LRMC nurse prepares for battlefield operations
U.S. Army 1st Lt. Aaron Higa, a medical-surgical nurse at Landstuhl Regional Medical Center, transports a simulated patient casualty during a medic competition in Landstuhl, Jan. 23. LRMC is preparing for Operation Courageous Danger, a joint exercise... (Photo Credit: U.S. Army) VIEW ORIGINAL

LANDSTUHL, Germany -- Nearly 400 medical personnel from Landstuhl Regional Medical Center and 30th Medical Brigade will participate in Operation Courageous Defense, a collective training exercise designed to showcase integrated medical operations in the European theater, March 3-6. As part of their preparations for DEFENDER-Europe 20, a theater-wide exercise with the largest deployment of U.S.-based forces to Europe in more than 25 years, Army doctors, nurses and medics will be tested on their critical skills, medical readiness, and abilities to conduct expeditionary and support operations.

"[Operation Courageous Defense] is a joint training exercise between LRMC, 557th Medical Company Area Support, 421st Multifunctional Medical Battalion, and the 67th Forward Resuscitative Surgical Team, 212th Combat Support Hospital," said Capt. Aaron Berg, commander of LRMC's Charlie Company and officer-in-charge of the exercise. "LRMC company elements will assess and certify in their Army Warrior Task skills for this quarter, and the teams from the 30th Medical Brigade will use the exercise as an evaluation for DEFENDER-Europe 20."

Throughout the three-day exercise, Soldiers and supporting medical personnel are expected to perform a variety of combat medical skills such as applying combat action tourniquets, casualty evacuation, field sanitation, obstacle maneuvering, and enemy engagement. Additionally, the training exercise is meant to stress command and control functions to perform pre-deployment alert activities, and manage health service support operations and ground evacuation protocols.

"[This exercise] will provide us an opportunity to train on mission essential tasks to ensure the unit is at its highest state of readiness in order to support DEFENDER-Europe 20 as well as future operations," said Capt. Sebastian Coates, commander of the 557th MCAS. "Additionally, it will allow us to foster relationships and build interoperability with organizations within and outside of 30th Medical Brigade."

During Exercise DEFENDER-Europe 20, the 557th MCAS will provide Role 1 -- initial medical treatment and evaluation -- support to units across the theater while simultaneously deploying a medical element to provide drop zone medical coverage for a joint forcible entry airborne operation. Following the high risk events, the unit will continue to provide Role 1 medical support to different ports and logistical support areas across Europe.

Although both are a part of the 30th Medical Brigade, Operation Courageous Defense will afford the 557th MCAS the opportunity to partner with the 67th FRST for the first time in nearly a decade.

"By NATO doctrine, when [557th MCAS and 67th FRST] are together, we would form a Role 2 level of care," said Coates, describing the second echelon of military care that provides advanced trauma management and greater capabilities for emergency resuscitation. "This allows us to seamlessly support our NATO allies and partners during any mission, to include large scale combat operations."

By the end of the exercise, Coates' goal is to ensure that the 557th MCAS is ready to support operations from across the U.S. European Command and other combatant commands. As a result of the months of planning and preparation for Operation Courageous Defense, Coates has already built a solid partnership with Berg and the team at LRMC.

"We wanted to create dynamic missions and scenario-based trainings which force our military personnel to utilize multiple skill sets and critical thinking techniques to solve complex problems," said Berg of the first operation of its kind at LRMC. "In this joint environment we have in the European theater, interoperability and streamlined processes with our partners and allies are critical for expeditionary deployment operations like DEFENDER-Europe 20."

The Construct for Implementation of Section 702 of the National Defense Authorization Act outlines the priority of operational readiness over the delivery of clinical healthcare, meaning military medical personnel must consistently maintain a high standard of critical lifesaving skills for mission-related operations. For LRMC, the Individual Critical Task List is the integral building block to train and sustain a ready medical force.

"Proficiency in a Soldier's ICTL can, for the most part, be obtained through direct patient care for those of us working in a clinic at LRMC," said Berg, a native of Sigourney, Iowa. "However, there are some in specialty care or assigned to a medical unit outside of the hospital who may not have as many opportunities for direct patient care, so simulation in LRMC's Europe Simulation Center of Excellence through training like Operation Courageous Defense is an added opportunity to ensure the readiness of our medical force."

As a Role 4 theater hospital, LRMC is responsible for the medical care of wounded, ill or injured warfighters evacuated from the U.S. European Command, U.S. Africa Command, and U.S. Central Command areas of operation. Exercises like Operation Courageous Defense prepares LRMC's medical personnel to implement lifesaving skills at the Role 1, 2 and 3 points of care, namely between the first contact made with the injured troop through when a decision has been made for medical evacuation to Germany.

The 30th Medical Brigade is the sole medical unit under the 21st Theater Sustainment Command and directs expeditionary theater-level medical operations throughout the U.S. Army Europe. With their headquarters located in Sembach, Germany, about 30 minutes away from LRMC, the 30th Medical Brigade is comprised of one combat support hospital and one medical battalion (multifunctional) with subordinate units supporting operations across EUCOM, AFRICOM and CENTCOM.

For more information on Operation Courageous Defense, please go to