In his own words:
Master Sgt. Richard Russell, operations noncommissioned officer with the U.S. Army Africa Surgeon's Office provides an overview of Tactical Combat Casualty Care training in N'Djamena, Chad.

September 19, 2013
Past 24 hours:
The Tactical Combat Casualty Care team headed to the training compound where we set up our class room for our third day of formal training with a class. Our class added three new students today, who had just returned from the anti-terrorism efforts in Mali.

The 12 students were given a brief overview of the two previous days of class, primarily focusing on hemorrhage. We stressed in great detail the aspects of care under fire and the subsequent evacuation, as we have done throughout the course. We quickly jumped into the air way segment of teaching; which incorporated the utilization of NPAs, chest seals, and needle decompression.

We utilized several training scenarios throughout the duration of the course at the day drew on to increase class involvement. All of the lanes incorporated various aspects of the course, the "casualties" were all in need of various medical interventions. These included multiple flesh abrasions, amputations, difficulty breathing, and unconsciousness; in addition we had patients demonstrate confusion and despair to increase stress and reaction time. The group was extremely eager to learn and participate in all of the mini lanes we conducted. The NPA portion was the most anticipated lesson for the days class, where over half of the class volunteered to partner up to administer a NPA on each other. We briefed in detail sucking chest wounds and the interventions to help the casualties (chest seals, NCDs). We were also able to cover abdominal injuries and eye injuries in detail, to better prepare them for their deployments.

The three new students in our course today provided a great deal of enthusiasm and knowledge to the class, as they all recently returned from fighting in Mali. They provided a great deal of real world insight to the rest of the group who had not yet experienced the fighting in Mali. We were as well able to educate them on their confusion of medical procedures they had witnessed on their tour.
We incorporated various forms of improvised procedures such as an improvised C-collar with boots and triangular bandages. This was done to provide a potential more sustainable method when all of the US supplies have been diminished.

Assessment: The class's attention is increasing everyday as we incorporate new and more interesting material. The additional students who are joining the course are providing a much more engaging and responsive learning environment. We have also been able to advance outside the basic spectrum of the standard TCIII material due to the eagerness of our students. We look forward to expanding further in the coming days, especially when we receive more students in the following days.
Next 24 hours:

Tomorrow we will continue on with splinting and improvised splinting, as well as the practical exercise of the trauma lanes. We also intend to go over heat casualty training due to the extreme evidence of chronic dehydration of the Soldiers here.