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Simulation Prepares Soldier-Medics for Combat

By Donna Miles
American Forces Press Service

FORT SAM HOUSTON, Texas, Sept. 30, 2004 – Move over, Resusci-Annie! Army medics-in-training are preparing for upcoming deployments to Iraq and Afghanistan by treating simulated combat casualties in conditions so realistic that they incorporate the look, sounds and smells of war.

Simulation is nothing new in medicine, and many people remember using the legless Resusci-Annie mannequin to practice their skills during cardiopulmonary resuscitation training.

But training at the U.S. Army Medical Department and School here is taking simulation training to a whole new level, giving soldier-medics who will be the first to provide care to wounded troops a taste of combat before facing it in real life.

With just three weeks left in their combat-medic training here, soldiers clad in body armor and tactical gear rush into a dark, smoky room to confront a downed helicopter and three wounded troops. The medics-in-training work in limited visibility, applying the basics of medicine they have learned during the past 13 weeks as they dodge smoke and simulated incoming gunshots.

The "patients" they treat are no Resusci-Annies. These full-body mannequins do almost everything a real body can do, including "bleed" to death, go into cardiac arrest and cease breathing.

As they triage the "patients" and begin administering life-saving procedures, the soldiers respond just as they could be called on to do on the battlefield - - possibly within weeks of graduation.

"We try to create as much realism as we can to give them a snapshot of what they could see on the battlefield," said Army Capt. Chad Garrett, chief of cadre. "Everything here is real time and has real consequences. That's critical, because for these students, it's not if they'll go (to Southwest Asia). It's when."

"They're motivated because they know this is for real," agreed Army Col. Patricia Hastings, medical director for the Department of Combat Medical Training. "They know that the lessons they learn here will be put to use."

Hastings said realistic simulation scenarios, put together by the school staff with limited funds and a lot of imagination, help drive home "very sophisticated concepts" students must learn before they deploy.

"They're getting their first year of medical school in 16 weeks," she said. "Our goal in incorporating simulation into the training is to develop a medic who can respond to trauma on the battlefield quickly."

Garrett said that's the rationale behind the tough training -- noisy, fast- paced and stressful, even to the nonparticipating observer. "You train as you fight, and you fight as you train," he said. "The more we go through this, the more mechanical the concepts become. And when you're faced with a real-life scenario, you fall back on your training. Everything comes back."

"It hits you in the face that this is going to be your reality," said Army Pvt. Rony Touch, who was catching his breath after going through the downed- helicopter simulation for the first time. "This hands-on experience emphasizes what we've been learning in the classroom and the importance of the basics in saving lives."

In another simulation scenario, Pvt. Michelle Wenger helped load a victim into an ambulance, hook up an intravenous drip, administer cardiopulmonary resuscitation and open up the patient's airway when he "stopped breathing" -- all while bouncing inside the vehicle just as she would while moving a real- life patient to a field hospital.

"This really gives us a chance to use our skills and work together as a team," she said. "It also gives you confidence in your training, and that's going to be really important when we do this for real."

Other scenarios at the simulation center replicate a wide range of medical emergencies, as well as austere conditions in a forward surgical tent or combat support hospital.

Hastings said the scenarios, like all training provided to the students, emphasize lessons being learned in Iraq and Afghanistan with a focus on the "ABCs" of combat medicine: opening up the airway, ensuring the patient is breathing, and stopping bleeding to maintain circulation.

"Simulation is a way for medics to become competent in their craft. It incorporates everything they've learned through the program to get them ready before they deploy," she said. "That helps give them the confidence they'll need when they apply these concepts on a real human in a real situation."

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