Help wanted: Medics train combat lifesavers

Published Dec. 30, 2009
By Staff Sgt. Jake Richmond
332nd Air Expeditionary Wing Public Affairs

JOINT BASE BALAD, Iraq -- Dressing wounds? Check. Strapping on tourniquets? Check. Sticking your fellow students with intravenous therapy needles and inserting curved, seven-inch nasopharyngeal airway tubes in through their nostrils and down into their throats? Check and check.

It's all part of a three-day course taught at JBB's own Jameson Combat Medic Training Center.

For military medics -- whose duties start with emergency medical treatment, but can include a wide range of health care work -- the JCMTC provides advanced training tailored to wartime environments. But many of those medics also have another responsibility: They train non-medical servicemembers to be "Combat Lifesavers," increasing the urgent medical care available to the battlefield wounded.

Just like the course name says, it's about saving lives. And, in combat, that often doesn't require sophisticated medical care. The treatment methods are relatively easy to learn, and they're effective when they're applied immediately after an injury occurs.

In a setting where the biggest enemy threats are improvised explosive devices and rocket-propelled grenades, bomb blasts have proved to be devastating and instant killers. But there's good news for those who are still breathing after an attack: Fast blood loss from extremities can be stopped with a secure tourniquet, and shock can be reversed with IV fluids. But none of that matters if there aren't enough medics to treat all of the casualties.

"In your average infantry unit or field unit, you have about one medic per platoon," said Army Sgt. Michael Welsh, CLS coordinator and instructor at the Jameson Center. "And sometimes, a platoon can be 40 or 60 guys. So, if you only have one medic, it's really invaluable to have combat lifesavers, because they have all these skills that the medic can rely upon to take care of his people."

Sergeant Welsh, a traditional "68 Whiskey" Army medic deployed here from the 47th Combat Support Hospital at Fort Lewis, Wash., said he was surprised when he got the news that he was going downrange...to be a teacher. But he and the other instructors all understand the importance of the training, and he said they happily train just about anybody who's interested.

"We take people from every service, as well as DOD civilians," he said. "And some contractors even come through the courses. Army, Air Force, Navy, Marines -- they've all been through at some point."

The curriculum is standardized. On the first day, the students learn tactical combat casualty care: hemorrhage control, airway assistance, and learning the steps in assessing a patient with unknown wounds. Day two brings the hands-on demonstrations, which include practicing IV's, putting on dressings, and inserting the uncomfortable NPA tubes.

Airman 1st Class Daniel Dayton, an entry controller for the 332nd Expeditionary Security Forces Squadron, remembers being slightly apprehensive in the beginning.

"At first, I thought it was going to be hard," he said. "But as I got into it, the instructors were very helpful. If you didn't understand, they would show you, they'd demonstrate it, and then you would practice until you felt comfortable."

Offsetting their periods of understanding and helpfulness, the medics are also known to sternly emphasize -- and routinely repeat -- that the students are warriors first.

"What's the first thing you do when someone gets shot?" barked Sergeant Welsh at a group of CLS graduates attending a refresher course. The group replied in unison: "Return fire!"

"That's always the No. 1 priority -- your own security on the battlefield," Sergeant Welsh said. "Once you neutralize the threat, the enemy's eliminated. You're no longer sustaining casualties, and that's when you're really able to give definitive treatment.

"You see the Medal of Honor write-ups and all that stuff, but the bottom line is that 99 percent of the time you run out in a hail of bullets trying to be a hero, and you're going to get yourself killed. Instead of you, as a CLS, being an asset to your team, you're now a liability because you're a casualty."

The reality of a combat situation is simulated on day three, when the students participate in a mass-casualty exercise, or "MASCAL." Sergeant Welsh said the scenario requires the students to don their battle gear and use all the skills they learned over the first two days.

"We go through two whole iterations of a MASCAL scenario. During the first iteration, it's usually pretty shaky and a lot of things go wrong," he said. "But we sit down, we have an (after-action report), we talk about what went well and what went badly, what we're going to improve upon the next time. And usually the second iteration is a hundred percent better. They come together. They work efficiently as a team. It's amazing -- just the transformation from the first iteration to the second iteration, how much they improve. And they usually love the training."

More than that, the students seemed to understand the academic part of the class. They're familiar with the most common mortal injuries in the current environment, and they're aware that a good portion of blast victims suffer wounds so bad that there's nothing anyone can do. But they mostly talk about the estimated 10 or 12 percent of casualties whose death could have been prevented -- if only a CLS were there.

"I think it's important for everyone to know how to take care of wounded people, especially in a war zone," said Airman Dayton. "You might run across it whether you like it or not, so having the education and training to help out in a situation like that, it's very critical."