JOINT BASE MCGUIRE-DIX-LAKEHURST, N.J. - A shrill whistle pierces the sky, a loud bang echoes through the trees, and screams followed close behind.

Military personnel rush to the scene. It is chaos.

"Is that the only tourniquet you can put on?" a voice shouts.

"We will make it work," came a reply.

Airmen from all over the United States came together to learn how to save lives using combat life saving techniques during pre-mobilization training on Joint Base McGuire-Dix-Lakehurst, N.J., March 11.

According to Combat Life Saver Course materials, blood loss from either limb or torso wounds is the main cause of deaths during wartime.

Deaths are also caused by blocked airways and collapsed lungs.

During the Vietnam War, the death rate due to blood loss was 44 percent for limb injuries and 32 percent for torso injuries, said Staff Sgt. Isidro Irizarry, a CLS Level 2 instructor with the 1-314th Infantry Battalion.

"There is not always going to be a medic," said Staff Sgt. Jeffery Ewart, CLS Level 2 instructor with the 1-314th Infantry Battalion.

A medic may not always be the first person on the scene, but these injuries can still be treated before they arrive.

"This training skill is between administering buddy aid and being a medic," said Ewart.

CLS training for service members is part of pre-mobilization training.

Blood loss deaths are currently reduced to nine percent and chest wound deaths to five percent, said Irizarry.

This four-day course provided first responders with the skill set needed to perform the life-saving actions.

"They learn how to open an airway, treat a collapsed lung and put on a tourniquet," said Staff Sgt. Isidro Irizarry, a CLS Level 2 instructor with the 1-314th. "These are the three course objectives to save a life in combat."

The course includes casualty assessment, administering first aid care, documenting injuries and calling for a medical evacuation of the patient.

Service members receive in-class instruction and hands-on training. They put their skills into practice during the CLS obstacle course.

"Going through each step makes us sure we will be prepared when we go out," said Capt. Corinne Slusher, a psychiatrist with 81st Medical Operations Squadron, Keesler Air Force Base, Miss.

The trainers created a real-world scenario. They sent the airmen out on two separate foot patrols. Sounds of fired shots, incoming bombs and colored smoke alerted the military personnel to respond. They located first-aid training dummies in various positions and states of injury.

"They take all the skill they learned, put it together and make it work," said Irizarry.

The service members provided initial care and assessment while experiencing the continued pressure of an attack. The mannequins were treated and moved to one collection point. The trainers called out prompts to the responders reminding them of lessons learned in class.

"What do we do every time we move a patient?" Irizarry called out.

"Re-assess!" came the reply.

Information cards were filled out with the casualty's name and areas of injury. The first responder records the pulse, blood pressure and areas of injury. The card also indicates what treatment the casualty received.

The airmen simulated a request for medical evacuation. Details of the number and types of injuries were reported and a plan for the pick up was coordinated with the medical evacuation team.

After the casualties were moved to the evacuation area, tourniquets, bandages and vital statistics were re-checked. Information cards are updated and stay with the injured person through each recovery step.

Service members made sure the casualties were in the pick up location ready for transport to a medical facility.

"I would consider it an emulation of the real world," said Senior Airman Terry Yates, noncommissioned officer with the 602nd Training Group. "You can't ask for more than that."

"Did we do the job in the midst of chaos?" asks Ewart.

The reply: "Hooah!"