INTO THE WAR THEATER

Learning How to Save Lives

06/08/10 - High in the rugged mountains outside Salt Lake City, FBI personnel preparing for assignments in Iraq and Afghanistan took their seats at rows of long tables inside a no-frills training facility and studied the first aid kits and CPR dummies in front of them. They were about to get a crash course in how to save a life.

“We’re here to teach you how to do the right thing if something bad happens,” said Paul Vecchio, a retired Army Special Forces combat medic who was leading a group of instructors from the Medical College of Georgia. “During the next few days we are going to give you valuable information we hope you never have to use.”

Tactical combat casualty care—far more advanced than routine first aid techniques—is an essential component of pre-deployment training. Students learn how to apply tourniquets, open airways, and quickly assess and treat serious injuries under battlefield conditions.

“If you’re driving in Kabul and your vehicle is blown up by an IED, you don’t have to be a doctor or have one there to keep someone alive until help comes,” Vecchio said.

The medical training is so realistic that students learning how to properly insert a needle to re-inflate a collapsed lung could feel actual tissue and bone because instructors inserted a rack of raw beef ribs inside the chest cavity of one of the plastic dummies.

As they practiced using tourniquets in a quiet, lighted classroom, some students were surprised to hear one instructor’s guarantee that before the training was over, they would accomplish the same task with one hand, in the dark, while under simulated enemy attack—and be able to do it in a matter of seconds.

It’s all part of the “crawl, walk, run” approach the entire pre-deployment training program is based upon.

“Right now,” said Special Agent Dave S., one of the training program’s managers, “we're crawling, learning basic principles like putting on a tourniquet, putting on a splint, checking airways. As we add layers of complexity and more stress to the drills, that’s when we ‘walk’ and ultimately ‘run’.”

“Walking”—and some dragging—began the next day on a cold and snowy morning. The class spent most of the day outside, repeating a variety of drills to hone their new skills. Some of those skills were being practiced on 185-pound, full-sized dummies. Often, the dummies needed to be dragged, sometimes by only one person, from attack scenarios to safety before teams could assess and treat their injuries.

In a war zone, the tactical aspect of trauma care is critical. Before being able to rescue and treat the wounded, students learned how to keep themselves safe by establishing a security perimeter and laying down suppressive fire if necessary. As everyone took turns being the lead medic or team leader, instructors—doctors and experienced combat medics themselves—monitored all the action, offering advice and providing additional challenges.

During the drills, instructors were seldom without squirt bottles filled with fake blood. If a tourniquet was not put on a dummy correctly or an injury was missed during the assessment phase, instructors would keep squirting blood around the wound until the correct care was given—only then would the “bleeding” stop.

“Next week we’ll put students in an even more stressful environment, with people shooting at them,” Agent S. said. “We keep applying stress so that they can repeat these techniques instinctively. In an emergency situation,” he added, “a few seconds can mean the difference between life and death.”