Regional Health Command Europe conducted Exercise Maroon Surge 17 from June 26 through July 22, to assess its ability to operate as a Medical Theater Enabling Command in support of U.S. Army Europe's Exercise Saber Guardian 17.

"Maroon Surge was a medical evacuation and care exercise that was tethered to a mass casualty exercise at Saber Guardian," said Brig. Gen. Dennis LeMaster, Regional Health Command Europe Commander and U.S. Army Europe Command Surgeon. "This gave us the opportunity to test our Speed of Assembly and medical enabling capability by stressing the system to understand what medical capability is needed based on what's available to the commander on the ground."

"The mass casualty scenario generated 40 exercise casualties who required medical evacuation and treatment." LeMaster said. "That treatment started at the point of injury and exercised the capabilities of medical assets from nine different countries."

There are five roles of medical care, beginning with the point of injury, Role I, and continuing to definitive care, Role V at a medical center in the United States.

Saber Guardian Mass Casualty participants included the Balkan Medical Task Force, which is comprised of Soldiers and equipment from Albania, Bosnia-Herzegovenia, Macedonia, Serbia, Slovenia, and Montenegro; a Romanian Role 2 hospital and a streamlined portion of the 30th Medical Brigades' 212th Combat Support Hospital.

Maroon Surge's culminating event evaluated the medical evacuation process and involved the reception of exercise casualties from the mass casualty exercise in Romania on July 16.

"Strategically, what this demonstrates to our adversaries that NATO and USAREUR's Regionally Aligned Forces have the full weight of the joint military health system enterprise behind them," LeMaster said. "As demonstrated, the Army Medicine enterprise is capable of evacuation by a combat medic to a ground or rotary ambulance, to a theater combat support hospital. And when necessary, critical patients can be strategically evacuated back to the Level 4 medical center at LRMC - the only overseas U.S. Army Medical Center in the world. I can't say that this has never been done before, but not in recent memory, so there's certainly some historical significance to this."

The 86th Airlift Wing from Ramstein Air Base, Germany participated in the exercise, and tested the loading and transport of fifteen exercise casualties to Ramstein, and then on to Landstuhl Regional Medical Center, for further treatment.

"This was a great opportunity for us to train with the joint and combined team on loading patient litters onto aircraft, "said Lt. Col. Ronald Jones, 86th Aeromedical Evacuation Squadron commander. "Although we work and train with the Army a lot, this training is extremely beneficial because it helps us to expedite the process. This enables us to move casualties faster and more safely."

During the flight, the 86th AES conducted their own training simulation involving a simulated medical emergency on a patient who was stable when loaded on the aircraft, but experienced a medical emergency during flight.

"In the exercise scenario, the patient's vitals changed and we had to simulate life-saving procedures to resuscitate and stabilize him," Jones said. "These exercises help us test the resources we have available on the aircraft and our ability to communicate as a team."

Upon arrival at Ramstein, Air Force members from the 86th Medical Group facilitated the transfer of patients from the aircraft to specially-equipped buses and transported to LRMC for further triage and treatment of injuries.

In addition to providing support to U.S. Army medical assets participating in Saber Guardian, Maroon Surge measured RHCE's ability to expand its medical capabilities at Landstuhl Regional Medical Center in support of a surge of casualties brought on by an exercise conflict. The tiered expansion plan involves the integration of both medical and administrative personnel into LRMC operations.

"The evacuation system was tested regularly during the height of combat operations in Iraq and Afghanistan," LeMaster said, "but over the last several years, the volume of trauma we see in our medical treatment facilities has been greatly reduced. Organizations can lose their institutional knowledge when they don't practice those capabilities regularly. These exercises enable us to work all these systems and standard operating procedures and it's very helpful."

LeMaster said that overall, the exercise went very well.

"In my 30 years in the Army, I have never seen so much enthusiasm and energy," he said. "The LRMC team had their litter teams set up, the buses would flow in, the patients were off loaded and triaged and sent to the appropriate location in the hospital. It all happened pretty fluidly. I was very proud of the hard work and planning that went into the exercise."

Readiness is the Army's #1 priority and exercises like Maroon Surge and Saber Guardian help ensure medical forces are ready to meet the demands of the mission.

"Army Medicine is all about readiness -- health powers readiness," LeMaster said. "We make sure we have the availability, capacity and capability and that our staff is present and ready to take care of our service members and their families to ensure they enjoy the same world class standard of care that they would get in the United States."

Lt. Gen. Nadja West, the U.S. Army Surgeon General and Command General of U.S. Army Medical Command, visited the European Theater during the exercise and got to see the exercise firsthand.

"I can't tell you how important it is to exercise our ability to support a large number of casualties if called upon," West said. "It was gratifying to see the training that all of our medical professionals bring together in the operational environment and to see them interact with our coalition colleagues.

"My vision for Army Medicine is that we're premier, expeditionary and globally integrated, and in order to make that more than just a bumper sticker, we have to exercise those capabilities."