By Capt. Maren ScheieOctober 17, 2017
Participants included the Camp Buehring 116th Military Police Co., Camp Buehring Emergency Medical Service and Fire Department, 420th Engineer Brigade, 29th Combat Aviation Battalion, 673rd Dental Company Area Support, 254th Combat and Operational Stress Control, and the Camp Buehring Chaplains.
The 86th CHS holds mass casualty events involving 86th CSH leaders and Soldiers to ensure continual process improvement and preparedness and readiness during times of emergencies. All services are part of planning efforts for the event, and each entity has their own objectives to determine success of the exercise.
"We have had an open dialogue with them concerning their objectives and how to best support each other in meeting them," said Capt. Nathaniel Turner, a physician assistant with the 86th CSH.
Typically, planned events are well known to all of the participants so the stress level isn't nearly as high as it would be in an actual emergency. In this case, though, the exercise was not made known to all participants ahead of time.
"This event will be unique because we have purposely not informed the clinic, to better assess our preparedness," said Turner.
"Separately, training events tend to focus on a specific tasks or a specific set of tasks," Turner continued. "Real time MASCALs stress any and all tasks that are required to provide the appropriate level of care."
The event was designed to ensure all emergency personnel are trained and proficient on emergency preparedness standard operating procedures and will continue to provide exceptional medical support, even in times of distress.
The event began at 7 p.m. with the intent to test and validate the SOP during off-duty hours. The SOP is all encompassing for a MASCAL and was submitted to the Camp Buehring emergency preparedness group so that if a MASCAL were to happen, everyone would know what to do.
"Capt. Cenon has done a great job at clearly communicating our objectives as the primary concern for us is to ensure that we can provide the most efficient, comprehensive response possible," said Turner. Capt. Mark Cenon is the 86th CSH's lead officer as well as the command and control for the exercise.
The orchestraters of the exercise attempted to make the training as real as possible by having Soldiers who served as patients undergo moulage - the process of using makeup to create the appearance of an injury - prior to the exercise. They spent about an hour of preparation at the fire department before the exercise, including a thorough brief on how to behave as if they sustained the injury they were about portray.
"I used simple terms and compare the pain that they would feel based on their real life experiences," Cenon said. "For example, for a fracture of a lower extremity, I may describe the injury to them as 'it hurts so bad that you will not be able to bear any weight with it' or 'there is no way you can walk with this extremity."
"We always want training events to be a life-like as possible," added Turner. "In medicine, it is quite difficult to replicate the injuries and processes that we see in trauma. Part of the preparation comes in the form of moulage and the rest will be coaching the 'patients' on how to act and what to say. This is necessary for the responders to get visual and audio cues to the injuries, rather than reading the injuries from a card or piece of paper tied around the patient neck."
The scenario unfolded with five personnel involved in a high-speed motor vehicle crash on a return trip from Camp Arifjan. A head-on collision with a t-wall resulted in three severely injured personnel requiring immediate attention, one delayed injury, meaning the injuries sustained can await immediate treatment, and one deceased at the scene, played by Capt. Cenon, who spent the exercise as an observer and evaluator.
The delayed victim was able to call military police, who responded to the scene first. Upon arrival, the MPs cordoned the scene by placing vehicles on roads in the area to divert any traffic. They approached the vehicle to assess the situation, check for fluids leaking from the vehicle, and do a quick assessment of the status of the passengers including questioning them to get an idea of their disposition and the events that led to the accident as well.
Next on the scene were three fire trucks, followed by two ambulances. In this kind of situation, the fire department has full control of the scene providing rapid first-responder medical treatment and assessing the situation to determine whether the vehicle is in danger of catching fire or exploding.
When the EMS personnel are available to step in, they take control over the victims and direct activities to move patients to the ambulance in the safest manner.
A report was called in to the troop medical clinic to alert them to prepare for incoming patients. As they are en route to the TMC, a MASCAL event is activated by utilizing the post intercom system.
"EXERCISE, EXERCISE, EXERCISE, MEDICAL, MEDICAL, MEDICAL - 86th CSH personnel to TMC" boomed over the post loudspeaker, triggered by the call in to the TMC about the accident. This signaled all 86th CSH personnel assigned to the Buehring TMC were cued to report to the TMC. The response was quick, as all required personnel arrived at the TMC within 12 minutes.
If not everyone had reported, there would be an effort to continue to reach out to gain full accountability of staff.
"We also have other means of notification, such as a group string on Whatsapp," said Cenon. "If they do not report promptly, efforts will be made to find them as we need 100 percent accountability during events such as these."
In addition to the crash victims, another patient was inserted into the exercise to walk into the TMC with an unrelated, but also life threatening condition. This patient arrived just prior to the MASCAL notification, which provided the medics the opportunity to work in a situation where more than one incident was occurring at a time.
Sgt. Damaris Kelley, a 420th Theater Engineer Brigade Soldier, a student in an EMT class at Camp Buehring and a full-time nursing student as a civilian, served as one of the crash victims.
"The exercise was a very neat experience for someone who is thinking about pursuing a career in the medical field," said Kelley. "As a victim, I was able to observe how the EMS system works when answering a dispatch call and treating patients. They did a really good job at keeping the patient calm despite the recent events. Just as with the EMT portion of this exercise, I was able to see all of my current nursing knowledge come together as one"
"Although we try to make the MASCAL as real as possible, such as teaching 'patients' how to act, dressing them up, or giving them fake wounds, there is always that 'urgency' factor that we can't completely replicate," said Cenon. "The participants know that the patients are not real world patients, and no matter what convincing or what instructing you do, even though they try, the stress will never be as high as when a real patient comes in."
During the after action review, the TMC personnel gathered to discuss how the event went. The event met its requirements to assess the response of the medical team and was considered a success. The different units involved were able to pinpoint where they had shortfalls and quickly identify solutions to avoid those in the future.
Staff Sgt. Rebecca Powers, 420th TEB medic, was an observer who helped assess the medics as they treated the patients.
"Capt. Cenon did a great job of executing a realistic effect that removed a few key staff members to force other Soldiers to step into new roles," said Powers.
"It was wonderful to be able to work with the 86th CSH as they refined their protocols to improve themselves and provide the best medical care possible," Powers stated.