U.S. ARMY GARRISON-YONGSAN, KOREA -- For the first time in 15 years, the 121st Combat Support Hospital (CSH) participated in a joint combined expeditionary exercise Operation Forlorn Reaper 19 from March 3 to 16 by deploying to Rodriquez Live Fire Complex to establish a 32-bed field hospital.

By successfully completing this operation, the CSH validated its expeditionary capabilities to build a field hospital in an austere environment prior to its conversion to the 549th Hospital Center later this fall.

"For this combined joint exercise, the 121st CSH deployed and established the 32-bed (field hospital) in an austere environment, integrated personnel and units throughout the (Korean Theater of Operations) and across the Pacific in order to increase expeditionary medical capabilities," said Col. Andrew Landers, 121st CSH commander.

The 121st CSH's Bravo Company (B Co.) took the lead for the establishment of the 32-bed field hospital by deploying a 32-bed slice out of B Co.'s 84-bed element to complete this task. The Headquarters and Headquarters Detachment (HHD) of the 121st CSH provided the mission command node and set up the Logistical Support Area (LSA). The whole set up was finished within 60 hours, which is 12 hours faster than the standard. The Emergency Medical Tent (EMT) was fully functional within six and a half hours on the first day of the exercise.

The EMT team was comprised of seven nurses and medics from the CSH and 14 from Tripler Army Medical Center in Hawaii and two Navy providers from Okinawa, Japan. Throughout the exercise, the team received nine to 10 "real-life" patients daily and provided emergency care. The injury scenarios ranged from common cold symptoms to a head laceration with one patient requiring evacuation to higher level of medical care with Computer Tomography (CT) to rule out traumatic brain injury (TBI).

These training scenarios based on real battlefield situations allowed the Soldiers to be trained to respond with required skillsets needed on the ground. The training included drawing and processing of Arterial Blood Gases, cleaning and closure of lacerations. Soldiers were also able to get hands-on experience of loading and unloading patients from non-traditional evacuation platforms such as M2A3 Bradley Fighting Vehicles and M1A2 Abrams tanks.

The Emergency Department also conducted whole blood auto-transfusion training for Alpha Company, 1st Battalion, 7th Special Forces Group, also known as ODA 7116, enhancing the team's ability to conduct prolonged field care and increase survivability in austere environments.

ODA 7116 along with other external U.S. enablers also showcased teamwork with the CSH. The participating units were 1-67th Combined Arms Battalion (CAB) of 3rd Brigade, 1st Armored Division (3/1 AD); 2-13th Cavalry Squadron (CAV), 3/1 AD; 304th Expeditionary Signal Battalion, 1st Signal Brigade; 3rd Medical Battalion, 3rd Marine Logistics Group, 3rd Marine Expeditionary Force; Charlie Company (C Co.), 123th Brigade Support Battalion (BSB), 3/1 AD; 560th Medical Company -- Ground Ambulance (MCGA); 563rd Medical Logistics Company; 618th Dental Company; and 106th Veterinary Detachment.

The 121st CSH also integrated health care personnel from multiple regions throughout the Pacific theater to increase proficiency, efficiency and build camaraderie. By working together as a team and sharing best practices in combat medicine, the exercise contributed to increasing medical capabilities and maximizing survivability of casualties on the battlefield.

Over 11 different U.S. military units, as well as nursing staff from the Republic of Korea Army and members of the Korean 13th Special Mission Brigade participated in the exercise. Additionally, 48 personnel from Tripler provided on-site support for the duration of the operation.

Operation Forlorn Reaper 19 was a great opportunity for new Soldiers, as they learned their roles in the field hospital -- and for combat veterans as they gained experience with the new design of the field hospital. During the two-week exercise, the 121st CSH was able to cross-train 48 enlisted Soldiers -- predominantly junior-enlisted combat medics -- from 1-67th CAB, 2-13th CAV, C Co. of 123th BSB, and 560th MCGA.

More than 20 hours of medical training in total was provided to 8th U.S. Army warfighters in support of the "Fight Tonight" mission. Training included: Focus Assessment Sonography for Trauma (FAST); ultra sound lectures with hands on training; suturing lectures and application on real-world patients; basics of X-ray; auto-clave training; layouts and capabilities of field hospital, vet, and dental section; medical equipment sterilization and sterilization components; and arterial line insertion.

"This was the first time in years the 121st CSH deployed and established a 32-bed field hospital in an austere environment, which included 618th Dental Company and 106th Veterinary Detachment in the (field hospital) set up. This added value to training and assisted us with looking at a broader line of patients on the battlefield, to include working dogs and dental injuries," said Capt. Jessica Dirks, B Co., 121st CSH commander. "Training exercises like this, give our Soldier's confidence in their abilities to deploy and provide the best medical care for our Soldiers on the front line."

"Soldiers in the 121st CSH will be ready to answer the call and provide state of the art health care throughout the Korean Theater Operation (KTO), if called upon," added B. Co. 1st Sgt. Daniel Cummings.

In July of 2019 the 121st CSH will convert from its current 248-bed legacy and construct into the 549th Hospital Center with two 32-bed field hospitals comprised of the 121st Field Hospital and 502nd Field Hospital with four medical detachments, or MEDs, organized underneath the hospitals, designated as the 125th MED, 129th MED, 197th MED, 150th MED, and the 135th Forward Resuscitation Surgical Team.