Mannequins help improve casualty care

  • Published
  • By Master Sgt. Timothy P. Barela
  • Air Force Print News
HURLBURT FIELD, Fla. (AFPN) --  As an independent duty medical technician with Air Force Special Operations Command, Tech. Sgt. Jared Schultz has done casualty evacuations in Iraq and Afghanistan with troops who have lost legs, as well as those who have been shot in just about any body part you can name. 

He says nothing came close to preparing paramedics for the chaos of combat … until now.

Sergeant Schultz says the new casualty evacuation course here is “about as close as you are going to get to the real thing.”

“I would have loved to have had this training before I went out on my first casualty evacuation mission,” said Sergeant Schultz, an instructor for the new course. “It’s focused on the trauma you’re gonna see, the aircraft you’re gonna fly, the equipment you’re gonna use, the chaotic environment you’re gonna be in, and the wounds you’re gonna encounter.  We’re able to simulate that stressed environment here.”

AFSOC began its first casualty evacuation course May 15, training five Reserve independent duty medical technicians from the 920th Rescue Wing at Patrick Air Force Base, Fla. The two-week course continues through May 26.

At the hub of the course is the Tactical Operations Medical Skills Lab, better known as the TOMS Lab, according to Master Sgt. Daniel Arnold, superintendent of medical evacuation operations at AFSOC, as well as the lead man for the casualty evacuation training.

“We needed a platform for our pararescuemen and our independent duty technician paramedics to get combat trauma skills to better support our special forces teams," Sergeant Arnold said. “And we wanted this training to be as lifelike as possible.”

That realism starts with two special training mannequins. These life-like “human simulators” have computerized sensors that react to any treatment students apply.

“The mannequins breathe, bleed, blink, urinate, tear, drool and secrete fluid from their ears,” Sergeant Arnold said. “You can hear their heartbeat, as well as sounds from their lungs and bowels.”

“These are the best mannequins I’ve ever seen,” Sergeant Arnold said. “They react to everything the medics are doing without instructor input. If they provide the correct treatment, the mannequin’s condition improves. If they provide the incorrect treatment, the mannequin’s condition worsens. It’s all computerized.”

For example, the mannequins can simulate cardiac arrest. The medics may give them a medicine like epinephrine to try to get the heart going again. If they apply the right medication and the correct amount, the heart will start beating and the “patient” will recover. If they apply the wrong medication and/or the incorrect amount, it’s curtains.

“The medication they give the mannequins is actually only water,” Sergeant Arnold said. “However, each syringe has a barcode on it. So the sensors in the mannequin read the barcode, telling the computer what type of medication is being used and how much of it is being administered. Then the mannequin reacts accordingly.”

They can even put chest tubes in the mannequins, do needle compressions and run tubes down their throats to secure airways and provide oxygen directly to the lungs. Students can rest assured that they will have to work on at least one simulated amputation, with blood squirting out of an artery in the mannequin’s leg.

But the instructors don’t stop there. The mannequins are only one aspect of the TOMS Lab. They’ve also set up the classroom to simulate the conditions in an aircraft during a casualty evacuation.

“We have speakers that blare out the machine-gun fire and rotor sounds of an MH-53 helicopter, as well as the high-pitched whine of an MC-130 (both aircraft used in casualty evacuations),” Sergeant Arnold said. “We also can make it very hot or cold, depending on the combat environment we are mimicking.”

Then, just to throw in a little more realism, they turn out the lights, as most combat casualty evacuations are done at night, Sergeant Arnold said.

After training in the TOMS Lab, students get a chance to test their new knowledge. First they set up equipment in a static aircraft and then receive 14 moulage patients -- volunteers from the base -- to treat. They eventually get to fly in an MC-130 Combat Talon out of Duke Field, Fla., using casualty evacuation equipment such as ventilators, suction units and monitoring gear. They pick up casualties in this phase as well.

“The flight is the ‘big hurrah.’ This is where you get to apply all that training learned in the TOMS Lab,” Sergeant Arnold said. “When you’re up in the air using the equipment and treating patients, the pilots are yanking and banking, as they simulate evading ground fire. That’s one aspect we couldn’t duplicate in the classroom. You might get motion sickness and still have to stay focused.”

Staying focused is key to saving lives.

“During my first time out on a real combat casualty evacuation, I was not aware of how difficult it was going to be to communicate in the back of the aircraft,” Sergeant Schultz said. “This training shows students how challenging it can be, how the chaotic environment can affect our judgment and performance. It will give them an advantage during the real thing.”

The students agree.

“The pressure is on in the aircraft where it’s so hard to communicate,” said Staff Sgt. Suellen Carire, a medical technician from the 301st Rescue Squadron at Patrick and one of the course’s first students. “But the best thing about this course is it prepares us for situations like that by getting us more hands-on training with realistic simulations.”

For Tech. Sgt. Kirk Bobleter, another medic from the 301st, he’s happy to be one of the first students because he believes the training will help save lives.

“That’s the bottom line,” he said. “We train to give patients a better chance of a normal, healthy life post-injury.”