FORT DRUM, New York –
Medics from the Connecticut Army National Guard’s 143rd Regional Support Group trained for a mass casualty event during their annual training in early August at Fort Drum, New York.
Between August 11 and August 13, 2023, medics attached to units across the 143rd Regional Support Group, including the 192nd Engineer Battalion, triaged and treated waves of simulated casualties that flooded their Role One’s, a mobile, tent based, medical facility designed to treat wounded personnel nearby the point of injury.
Role One’s are found close to the frontline. These facilities are intended to have a small footprint and thus do not have the equipment or staff to conduct complex medical interventions such as surgeries. These facilities provide medics an area where they can perform immediate life saving methods as well as a centralized location for casualty collection. From here, patients will be stabilized and then evacuated to a Role Two.
Role Two’s are normally found at the brigade or higher level, and are equipped to receive patients from the Role One. These facilities come equipped with a trauma section, have a laboratory, and can even conduct X-rays and perform emergency dental treatment. Soldiers will typically stay at this facility until they are well enough to return to duty, or, if they require further specialized care, they will be evacuated to a Role Three medical facility.
“We had a lot of patients with amputations of the extremities, large abdominal wounds, sucking chest wounds, respiratory distress, burns, fractures, we had patients with heatstroke, we had patients with shock,” said Cpt. Melissa D’Amato, a physician assistant for the 192nd Engineer Battalion. “The most common things we see [are the result of] indirect fire.”
After a medic received, or in some instances, came upon a casualty, they immediately performed tactical field care, part of tactical combat casualty care, or TCCC. TCCC is a process of assessing and applying life saving measures to a casualty to stabilize them so they then can be evacuated to a more advanced military medical facility, normally a Role Two or Role Three.
Tourniquets were applied to limbs to stop hemorrhaging, chest seals were placed on sucking chest wounds, casualty cards were filled out and kept with the patient so that the next medic who received the wounded would have an understanding of the casualty’s injuries and treatments that medics or their battle buddies had already provided in the field, helping these soldiers continue appropriate medical care.
As the casualties poured in, nine-line medical evacuation, or medevac, requests poured out over the radio. These requests are a simplified radio transmission designed to ready an ambulance, either air or ground, to transport a casualty from the Role One to a Role Two or Role Three military medical treatment facility, in this case, the 118th Multifunctional Medical Battalion’s battalion aid station.
When a nine-line was received, the closest M997A3 ambulance from the 141st Medical Company (Ground Ambulance) traveled to the Role One. Here, they picked up the patient, or patients in many cases as each ambulance is capable of transporting four litter patients or eight ambulatory patients, and began a life-saving relay.
“I think this was the first time I actually had to care for more than one patient at a time,” said Spc. Riley Sullivan, a combat medic specialist, part of one of the ambulance teams with the 141st Medical Company (Ground Ambulance). “I’m an EMT, civilian side, and we rarely have more than one patient that we are transporting. It was my first AT [Annual Training], my squad leader was right next to me, and he was like, you’re doing good, grab him, you have to be louder. I had to care for the person on top [rack of the ambulance], care for the person on the bottom. It was a little stressful.”
The ambulance would travel to the next prepositioned ambulance team and then transfer their patients to that team. This process would continue until the patient reached the battalion aid station. This prevented one ambulance from traveling the entire distance back and forth to the battalion aid station, which conserved fuel and ensured an ambulance team would never be too far from the Role One.
“It’s a lot of reassessments,” said Sullivan as she recounted the duties she performed during the ride to the next ambulance team. “If they [the patient] have a tourniquet [applied], you have to make sure it is actually working and they’re not bleeding out. If it’s not [working], then you reapply another one. If [the medics who cared for the patient prior to being picked up by Sullivan] weren’t able to do secondary measures, maybe they haven't given them antibiotics, that could be helpful.”
For the medics, this is their crucible. Exercises like these ensure that all their systems work and that their personnel are adequately trained. If a soldier doesn’t know how to communicate a nine-line via a radio, an ambulance will never get dispatched and a casualty will never get medevaced. Likewise, if an ambulance isn’t properly inspected and maintained, it will never reach the aid station. If the time comes, thanks to exercises like these, Connecticut’s medics will know exactly what they need to do to save lives, and they will be ready.