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Combat Medics Train For The Worst
by U.S. Army Staff Sgt. Ian Kummer - March 31, 2016

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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!”

The 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)
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 location.

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.

Medical 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.

So 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,” Goldsmith said.

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 gauze.

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 refresher.

“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 Public Affairs
Provided through DVIDS
Copyright 2016

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