FORT BENNING, GA – This is just an exercise, but the training is very real as bomb blasts and enemy fire rip through your patrol. As you get your bearings amid the battlefield carnage and chaos, you realize several in your unit are severely injured and bleeding profusely.
“Almost every casualty scenario I have had in combat has been multiple simultaneous casualties,” said Troop Command Commander Lt. Col. Ryan Knight. “Each event created a myriad of problems with limited resources, limited time and complex wounds.
“I never had everything I wanted or the right conditions. Realistic training that took me out of my comfort zone in the hospital and forced me to adapt, improvise and problem solve made every casualty scenario easier.”
Harsh and unforgiving conditions are exactly what nearly 150 Fort Benning Soldiers encountered during the Combat Trauma Management training, February 10. Medical personnel demonstrated mastery of their skills, triaging and treating the wounded from initial point of injury … to final air evacuation. All while also integrating their Warrior Tasks to better prepare them to shoot, move and communicate in future combat.
Knight procured the expertise of Joint Trauma System Chief Col. Stacy Shackelford to mentor the surgical aspect of the training. The Air Force trauma surgeon has deployed five times to CENTCOM, coordinating trauma care delivery in both Iraq and Afghanistan.
“This is a little bit of a unique exercise because it actually involves all roles of care,” said Shackelford. “We don’t often get to do that with all the different types of people [pre-hospital, en route care, and surgical teams] that we need to take care of combat casualties.”
Rotating through the stations, Soldiers provided point of injury and en route care while transferring patients by ground MEDEVAC (medical evacuation). A Forward Resuscitative Surgical Team (FRST) then performed damage control surgery and resuscitation, before administering post-operative hold and care. Finally, UH-60 helicopters air evacuated the combat wounded patients to a Role 3 fixed facility hospital.
“Our Soldiers and medical professionals provide world class health care every day to the patients of BMACH in a hospital setting … and we are testing their ability to provide that same level of care in an austere setting with limited resources as they would have to do in combat,” said Knight. “Not just medics, but all specialties across FBGA (Fort Benning) are participating to recreate all echelons of battlefield care. This will help build relationships across our specialties as we create cohesive teams that will work together to save their patients’ lives.”
Role players, task trainers, low and high fidelity simulators, as well as perfused and non-perfused cadavers helped ensure the combat medical training was as realistic and immersive as possible. For many, today was the first time performing life-saving interventions on actual human tissue which sustained extreme trauma such as broken bones, fractures, compartment syndrome, septal hematoma … as opposed to a simulator with fake wounds.
“The trick to realistic training is matching the right patient model to the training objective. Nothing can recreate true human anatomy like a cadaver,” explained Knight. “For our surgical teams and resuscitation teams, they will have to perform actual trauma surgery procedures to stop bleeding and resolve life threatening physiology.”
Soldiers were able to use the same equipment they would use on the battlefield during a future fight, on cadavers. Practicing sometimes invasive medical procedures on cadaveric tissue helps prepare medics for what to expect in a life or death situation, where reaction time down to the second matter.
“The people who deploy downrange deserve our best game,” said 1st Marine Expeditionary Force Surgeon Cpt. Brendon Drew. The Navy instructor is the Joint Trauma System Committee on Tactical Combat Casualty Care Chair. “To be ready to deliver that type of care downrange, you have to practice it. That means you have to practice it outside of hospitals.
“The medics and the physicians and the nurses know their medicine. But it’s very difficult to apply that medicine in a limited resource and operational environment, where you may not have access to things like radiology and CT and lab. This training is invaluable.”
Learning how to suture with the cadaver was the most challenging skill for BMACH Medical Surgical floor licensed practical nurse (LPN) Cpl. Cindy Zambrano.
“Lt. Col. Knight, who was an ER doctor, encouraged us,” said Zambrano. “He was very hands on in showing us different life-saving skills that would be used in the field.”
“I have not worked on cadavers before,” added BMACH Operating Room specialist Cpl. Miranda Rauner. “I enjoyed getting to practice procedures and see anatomy that I have only ever studied in the classroom.”
“We have multiple units from across Ft. Benning participating in this exercise – ARTB, Air Ambulance Detachment, TRADOC Brigade medical personnel, 75th Ranger Regiment, SFAB, Warrior Training Center and BMACH,” said Knight. “We’ll accomplish much more together and hopefully this event helps build those bonds that others can fall back on if asked to do this again in combat.”
Martin Army Community Hospital commander Col. Kevin Kelly added that bringing in the valuable expertise of Navy and Air Force partners for this hyper realistic training will help build not only a medically ready force, but just as importantly a ready medical force.
“Our dual mission is ensuring our medical teams and our medical professionals are as ready as they can be for the rigors of combat, the challenges of doing medicine in combat, and all of the skills that are necessary to bring that world class health care forward into any environment at any time the nation needs us,” said Kelly.
“I could always fall back on a time where I was more stressed in training,” agreed Knight. “In cases like that, you just take a deep breath and get to work.”