CAMP TAJI MILITARY COMPLEX, Iraq -- Medical providers from the 449th Combat Aviation Brigade facilitate a 10-day aeromedical evacuation training course with Iraqi nurses April 22 - May 3 at Camp Taji, Iraq.

The concept of the program was to use the train-the-trainer model, where the 449th CAB medical staff provided information on medical evacuation principles and tactical combat casualty care to the Iraqi nurses so they are able to self-sustain and teach courses in the future.

"Battlefield trauma research shows that uncontrolled blood loss is the leading cause of death in 90 percent of the potential survivable battlefield cases, which makes this training necessary," said the 449th CAB Aeromedical Physician Assistant Capt. Jonathan Campbell.

The primary instructors, Campbell and the brigade surgeon Lt. Col. Wes Hite, began the course by assessing the medical knowledge of the students with a written exam. Co-written with an Iraqi flight surgeon, the test gave the instructors a starting point for teaching the class and guided which lessons needed to go more in depth.

"A lot of their knowledge was from a nursing standpoint or hospital-based care," said Hite. "We have been able to provide them a different way of looking at point-of-injury care, that additional minutes to hours that takes place with battlefield trauma."

Hite and Campbell presented the majority of the material to the students in the class and stressed the basics. Their teaching techniques were designed to address the most likely injuries that will result in battlefield death in the appropriate order.

"The biggest key points emphasized throughout the course was the M.A.R.C.H. algorithm, which is a technique used to treat for massive hemorrhage, airway, respiratory trauma, circulation, and hypothermia," said Campbell.

The United Kingdom Training Team 1, Armored Medical Regiment medic instructor Staff Sgt. Natalie Jackson helped support the course and stressed the importance of understanding anatomy and physiology and the ability to recognize normal and abnormal signs with casualties.

"It was important to deliver the course at the right level across a range of trade qualifications, ensuring the basic principles and treatment techniques were fully understood," said Jackson. "Practical sessions allow for the students to practice skills in developing life-saving treatment techniques."

This additional medical knowledge further allows the Iraqi medical staff to join in the fight against ISIS by enhancing their effectiveness on the battlefield.

"[MARCH] spans their capability to push out into battlefield operations when they know their ability to care for the wounded is elevated to a level that aeromedical evacuation can do," said Hite. "They have the capability and training to provide point-of-injury care to evacuate soldiers from there back to a hospital setting in a short amount of time."

The course came with its challenges to include language barriers and the slight differences between U.S. and U.K. treatment and assessment methods. However, learning different methods can be beneficial and enhance preferred techniques according to Jackson. These techniques were tested during the student's final training event.

The culminating training exercise was comprised of a scenario where students provided point-of-injury care and MEDEVAC care while flying on the Eurocopter to a multi-trauma casualty mannequin under stress inoculation.

The premise of stress inoculation is that exposure to different stressors and sensory inputs to include: fake blood, smoke grenades, and noise from a nearby aircraft, will prevent medics from being easily distracted and overwhelmed during a real-world medical crisis.

"Students should be able to perform basic functions the same regardless of the environment they are in," said Campbell.

Seven Iraqi students assigned to the Iraqi army aviation graduated from phase one of the aeromedical evacuation course May 3, with hopes of continuing the additional phases in the near future.