November 27, 2006
New training centers bring medics close to war
By William Kates
FORT DRUM, N.Y. — Their vision obscured by thick smoke in the semidarkness, heads rattling with the deafening booms of nearby explosions and lungs choked by the paralyzing stench of burning diesel fuel, two Army medics work fast to stabilize the wounded patient for evacuation.
Every move is being watched and recorded by operators in the control room at the Medical Simulation Training Center at Fort Drum, one of 18 new training facilities being built worldwide to improve the Army’s combat medic training.
“You smell burning hair. You smell the diesel fuel,” said Spc. Robert Trimble, one of the medics in the drill. “You hear the sounds of battle all around you. Without bullets flying over your head, this is about as real as it can get.”
The new facility at Fort Drum is the first Medical Simulation Training Center designed specifically for that purpose and built from the ground up, said Army Surgeon General Lt. Gen. Kevin Kiley, who helped open the new center last month.
Trimble, who was paired with Sgt. Bob Kiser in the exercise, just spent a year in Iraq with the 10th Mountain Division.
“No training can compare to real combat,” said Trimble, of Seattle. “But this will take away the initial shock for a lot of soldiers. This training will definitely save lives.”
Since 2000, the Army has upgraded and broadened the training for its medics, extending instruction from 10 weeks to 16 weeks so soldiers emerge with the qualifications of a nationally certified EMT, Kiley said. The new centers merge classroom instruction and specialized training with innovative technology and the actual battlefield experiences of combat medics, Kiley said.
“We are learning lessons of the battlefield today that we need to impart to our medics. We can’t wait for them to get to combat to learn those lessons,” Kiley said. Presently, the survival rate for wounded soldiers is over 90 percent, the highest in the Army’s history.
Fort Drum’s simulation center contains more than $1 million in high-tech equipment and supplies, including three computerized mannequins, said Lt. Col. Drew Kosmowski, the division surgeon.
“The mannequins can breathe, bleed, blink and even talk to give the medic the feedback needed to manage treatment,” Kosmowski said. “Their condition will improve if the proper interventions are performed. The mannequin will die if it is not properly cared for.”
The four simulation rooms are carefully monitored, with a control room that allows an operator to control light levels, temperature, smoke, strobes, smells and other stressors while observing and recording the training, Kosmowski said.
One of the rooms is a replica field clinic. Trimble and Kiser worked in a simulated field evacuation site. Two other rooms recreate combat zones. Sand and debris cover the floors; images of a village at war cover the walls. There are sandbags, barbed wire, weapons and other military equipment spread about. Mannequins serve as dead bodies and severed limbs.
In one room, there is a mock-up of the inside of an UH-1 medevac helicopter that allows medics to train in tight spaces. The dummy chopper sits on springs that can be vibrated to imitate the rocking of a flying helicopter.
“Before, the alternative was you learned it in a classroom,” Trimble said. “The most stress you had was from the drill sergeant standing over you yelling.”
Outside the center, a 14-acre training area trains medics for patient extrication and evacuation.
In one training sequence, a medic must sprint 100 yards to a fallen comrade in the battlefield — actually a 165-pound mannequin. Hoisting the mannequin on to his back, the medic must carry it 50 feet out of the line of fire, quickly assemble a plastic portable stretcher then drag the patient another 100 feet where the victim is transferred to a regular litter.
With a partner, the medic must next navigate an obstacle course with the stretcher, going over high and low walls and through barbed wire. Physically and mentally fatigued, the medic is then hurried into one of the combat simulation rooms to treat a wounded soldier in the midst of a gun battle.
The simulation rooms also can be used to present medics with psychological, emotional and moral dilemmas, said Kosmowski.
In one scenario, medics come upon a pregnant Iraqi woman, an insurgent and an American soldier. All three are severely wounded and will die without immediate care. The medic can only save one.
It might seem an easy choice to treat the fallen soldier, but Kiser said a medic must evaluate each situation and decide who has the best chance of survival.
“We have to make difficult decisions out there, and make them fast,” said Kiser, a combat veteran from Johnstown, Pa. “It helps tremendously if you’ve had a chance to think something through in here first.”