Thank you very much for that excellent question. I'll speak both about the medical technicians and about nursing.
You've probably heard of this thing called tactical combat casualty care. This is a system of pre-hospital care that focuses directly on what injures soldiers on the battlefield. The Canadian Forces have run several large courses to prepare medical technicians to deploy. This paradigm came out in 1996, but it was really adopted probably in 2001-2002 with the beginning of Operation Apollo.
It focuses on simple manoeuvres, such as providing a tourniquet or providing a needle decompression for a collapsed lung. In fact, IV training in the pre-hospital setting is actually frowned upon now. It's less important, because there have been some studies to suggest that giving fluid early on in the field may actually be detrimental to patients.
The medics now are trained within this new paradigm called tactical combat casualty care. Having served in the Balkans in the nineties and in Afghanistan in this decade, I have to say the medical technicians have really come into their own. They have a defined mission. They have a defined specialty. No one provides better pre-hospital trauma care than they do. We have a pretty good way of providing pre-hospital care training for the medical technicians.
The nursing staff are now using the same model the physicians are using, which is the realization that if you're going to prepare for treatment for critically injured patients, you need to see critically injured patients in your normal day-to-day activity. Nursing staff are more and more embedded in hospitals, or they're sent for what we call “maintenance of competence”. There is a program under which we send nursing staff, particularly emergency medicine nurses, critical care nurses, and OR nurses to work in civilian hospitals to provide these skills so that when they deploy, they're able to treat our soldiers.