Martin Army Community Hospital (MACH) at Fort Benning, Georgia conducted its second iteration of its semiannual Combat Trauma Management (CTM) training to translate high-quality patient care to high quality austere environment care. The goal of the CTM exercise was to complete Individual Critical Task List (ICTL) requirements that our Service Members (SM) require in a field environment and then to stress those SMs in a collective training event. The event was composed of medics, nurses, physician’s assistants (PA), residents, doctors, anesthesia providers, and additional medical staff to build comradery and “train how you fight”. In partnership with the Airborne and Ranger Training Brigade and the 75th Ranger Regiment, approximately 150 Soldiers conducted training on point of injury Tactical Combat Casualty Care (TCCC), CASEVAC, MEDEVAC, Prolonged Casualty Care (PCC), and Resuscitative Surgical Care. Training in limb saving fasciotomies was also conducted. In Large Scale Combat Operations (LSCO), the requirement to hold patients requires the performance of these procedures further forward on the battlefield versus where these procedures were historically performed on the battlefield.
Nurses led a hospital wide “Skills Fair” prior to the event. All participants executed tasks they would need for the CTM such as: using a rapid infuser, achieving intraosseous access, administering a needle decompression, identifying compartment syndrome, triaging patients, and more trauma related skills.
After the skills fair days, the CTM mission was briefed, and personnel were divided into their lanes. Medics were designated to conduct tactical movements to checkpoints, then triage, and medically evacuate patients to the PCC lane. At the PCC lane, medical staff stabilized patients and maintained care overnight. The patients were a mix of volunteer Soldiers with TCCC cards indicating their injuries and simulation. Utilizing simulation, medical personnel were able to practice trauma management skills such as a fasciotomy when identifying compartment syndrome or cricothyrotomy to establish a lifesaving airway. It was an incredible learning environment to not only work through trauma management scenarios as a team, but also to complete the actual medical procedures in real-time.
At sunrise, the PCC lane concluded by evacuating the patients onto M1126 Stryker Infantry Carrier Vehicles. This next phase of the CTM required personnel to perform casualty evacuation and patient care enroute to the following lane. The Strykers were guided and operated by the 75th Ranger Regiment while medical personnel from Martin Army provided continued prolonged care during the route. Upon arrival, the patients were transported to the final CTM lane: the Forward Resuscitation Surgical Team (FRST).
The FRST was composed of specialized surgeons, one anesthetist, surgical techs, and nurses. The controlled, fast pace of the lane was showcased by their flawless communication; despite dealing with critically injured patients in an austere environment. The team utilized simulation to complete their trauma lanes and stabilize patients. The surgical staff performed thoracotomies and exploratory laparotomies while the others were able to practice chest tube insertion, intraosseous access, and cricothyrotomy.
In addition to involving hospital wide participation for the CTM, MACH also welcomed the participation of 15 cadets from Auburn University ROTC War Eagle Battalion. These cadets spanned from future Army nurses, doctors, and medical officers who were eager to experience deployment level medicine. The cadets are taught basic medical skills for their tactical environment labs but participating in this experience gave them the ability to visualize prolonged care and set them ahead of their peers. The cadets all stated that the CTM was the best training they participated in during their ROTC experience.
The CTM exercise allowed all the participants to learn and practice their trauma management skills both individually and collectively. All the Soldiers were able to obtain over 200 ICTLs and build confidence to utilize these skills if the mission calls for it. CTM furthered the goal of enhancing a medically ready and deployable force by developing critically needed, agile leaders within Army Medicine.
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