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U.S. Army Institute of Surgical Research provides realistic combat casualty care training for deploying troops

By Dr. Steven Galvan | U.S. Army Institute of Surgical Research Public Affairs | Aug. 13, 2018


For more than seven decades, the U.S. Army Institute of Surgical Research at Joint Base San Antonio-Fort Sam Houston has conducted research to save lives on the battlefield.

The wars in Afghanistan and Iraq have focused research on the leading causes of preventable deaths on the battlefield. These efforts led to the creation of products, medical procedures and clinical practice guidelines that have proven to save the lives of combat wounded.

Products like limb and junctional tourniquets, hemostatic or blood clotting dressings, and guidelines for airway management of traumatic injuries, just to name a few, have been instrumental in saving thousands of lives.

To ensure that Soldiers deploying in harm’s way are trained to properly use tourniquets, combat dressings and are able to perform life-saving procedures like a cricothyrotomy, the Program Executive Office for Simulation, Training and Instrumentation, or PEO-STRI, along with the U.S. Army Medical Department Center and School and the U.S. Army Installation Management Command, fielded a state-of-the-art simulation system, Tactical Combat Casualty Care-Exportable that will be used train all Soldiers on basic warrior medical skills.

The inaugural TC3-X fielding took place at the JBSA-Fort Sam Houston Training Support Center July 10-12. Units supported by the TSC will be able obtain these TC3-X systems to support TC3 training to non-medical Soldiers.


The TC3-X mannequin allows Soldiers to apply tourniquets to stop limb bleeding, pack a gunshot wound with combat gauze, perform a needle decompression to restore breathing and treat airway emergencies. The mannequin is operated by a remote control, forcing the Soldiers to assess and treat the “patient” without interruption from the instructor.


‎”The realistic wound patters and immediate feedback mechanisms of the TC3-X mannequins make this capability truly unique for point of injury care training,” said Master Sgt. Rich Jarrett, AMEDDC&S Center for Pre-hospital Medicine.


“While this capability was initially designed for Army combat medic training, these life-like mannequins are now available for non-medical Soldiers,” Jarrett added. “Incorporating TC3-X into individual and collective training at the unit level will undoubtedly improve Soldier’s skills to treat life threats and reduce potentially preventable causes of death.”


“The bottom line is that every Soldier should have the training and capability to provide lifesaving aid at the point of injury to decrease preventable deaths on the battlefield,” added Lt. Col. Robert Carter, Ph.D., Army Product Manager for Medical Simulation at the PEO-STRI and former TC3 researcher at the USAISR. “Over the years, the U.S. Army Institute of Surgical Research has researched and aided in the development of the tourniquets, chest seals and airway management devices to address the three leading causes of death on the battlefield.


“Now, the newly fielded high fidelity trauma manikins known as TC3-X, when used in conjunction with lifesaving equipment found in Soldier’s individual first aid kits, will increase the unit’s combat effectiveness and survivability,” Carter added.


“This level of training was been a long time coming in the Army,” said Command Sgt. Maj. William “Will” Rinehart, United States Army South, JBSA-Fort Sam Houston, after he successfully applied a tourniquet and performed a needle decompression to restore breathing on the TC3-X mannequin.


“The days of Soldiers not providing self-aid and laying there yelling ‘medic’ or ‘doc’ are over,” said Lt. Col. (Dr.) Benjamin Baker, PEO-STRI clinical advisor. “All Soldiers must have the proficiency to assess their own wounds, provide self or buddy aid if needed, and continue the mission if able.”


“The TC3-X systems that will provide commanders the capability to execute realistic casualty Warrior Skill level 1 through 4 training at the individual, leader and collective levels,” Carter added. “Seventy-seven TC3-X systems will be fielded to Army Training Support Centers to support training in the Army, National Guard, and Reserve components. Previously, these mannequins were only available for combat medics, but now they will be available for home station training throughout the Army.”