirements, and the EAS team members meet the necessary security requirements.

The well-being of our servicemen is of paramount importance to the Ministry of Defence and SAF. We will continue to enhance the SAF's safety and medical support systems.

Poon Beng Hoong (Colonel Dr)
Chief Army Medical Officer and Commander
SAF Medical Training Institute
ST Forum, 27 Apr 2015

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