JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas –
The scene in a valley in Afghanistan is gruesome, bloody and chaotic. There is smoke, an explosion, gunfire, an overturned armored vehicle and bodies of Soldiers strewn out all over the place.
Arriving on the scene are two Army combat medics, Pvt. Casey Huskins and Spc. Nick Carlson, who are treating a Soldier who was injured after the armored vehicle he and his patrol unit were riding in was damaged by an improvised explosive device, or IED, during an ambush.
The servicemember the medics are tending to has several traumatic injuries: an amputated leg, bleeding from the upper thigh and a chest wound from a gunshot that went through his back. Amidst the chaos, the combat medics are assessing the injuries and taking actions to save the life of the Soldier, including putting a tourniquet on the amputated leg and gauze on the thigh.
Several minutes later, the smoke disappears, sounds of gunfire stop and the lights come on. Huskins and Carlson, both with Company B, 232nd Medical Battalion, are not really in a war zone and the body they are treating is a mannequin of a Soldier on a mockup set at the Combat Trauma Patient Simulation Lab, located at the Medical Education Training Campus at Joint Base San Antonio-Fort Sam Houston.
The simulation lab is part of the Department of Combat Medic Training at METC. The DCMT trains service members in the Army who want to become 68 Whiskey combat medic Specialists.
Carlson said the simulation lab provides a more realistic type of training experience from the classroom in learning how to treat wounds on casualties in a life or death situation.
“You are actually seeing the injuries,” Carlson said. “You are seeing an amputation and you are seeing all the stuff we have talked about in class. On top of that, with the environment you are in – the loud sounds going off, the gunfire in the background, the lighting and the smoke – it made it harder to do what we normally have been doing.”
Camille Espinoza, DCMT training instructor and simulation technician, said the simulation lab puts the combat medic trainees in a setting where they feel like they are in a combat zone.
“We get as close as we can to real life with simulation,” Espinoza said. “We try to make it as realistic as possible.”
Espinoza and Donnie Cromartie, DCMT training instructor and simulation technician, run the simulation lab control room. The control room includes monitors and instruments for sound effects, lighting and the movement of the Soldier mannequins.
On the other side of the lab is the set of a Middle Eastern marketplace in the aftermath of an explosion that has been set off by a suicide bomber, which includes mannequins of several injured Soldiers, as well as civilians. The marketplace setup includes a courtyard, shops and a cart.
To make simulation scenarios as realistic as possible, Espinoza and Cromartie use a touch screen to produce sound effects and control the lighting and the smoke. Remote control is used for the movement of the mannequins and to simulate breathing, bleeding, respiratory and pulse rates while the combat medic trainees are working on them. Each simulation is also video recorded.
Espinoza said there are 10 mannequins on each of the two sets with several simulated traumatic injuries, including amputation, chest and head and gunshot wounds. A workshop in the back of the simulation lab allows the technicians to put makeup on the mannequins to create the injuries the combat medic trainees will treat, and fake blood can be created by mixing powder, water and dish washing liquid.
After the simulation is completed, Espinoza said the video is replayed in each of the scenario sets, so instructors can point out to the combat medic trainees what they did right and what they need to work and improve on.
Depending on the phase of training the combat medic trainees are in, each simulation is between seven to 15 minutes and includes groups of six to eight students working together. Throughout the year, about 5,000 students – the number that graduates from combat medic training – go through the simulation lab.
By doing part of their training in a simulation lab, Espinoza said the combat medic trainees will get to know the different types of traumatic injuries they could encounter in a combat zone and how to assess and treat them on a mannequin.
“We want them to practice on something as close to realistic as possible,” she said. “We want them to practice and make all their mistakes in here so that when a real-life situation occurs, they can respond correctly. It gives them an idea of what they will see in real life and train them properly for the battlefield.”
Huskins said training on mannequins with injuries is more realistic than working with other combat medic trainees, or battle buddies, who are pretending to be injured.
“You could see where they would be hurt at and how they would be moving,” said Huskins, referring to the mannequins. “It’s a lot different than our battle buddies acting like they are hurt. Seeing it is much more helpful.”
Staff Sgt. Melvin Walker, Company E, 232nd Medical Battalion field craft instructor, said the time he spends in the simulation lab with the combat medic trainees gives him an opportunity to provide more one-on-one instruction time with them.
“It allows us to provide a lot of one-on-one opportunities with the students,” Walker said. “It gives them that attention that we may not always be able to give them inside the classroom and during large group instruction.”
Walker said the combat medic trainees go through the simulation lab two to three times during their training. He says the students usually perform better the second time they are in the lab.
“We see a huge difference when they come in the second time in being able to remain calm and remembering the skills they have been taught,” Walker said.
Walker, who served two tours in Iraqi as a combat medic, said the simulation lab at JBSA-Fort Sam Houston is one of the best he has worked in.
“This is about one of the most realistic simulation centers that I’ve been in,” he said. “I taught at another one previously and this is by far one of the best experiences we can provide these Soldier medics outside of actually treating real casualties. I think this is about as close as it gets.”