Fort Bliss, Texas (July 10, 2012) -- For a decade Soldiers have asked combat life saver instructors the same question: How does this fit into my mission?Will there be time to place a tourniquet? Will there be a reason to take action on a tension pneumothorax patient in the field? Can a non-medic under the pressure of time, distractions and supplies really save a life?Instructors and trainers with the Army's Medical Simulation Training Centers at 18 installations around the world have responded with a resounding "yes.""You won't always have a medic on the ground," said Sgt. First Class Warren Wright, technical oversight representative for the Fort Bliss MSTC."But you can have someone with these medical skills on the ground. It increases the chances of survival."And with cutting-edge simulators provided through the Army's Program Executive Office for Simulation, Training, and Instrumentation and funding for real medical supplies through the Army Medical Department, MSTCs have evolved with one facet of battlefield medical treatment in mind. Make it as real as possible.Spc. Demetriuce Britton, 127th Aviation Support Battalion, Combat Aviation Brigade, 1st Armored Division, and PFC John Summers, 208th Signal Company, 212th Fires Brigade, 1st Armored Division, enter into a darkened room.A strobe light pulses accompanying a constant rhythm of weapons fire, screams and incoming rounds. The duo observes the scene. Bodies. Bodies on the floor.Dressed in full battle rattle, the two men set to work. They crouch by the first dummy. Unresponsive. The next is the same.In the corner, Britton sees the uneven rise and fall of a chest cavity. He signals to his partner. "We've got a live one."As the duo's simulation at the Fort Bliss MSTC ended, Summers glanced down at a METI mannequin -- a training dummy that simulates human bleeding, breathing and other responses for medical training."There was so many things wrong with him," Britton said of the METI dummy -- painted with the wounds of a gunshot to the chest, an amputated left leg and superficial wound on the right shin for his simulated exercise."Even though this was just training, I was still in panic mode."The Fort Bliss MSTC has trained about 4,300 Soldiers in CLS courses this year alone.The annual attendance numbers continue to grow as units on the expanding installation begin to hear word of the real-life scenarios and hands-on training the center offers, Wright said. Army MSTCs are designed to better prepare Soldiers, Sailors, Airmen and Marines for the application of medical interventions under combat conditions. The MSTC program supports training for medical and non-medical personnel including active duty, Reserves and National Guard, with priority given to deploying units."The two biggest things to learn in combat situations are how to control hemorrhaging from the limbs and a tension pneumothorax," Wright said.For each of these skills, the Fort Bliss MSTC has a dummy to aid in Soldier training. The Multiple Amputation Trauma Trainer mannequin or MATT gives on-hands experience to Soldiers learning to apply tournequettes to dummies that actually bleed from amputated leg wounds.The METI -- frequently used in the validation room scenarios at Fort Bliss MSTC -- are used to explain the complexity and simplicity of recognizing respiration problems with wounded Soldiers."I thought it was just going to be a dummy," Summer said of his surprise to find a casualty he would be expected to conduct treatment on for a tension pneumothorax.Pneumothorax is an abnormal collection of air or gas in the pleural space that separates the lung from the chest wall and may interfere with normal breathing. A tension pneumothorax is a significant impairment of respiration or blood circulation.As an instructor and site manager at the Fort Bliss MSTC, Jason Schwenk said Soldiers often question whether they can be expected to apply CLS skills in the field.Schwenk, a former Marine corporal now working under the federally-contracted Warrior Training Alliance, says it's a good question.The realism of WTSC simulations and the use of real medical equipment are all important contributions to train deploying troops whose first encounter with CLS skills could come at a moment's notice."In the real battlefield, you won't have to go out and get casualties," Schwenk said. "Casualties will come from within your team."