Reserve Citizen Airmen from the 944th Fighter Wing’s Aeromedical Staging Squadron took combat casualty training to a new level of realism during a January training event at Luke Air Force Base, Arizona.
The 944th ASTS is certified by the National Association of Emergency Medical Technicians to provide Tactical Combat Casualty Care training. TCCC is designed to use evidence-based practices to provide life saving measures and trauma management strategies in battlefield conditions.
The squadron has been facilitating this training since 2012 and provides the course for all branches of the military as well as civilian organizations.
“The Air Force is phasing out what we know as Self-Aid and Buddy Care and moving into TCCC,” said Capt. Breck Smith, the officer in charge of the joint medical operations training initiative.
The transition comes after evaluating the needs of the military over the past several years.
“SABC is basic first aid, and at the time, that was OK,” Smith said. “But, TCCC is an adaption of what we are learning from war. The easiest way to think of it is that TCCC means taking care of patients while getting shot at.”
After studying patient care and deaths over the past few years, the Defense Health Agency determined that almost 90% of all combat deaths occur before the injured person reaches a medical treatment facility.
“We learned that a large portion of those deaths were preventable,” Smith said. “The two biggest causes of death were hemorrhaging and airway obstruction.” TCCC focuses on how to reduce the number of preventable deaths.
“During the three-day course, participants learn the three phases of care: care under fire, tactical field care and tactical evacuation,” said Master Sgt. Lysa Busalacchi, 944th ASTS NAEMT site coordinator. “Students practice learned skills in static stations, where our goal is to emulate realism. This includes utilizing pork tracheas for advanced surgical airway training, chicken legs for simulated intraosseous (bone) infusions and racks of ribs to simulate needle decompression techniques.”
After learning new techniques, the students are put to the test during a field exercise on the final day of training.
“TCCC means care under fire, which means we conduct the training under fire,” Smith said. “As nurses, when we deploy, we are noncombatants under the Geneva Convention, but we still have to train with weapons because we have to protect our patients.”
To help with this aspect of the training, the ASTS reached out to the 944th Security Forces Squadron and acquired paintball guns to replicate a live-fire environment.
To take the training a step further, Smith’s team coordinated with Techline Technologies Inc.
“Technline Technologies offers trauma simulation equipment to help in the training process for the military, law enforcement, fire departments and medical responders,’ said Jay Hibberd, the company’s business development specialist and director of training.
Techline has a mobile training unit that provides everything from basic life saving techniques to courses like TCCC.
“We brought our ‘TOMManikin’ to the training,” Hibberd said. “It is a breathing, bleeding, talking, articulating 185-pound mannequin that we control through a tablet.”
“It’s one thing to learn something on a PowerPoint,” Smith said. “It’s totally different performing your task on a mannequin that is giving you direct feedback. When you perform the task correctly, you can see the result first-hand, all while under fire.”
One participant said she quickly understood the impact of the training.
“In most of our training, we have been working with basic dummies with imaginary wounds, and the most we could do is talk through what we would do to fix the problem in a classroom,” said Staff Sgt. Catelynn Apple, 944th ASTS medical technician. “In this training, we had the realistic dummies that were yelling, communicating and bleeding. They only stopped bleeding when we did the proper care. It was great hands-on training because we could see if we were doing anything wrong.”
During the field exercise, Airmen were tasked with providing security and moving out of a hostile environment in addition to conducting patient care. For some of the medical specialists, this was challenging.
“Our mindset is to go straight to the patient to take care of them, but we have to put in our minds to stop and evaluate the scene, then stabilize the patient enough to move them to a safer location,” Apple said.
She said she had to convince herself that she was still helping the wounded even when she didn’t actually have hands on the patient.
“Having to break the role from medic to security was a lot easier than I thought it would be because in my mind I am still taking care of the patient while I’m holding the weapon,” she said. “If I move, I endanger everyone behind me who is providing direct patient care. Knowing when to switch and how to effectively do that was a great learning experience for me.”
In addition to the military members, local law enforcement specialists and first responders took part in the training as well.
Jim Clark, a fire captain and special weapons and tactics medic from the Buckeye, Arizona, fire department, said training with people from other agencies was extremely helpful.
“We typically focus a lot of training on our respective battlefields, but with the world changing, our battlefields are now across the United States,” he said. “This training was real-life. It reinforced what I know and opened my eyes to something I lost value in – communication.
“When I am with my SWAT team, I know what they know. I know their movements and hand signals and they know mine. This training made me realize that if I found myself in a situation while off-duty, I might be rendering care with the aid of any other concerned citizen and I wouldn’t know how they think. So, communication could save a life. Being in this class was perfect for me because I was able to work on my communication skills and help extract and treat patients.”
Smith said he had one main goal for the class.
“I hope to provide a whole new level of realism to the students so that when they go downrange or respond in any emergency situation, they don’t freeze,” he said. “They’ll know what that stress can feel like and the shock value is lessened. They can let muscle memory take over, making them capable of providing patient care as needed.” #ReserveReady
(Richardson is assigned to the 944th Fighter Wing public affairs office.)