WHEELER ARMY AIRFIELD, Hawaii - At war, the reality exists that the first Soldier to respond to a casualty in need of immediate medical care is not a medical professional. For that reason, the 25th Combat Aviation Brigade (CAB) prioritizes teaching and training the fundamentals of combat lifesaving (CLS) to all its Soldiers.The first forty-nine 25th CAB Soldiers participated in the CAB's CLS training and qualification program since returning from Iraq, and earned their CLS certification at Wheeler Army Airfield (WAAF), Nov. 18.According to Staff Sgt. Alhassane Bah, combat medic and non-commissioned officer-in-charge, CLS certification program, Headquarters and Headquarters Company, 25th CAB, the brigade plans to conduct two comprehensive CLS certification courses and one CLS re-certification course each month until its anticipated deployment to Afghanistan.The recent, inaugural CLS certification course consisted of two days of classroom instruction and a written exam covering a host of medical techniques and procedures from evaluating a casualty, controlling bleeding and managing airways to treating penetrating chest trauma, using an improvised litter and requesting a "nine-line MEDEVAC," where a Soldier communicates critical medical and tactical information to a medical service provider in order to receive patient evacuation. On the third day, Soldiers participate in hands-on field training with combat medics.During the fourth and final day, also called the culminating field training exercise, Soldiers team-up in squads and treat and evacuate multiple patients under simulated battle conditions. "We make this training as realistic as we can," said Bah. "When we deploy, combat lifesaving will be needed for Soldiers on mission. [Often] before any higher level of medical care is available, it's the Soldiers in that convoy or on that mission that will need to suppress enemy fire and treat casualties until medical professionals arrive. We must train Soldiers in circumstances that they will confront in combat."One of several 25th CAB medics who teaches CLS certification is Spc. Robert Vertullo, combat medic, 209th Aviation Support Battalion, 25th CAB. Vertullo explained that his job is not to teach advanced medical techniques."As instructors, our job is to show Soldiers how to save and prolong life until a medic or a higher level of medical care arrives. For instance, some of the most critical elements of initial care are controlling massive bleeding, which is a primary reason Soldiers die on the battlefield, and then how to observe and treat airway [issues], among other things," said Vertullo. "We evaluate theSoldiers in the combat lane scenario because handling things like massive bleeding must be [instinctive] which can be challenging under simulated combat."Specialist Bret Trunnell, vehicle mechanic, E Company, 3rd Battalion, 25th General Support Aviation Battalion, 25th CAB, and Sgt. Bob Calimlim, multichannel transmission systems operator, C Company, 209th Aviation Support Battalion, 25th CAB, earned their CLS certification. Both have deployed and both recognized the importance of becoming CLS proficient."Throughout the week we received great training, very in-depth and thorough," said Trunnell. "It's [rigorous], especially the [culminating field exercise]. Carrying the SKED [stretcher], low crawling to avoid simulated direct fire and just conducting all of the tactical field medical care is exhausting," he continued. "Hands-on is the best way to learn CLS, and this training [simulates] a real experience that feels like you're there treating real patients under a tough environment.""The final lane day was realistic and challenging," added Sgt. Calimlim. "Showing the instructors what you've retained while exercising squad movements, tactically providing medical care to a number of patients, and then getting them evacuated is incredibly stressful. But it is definitely training that all Soldiers should [complete] and continue to refresh; it will definitely save lives."