CAMP HUMPHREYS, Republic of Korea -- The injuries weren't real, but the training certainly was.
Soldiers with the 121st Combat Support Hospital were tested on their ability to respond to a mass casualty during an exercise here March 6.
With notional patients wailing and others in shock, doctors, medics, nurses, and support staff swung into action. The number of patients greatly exceeded what a normal day would feature, and most had more serious injuries than what are usually handled. Also, many of the Soldiers giving treatment were operating outside their areas of expertise.
It's all by design, according to Lt. Col. Eric Gourley, deputy commander of clinical services for 121.
"It definitely overwhelms you," he said. "We normally have the capacity to handle three patients and we have about 20 come in."
Success under these conditions requires teamwork, according to Capt. Kay Bolin, officer in charge of one of the field hospital clinics. Bolin oversees Soldiers who are often times doing something different than what they trained for.
"We have people out of their comfort zone," she said. "So we do a lot of cross training. Soldiers from each unit have come together and taught us what they know."
Casualties are first diagnosed in a triage tent, where they are categorized into one of four areas. The first category is for patients who are facing a danger to life, limb, or eyesight.
For many of these Soldiers, the next stop is to see Maj. Eric Baden, an emergency physician.
"Our job is to initially resuscitate them," Baden said. "We improve their condition the best we can in preparation for definitive care, which is usually in the operating room."
Baden stressed the importance of communication in a mass casualty exercise, and said that continual practice has paid off. "In the Army, we are very good at what we do in regard to handling mass casualties," he said.
The second category is for those with significant injuries, but who are not facing a danger to life, limb, or eyesight. The third category is for those who have minor injuries. In some case, those persons are treated and then begin helping the more seriously wounded. The fourth category is for Soldiers who are not expected to survive.
When patients come in, they have an injury card listing their maladies. From this, medics determine what type of treatment to give and where the patient goes from there. The exercise featured simulated fractures, burns, bullet wounds, and more.
While the exercise lasted just a few hours, it is part of continual training.
"This requires a chronic state of preparation," Gourley said. "Repetition is the key."
So when the exercise ends, the training goes on. "We evaluate ourselves in an After Action Review," Gourley said. "We talk about the good points and we talk about the bad points and what we need to improve on. It gets looked at from every possible angle."
There are many boxes to be checked, such as having a blood replenishment system in place.
"Badly injured Soldiers can lose a lot of blood quick," Gourley said. "If that happens, we can pull up a list of persons with matching types and draw blood. Within 10 to 15 minutes, it's being given to the injured Soldier. And, actually, the best way to resuscitate is with whole blood."
There are dozens of patients and no one has to keep tabs on them better than Capt. Cicely Dent, 121 chief of patient administration.
"We keep track of every patient who comes in," she said. "Access is the key to proper patient care."
Dent and her four-person team help ensure the right patient is with the right doctor and receiving the correct medication. It all makes for an extremely fluid situation.
"Patients move all the time," Dent said. "We have to be flexible and move with them."
And it's more than just making a note of who they are. "It's more than just getting their name. That would be the easy part," Dent said. Instead, Dent and her team must note the gender, age, and diagnosis, among other items.
"Communication is the biggest thing with this," she added. "We have a lot of different tracking mechanisms."
Besides the injuries and medics operating outside their specialty, more mundane items can come into play. The field hospital runs on a myriad of wires, generators, computers, and machines, all of which can malfunction.
But that and other struggles were overcome, and at the end, 121 Soldiers were able to look back on another successful mass casualty exercise.
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