CAMP BUEHRING, Kuwait – Five Soldiers carefully patrolled through
a cramped compound of wood and tin buildings. The sky was overcast.
The sand beneath their feet was as fine as sawdust. As the Soldiers
moved, they scanned nearby rooftops and windows for possible
threats. All was quiet, for the moment.
Sounds of gunfire
and explosions echoed throughout the cramped compound of tin and
wood buildings. A panicked cry rung out... “Medic!”
patrol broke into a run, it only took a few seconds to arrive at a
chaotic scene: Several smashed vehicles surrounded by bodies. A
wounded Soldier was crouching behind cover a few meters away.
What started out as a foot patrol turned into a rescue party.
Soldiers from 1st Battalion, 63rd Armor Regiment, and the 10th Combat Support Hospital, treat simulated patients at a tactical combat casualty care lane at Camp Buehring, Kuwait, February 23,
2016. The 40th Combat Aviation Brigade ran a two-day TCCC course for medics stationed at the camp. (U.S. Army photo by Staff Sgt. Ian M. Kummer, 40th Combat Aviation Brigade Public Affairs)
The rescuers set to work immediately, rallying wounded
troops who could walk, and retrieving those who couldn't.
Within a few minutes, all survivors were evacuated to a safe
But the job was far from over. Two
casualties were critically wounded. Without immediate and
effective medical care, they would die.
Fortunately, the mission was only a
training exercise. The “battlefield” was a training compound
in Kuwait. The “casualties” were training mannikins. But the
scenario depicted was a very real one for millions of
Soldiers across the world throughout history.
staff from the 40th Combat Aviation Brigade operated a
Tactical Combat Casualty Care training lane for 10 Soldiers
stationed at Camp Buehring, Kuwait, Feb. 22-23.
far, the 40th CAB had trained more than 60 Soldiers in the
TCCC lanes. Their mission: To familiarize medics with the
conditions and challenges they may face in combat.
“The goal here is to have an all inclusive training event,
from the point of injury, casualty collection, the
[Battalion Aid Station], a medevac request and the medevac
itself,” said Sacramento, California, resident Capt. J.C.
Devilla, an aeromedical physician assistant with the 640th
Aviation Support Battalion, 40th CAB. “If they can work out
here with the skillset to stop preventable deaths ... we've
done our jobs.”
The 40th CAB's TCCC class consisted
of two days of training. Participating medics spent the
first day receiving classroom instruction to as a refresher
to the procedures and equipment they would be expected to
use in the field. On the second day, the medics went out to
combat training lanes designed to simulate real-world
conditions as closely as possible. The student medics were
split into two teams – a five-person group at the point of
injury to provide care-under-fire and tactical field care to
patients immediately after being wounded. A second team
positioned at a simulated battalion aid station then
stabilized the patients sufficiently for a medevac by a
UH-60 helicopter from Company F, 2nd Battalion, 238th
Aviation Regiment, 40th CAB.
After completing the
exercise, the two teams swapped places for a second batch of
simulated patients. After a break for dinner, everyone
returned to complete the whole exercise again at night.
“By having the teams swap, they gain an appreciation for
the other guy's job, and the limitations involved,” said
Sacramento resident Lt. Col. Brian Goldsmith, a flight
surgeon in 1st Battalion, 140th Aviation Regiment, 40th CAB.
Every step of the process involved real medical
equipment, and medics were required to place tourniquets,
IVs and other life-saving aids on the dummies as they would
on a real patient.
“Nothing is notional, here we have
actual hands-on muscle memory and tactile experience,”
Many of the tools and techniques the
medics used on the trauma lanes were new, but the challenges
they faced were as old as war itself. Throughout the
millennia, it was a generally accepted fact that the vast
majority of Soldiers who sustained serious injuries would
die. Even as late as the American Civil War, poor nutrition,
unsanitary conditions, crude medical technology and lack of
antibiotics sealed the fate of tens of thousands of wounded
fighting men – even ones with relatively minor injuries.
According to the Civil War Academy, battlefield surgeons
were unfamiliar with the risks of infection and typically
used the same surgical tools on patient after patient.
By World War II, improvements in medical science both on
and off the battlefield vastly improved the care wounded
Soldiers received. However two vital tools were still
missing. Firstly, a helmet and wool uniform were typically
an infantry Soldier's only protection against enemy weapons.
If he was caught in a blast or heavy fire, even if he
survived, he would likely be too severely wounded to be
saved. Secondly, even after receiving first aid treatment,
it could be hours or even days before a casualty could be
evacuated to a properly equipped hospital. Motor vehicles
were in use, but relied on roads that were often in poor
condition or sometimes even fell back into enemy hands
during the course of a battle.
Solutions to both of
these problems debuted in the Korean and Vietnam conflicts.
Body armor started coming into widespread use, which helped
protect a Soldier's vital organs against gunfire and
shrapnel. Helicopters also joined the fight, enabling rapid
evacuation of wounded troops.
A new term came into
use: The golden hour. If a Soldier with treatable injuries
is kept alive and transported to a proper operating table
within 60 minutes, he has a fighting chance of recovery.
Medical science, military training and doctrine
continued to improve in subsequent conflicts. In the Global
War on Terror and the following military operations to the
present day, the biggest threat to wounded American service
members is hemorrhage. A Soldier wounded by a gunshot or an
improvised explosive device can bleed out within a couple
minutes. The military developed new tools to combat
hemorrhaging, like tourniquets and chemical-laced combat
But these advances aren't effective without
well-trained and quick-thinking medics to employ them.
Simply knowing the textbook answer to a medical problem
isn't enough. An effective medic must be able to handle a
stressful situation where even a short delay or a small
mistake can be the difference between life and death.
“We stress [the training medics] so they fall back on
their basic knowledge of what they need to do to save a
life,” Devilla said.
No one was allowed to stay in
the role they were most comfortable with, instead cycling
through as many different tasks as possible to ensure every
trainee was well-rounded.
The most junior medic at
the trauma lanes, Pfc. Baker Zarzour, a Chattanooga,
Tennessee, resident in 1st Battalion, 63rd Armor Regiment,
found himself appointed as a team leader. Zarzour graduated
from his job training last August, and deployed to Kuwait in
October. The 40th CAB's trauma lanes were one of Zarzour's
first tastes of practicing medical skills since his initial
certification has a medic.
“I'm glad I got the chance
to do something I'm not comfortable with,” Zarzour said.
“Being tasked as a team leader, I've never done that before
and I did my best ... it was good training, I liked it.”
Even experienced medics got the chance to hone their
skills out in the lanes. Long Beach, California, resident
Sgt. Ravalene Butler, the aviation medical noncommissioned
officer for 1-140th AVN, is on her second deployment with
the 40th CAB. Her current job doesn't take her into the
field very often, making the trauma lanes a welcome
“It's good to get out of the office, get
your hands dirty and get back into the combat medical
mindset,” Butler said.
More photos available below
By U.S. Army Staff Sgt. Ian Kummer, 40th Combat Aviation Brigade
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