PRINCE SULTAN AIR BASE, Kingdom of Saudi Arabia -- “EXERCISE! EXERCISE! EXERCISE!”
Alarm black initial release, bellows from the alarm towers, as the 378th Air Expeditionary Wing simulates an airborne missile attack, May 13, on Prince Sultan Air Base, Kingdom of Saudi Arabia.
The goal of the exercise is twofold: Train the U.S. service members on PSAB how to take cover in the event of a real attack and possibly most importantly, how to react after one.
The biggest player in this specific exercise was the 378th Expeditionary Medical Squadron, who responded to a simulated mass casualty incident. As one of the first groups out of the bunkers, their job is to find those who were injured before finding cover.
“During base emergencies we split into our Medical Contingency Response Team, which includes field response teams,” said Capt. Jessica Barlow, an emergency room physician with the 378th EMDS. “The field response teams will go out and do point of care treatments, like quick stabilization to stop the bleeding as much as possible and other quick interventions they can do while trying to evacuate patients.”
The 378th EMDS’s emergency medical services teams which are embedded with the fire department are unique to U.S. Air Force Central Command’s area of responsibility, as no other wing in the theater embeds medics with the firefighters. Even though it's long been a common concept in the civilian sector, implied Barlow. The partnership between the medics and fire department, assigned to the 378th Civil Engineer Squadron, is highlighting the effectiveness of the practice in military operations.
“It’s been really beneficial for all parties involved to make sure we have a quick response to any medical situations, and it helps us all cross-train and be multifaceted Airmen,” said Barlow.
The quicker a casualty can be found, stabilized and sent to their next stop for treatment, the more likely they and the other casualties will survive. Having professionally trained medics in the field as soon as possible, alongside the firefighters who are trained in tactical combat casualty care and who can help ensure scene safety allows for a smoother road of care and more hands available for the casualties.
The 378th EMDS has yet another piece standing out within the U.S. Central Command theater, that may help those who are most likely to succumb to their injuries, to have a far greater chance of survivability. That resource is the squadron's Ground Surgical Team (GST).
The GST includes: an emergency physician, an anesthesia provider, a general surgeon, an intensive care unit or ER nurse, a health administrator who helps drop the 9-lines (which initiates the medical evacuation process), and a surgical technologist.
“If we have anybody that needs surgery, we will decide whether or not doing it here is the right thing to do for the patient,” said Barlow. “But it comes at a cost. By performing surgeries here in a tent, there's usually infection risks. If it means saving a patient's life before transporting, we absolutely will do that if we need.”
The 378th AEW at PSAB is currently in the process of building more permanent structures that could in the long term greatly increase the unit's medical capabilities. But in the meantime, a joint force partnership with the U.S. Army’s Task Force Longhorn and their HH-60M MedEvac Black Hawk helicopter services is making up for the current resources versus infrastructure gap.
“If we can do a stabilizing surgery in less than 30 minutes, we would do that here,” said Barlow. “If it would take more time and/or be less beneficial for the patient to do that surgery here, then we’ll transfer the wounded to Task Force Longhorn. With them, it takes about 45 minutes total to get the patient to Riyadh from us responding to the 9-line and calling them in.”
The partnerships the 378th EMDS has formed are both critical to the augmentation of the unit’s surgical and medical capabilities, and the overall onward direction of AFCENT’s medical capabilities in the region.
“It's really a unique situation we have here and really beneficial to have that partnership,” said Barlow. “The last rotation did a fantastic job fostering that relationship and really creating a much safer route for taking care of all of our patients here, not just in simulated mass-cal exercises.”
In the event of a real mass casualty situation, it is likely that many patients may fall into a “critical” category during triage. The 378th AEW’s quick response time, EMDS partnerships, and strong transportation relationships as well as available expeditionary treatment, all contribute to ensuring the best standard of care possible. As a more enduring presence at PSAB increases, so too will the 378th EMDS capabilities that may in the future be able to support other units in the Ninth Air Force's area of responsibility.
“I feel very fortunate because I had an excellent handoff from the group that came before me,” said Barlow. “These relationships and these partnerships and all the other things that we’re doing together, we’re doing it as a team and really supporting the overall mission and not just the medical mission.”
Like their ambulances that don’t stop when the lights are flashing, the 378th EMDS traverses the stretcher road as fast and safely as they can to get the wounded in the right lane to a longer life. Practice makes perfect and that's what mass-cal base exercises are for.