Charlie med's MASCAL: we train as we fight
May 26, 2013
NANGARHAR PROVINCE, Afghanistan - Amid a cacophony of theatrical shrieks and cries of pain, medics from Charlie Company, 426th Brigade Support Battalion, 1st Brigade Combat Team, 101st Airborne Division, sharpened their skills with a mass casualty training exercise at Forward Operating Base Fenty, Afghanistan, May 12.
"You train as you fight," said 2nd Lieutenant Thomas Watts, treatment platoon leader, Charlie Co., of Bardstown, Ky., who spearheaded the drill.
He's not just saying this, either. The medics of Charlie Co. had only been in country a few weeks when a complex attack at Fenty on December 2, 2012, created an actual mass casualty event.
In order to stay prepared for these types of events, Charlie Co. conducts these mass casualty exercises, or MASCAL drills, about once per month to hone perishable medical skills, said U.S. Army Spc. Stephanie Emerson, medic, Charlie Co., of Peru, Ind.
The May 12 training exercise had a particular focus: to break in a new provider (doctor) and a new forward surgical team.
"We wanted to do a MASCAL drill to incorporate both of them so they could see how it actually functions," Watts said.
In addition to this, Charlie Co. tested emergency blood-drive procedures for the first time.
The Dec. 2 attack tested the blood supply system at the aid station, so they have to be prepared for resupply from elsewhere while handling casualties, Watts said. In case they ever need whole blood again in an emergency situation, Charlie Co. has had the practice now to meet the need locally.
During the MASCAL exercise, volunteers sporting note cards describing their injuries sprawled all over the pavement outside the aid station, clamoring for help.
Charlie Co. medics attended to each simulated victim in turn, first ascertaining the severity of the soldier's injuries, and then establishing an order for treatment based on the soldier's chances for survival. Those most critically injured were seen first.
After triage, medics carried the wounded soldiers into the aid station on litters. Depending on the severity of the injury, the soldier was either transported to the treatment room and from there to holding, or directly to patient holding.
"It was chaos," Emerson said. "It was a joint effort to treat the patients and get them life-saving procedures and get them to a higher echelon of care."
After the first round of volunteers had been put through the team's care, another wave of casualties showed up, similar to what happened during the Dec. 2 attack. This wave of casualties included a handful of medics tapped to play victims for their teammates.
Emerson was one of the medics who became a victim during the second round. Her injury was a gunshot blast to the jaw, which meant she couldn't speak during the drill.
She said she was quite impressed with how her fellow medics handled themselves and how they cared for her.
"They were asking me questions, and asking me to answer yes or no to see if I was coherent," Emerson said. "They were doing a great job. I'm very proud of them."
From the perspective of a patient, of a frontline medic, and of the officer in charge, the exercise was a success.
"There was no hesitation, there was good communication flow, everything was done in a quick and important manner," said Watts. "They didn't act like it was a drill; they acted like it was for real."