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Training combat medics beyond the ‘Golden Hour’

By Michelle GonzalezJuly 21, 2021

Soldiers from Regional Health Command-Atlantic and U.S. Army Medical Research and Development Command stabilize a notional patient during the assessment for the Delayed Evacuation Casualty Management (DECM) training held at Kimbrough Ambulatory Care Center July 16, 2021. From left to right: Sgt. Richard Gonzales, Kimbrough Ambulatory Care Center, Staff Sgt. Jeffrey Carter, U.S. Army Medical Research and Development Command, Staff Sgt. Edwin Galarzaseda, Fillmore Army Health Clinic, Staff Sgt. Edd Laurent, Walter Reed National Military Medical Center, completed the five-day course and learned critical care concepts preparing them to stabilize and sustain a casualty in an extended-care scenario before casualty evacuation. (U.S. Army photo by Michelle Gonzalez)
1 / 3 Show Caption + Hide Caption – Soldiers from Regional Health Command-Atlantic and U.S. Army Medical Research and Development Command stabilize a notional patient during the assessment for the Delayed Evacuation Casualty Management (DECM) training held at Kimbrough Ambulatory Care Center July 16, 2021. From left to right: Sgt. Richard Gonzales, Kimbrough Ambulatory Care Center, Staff Sgt. Jeffrey Carter, U.S. Army Medical Research and Development Command, Staff Sgt. Edwin Galarzaseda, Fillmore Army Health Clinic, Staff Sgt. Edd Laurent, Walter Reed National Military Medical Center, completed the five-day course and learned critical care concepts preparing them to stabilize and sustain a casualty in an extended-care scenario before casualty evacuation. (U.S. Army photo by Michelle Gonzalez) (Photo Credit: Michelle Gonzalez) VIEW ORIGINAL
From left to right: Sgt. 1st Class Garrett Rogers, Fort Belvoir Community Hospital, Staff Sgt. Edd Laurent, Walter Reed National Military Medical Center, Staff Sgt. Edwin Galarzaseda, Fillmore Army Health Clinic, stabilize a notional patient during the assessment for the Delayed Evacuation Casualty Management (DECM) training held at Kimbrough Ambulatory Care Center July 16, 2021. Five Soldiers from Regional Health Command-Atlantic and the U.S. Army Medical Research and Development Command completed the five-day course and learned critical care concepts preparing them to stabilize and sustain a casualty in an extended-care scenario before casualty evacuation. (U.S. Army photo by Michelle Gonzalez)
2 / 3 Show Caption + Hide Caption – From left to right: Sgt. 1st Class Garrett Rogers, Fort Belvoir Community Hospital, Staff Sgt. Edd Laurent, Walter Reed National Military Medical Center, Staff Sgt. Edwin Galarzaseda, Fillmore Army Health Clinic, stabilize a notional patient during the assessment for the Delayed Evacuation Casualty Management (DECM) training held at Kimbrough Ambulatory Care Center July 16, 2021. Five Soldiers from Regional Health Command-Atlantic and the U.S. Army Medical Research and Development Command completed the five-day course and learned critical care concepts preparing them to stabilize and sustain a casualty in an extended-care scenario before casualty evacuation. (U.S. Army photo by Michelle Gonzalez) (Photo Credit: Michelle Gonzalez) VIEW ORIGINAL
Soldiers from Regional Health Command-Atlantic and the U.S. Army Medical Research and Development Command stabilize a notional patient during the assessment for the Delayed Evacuation Casualty Management (DECM) training held at Kimbrough Ambulatory Care Center July 16, 2021. The five Soldiers completed the five-day course and learned critical care concepts preparing them to stabilize and sustain a casualty in an extended-care scenario before casualty evacuation. (U.S. Army photo by Michelle Gonzalez)
3 / 3 Show Caption + Hide Caption – Soldiers from Regional Health Command-Atlantic and the U.S. Army Medical Research and Development Command stabilize a notional patient during the assessment for the Delayed Evacuation Casualty Management (DECM) training held at Kimbrough Ambulatory Care Center July 16, 2021. The five Soldiers completed the five-day course and learned critical care concepts preparing them to stabilize and sustain a casualty in an extended-care scenario before casualty evacuation. (U.S. Army photo by Michelle Gonzalez) (Photo Credit: Michelle Gonzalez) VIEW ORIGINAL

FORT GEORGE G. MEADE, Md. –Soldiers from Regional Health Command-Atlantic and the U.S. Army Medical Research and Development Command completed a Delayed Evacuation Casualty Management (DECM) training held at Kimbrough Ambulatory Care Center July 12-16, 2021.

The five-day course covered didactic and hands-on practical exercises focusing on mitigating what is known as the ‘lethal triad’ in combat casualties.

“Combat casualties often experience three compounding factors that lead to their death,” said Staff Sgt. Nathan Sanchez, Kimbrough Department of Primary Care noncommissioned officer in charge. “These are hypothermia, acidosis, and hypovolemia or dilutional coagulopathy.

“Simply stated: The medic must be able to administer fresh whole blood; warm the casualty; and control breathing volume, rate and Positive End-Expiratory Pressure (PEEP) to help control acidosis.”

Graduates of the course learn critical care concepts that prepare them to stabilize and sustain a casualty in an extended-care scenario before casualty evacuation.

“DECM makes you aware of what needs to be done for the patient past the normal tactical combat casualty care,” said Sgt. Richard Gonzales, Department of Specialty Services noncommissioned officer in charge. “This training makes the combat medic more effective in prolonged field care.”

A concept echoed by Fort Meade Medical Department Activity’s Command Sgt. Maj. Michael P. Morrill.

“What has been known as the ‘golden hour’ for the past 20 years may turn into the golden day or week,” Morrill said. “Combat medics need to have the ability to not only save lives, but to sustain those lives for longer periods of time.”

Training for prolonged field care is not a new concept. Much of the DECM course is based on the Special Operations Tactical Trauma Medical Emergency Protocols.

According to Morrill, the goal for the course at the Fort Meade MEDDAC is to provide a program for the National Capital Region that enables Army Medical Treatment Facilities and other medical organizations better access to training without sending Soldiers on temporary duty travel.

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