SAGAMIHARA, Japan - Greeted by simulated mortars, Japan Ground Self-Defense Force members and U.S. Army medical Soldiers underwent a grueling physical and mental test of their ability to triage and evacuate casualties in the final phase of their assessment.The U.S. Army Medical Department Activity-Japan, U.S. Army Japan hosted Tactical Combat Casualty Care training Sept. 30 through Oct. 3 to improve medical capabilities and interoperability amongst both Japan Ground Self-Defense Force members and U.S. Army medical Soldiers at Sagami General Depot."It was my honor to have worked alongside the Japanese Ground Self-Defense Force. It was the first time in history that we were able to incorporate aviation assets, U.S. Naval Hospital Atsugi, and Yokota Airbase Soldiers to amplify the experience," said Sgt. Douglas Pistner, MEDDAC-J lead TCCC instructor. "The skills learned will help the U.S. Army, Airforce, Navy and JGSDF medical units when Japan and U.S. forces have to work together in contingency operations, such as natural disasters, to save countless lives."TCCC, the new standard of medical training proficiency for military personnel, will replace the Combat Life-Saver course and better prepare Soldiers for potential combat situations in an ongoing effort to heighten medical readiness."In my experience, traveling the world and attending various medical courses, the way we learned this course here was more organized and comprehensive," said Master Sgt. Mori Kimiyoshi, licensed practical nurse, 302 Ambulance Unit, JGSDF, and class participant. "This training required me to make quick analysis of the patients under high-pressured scenarios, which kept me thinking on my toes, ensuring my patients had the best chance of survival."Following trauma, the chance of a casualty surviving are dependent upon numerous variables including the speed at which appropriate medical treatment is administered."From start to finish, the assessment was designed to get participants to apply their classroom knowledge in a high-stress, real-world situation," said Staff Sgt. Karim Acosta, MEDDAC-J operations noncommissioned officer in charge. "When employed correctly, TCCC can decrease preventable combat death. Our goal is to resource the tactical healthcare professional with the right tools to significantly decrease preventable combat death."MEDDAC-J provides training to various medical units annually throughout Japan."This was the eighth year we have done this training, certifying more than 225 JGSDF members from different units throughout the country," said CPT Dustin A. Thomas, MEDDADC-J chief of operations. "The joint training helps build interoperability as members from both forces work together to apply the right intervention at the right time to which will lead to saving casualties in the future."TCCC training focuses on treating massive hemorrhage, airway, breathing, circulation and shock prevention."TCCC is a critical component to ensure we keep Soldiers and civilians alive until they are able to receive a higher level of medical care," said Col. Marvin A. Emerson, MEDDAC-J commander and USAR-J surgeon. "MEDDAC-J had the great privilege in being able to teach members of the U.S. Military and JGSDF in this rewarding experience, to build the framework and combine our forces into one to serve a greater purpose. TCCC was originally designed to support combat operations, but it is also equally useful for humanitarian assistance and disaster relief."Due to its geographic location, Japan experiences various natural disasters such as tsunamis, floods, typhoons, earthquakes, cyclones, and volcanic eruptions.MEDDAC-J and JGSDF's teamwork enhances their longstanding partnership, yielding a stronger fighting force. The latest push for TCCC training will add to the readiness and battlefield capability of Japan and U.S. forces throughout the Indo-Pacific region.