VENTURA, CA -- On the sun-scorched, rolling hills outside Ventura, California, four medical tents bustle with activity as dozens of Air Force medical personnel attend to wave-upon-wave of patients. Medics are pushed to the limit by the number of injured and the ensuing chaos resulting from a mass casualty event.
Simulating a southern California earthquake in which local hospitals are overwhelmed, 65 members of the Tennessee Air National Guard’s 118th Medical Group (MDG) and support staff from the 118th Wing took part in a training exercise Sept. 5-14, 2021 to prepare them for front-line patient staging during contingency operations.
With a new federal tasking for the 118th MDG to expand its deployable mass casualty care team from 10 to 28, training was necessary to get new members spun up. The additional staff increases the number of treatable patients from 10 to more than 50.
"This mission is so important because it increases our ability to manage more patients when federally activated," said Col. Grace Gibbs, 118th MDG commander. "And we're more capable of responding domestically when called upon by the Governor of the State of Tennessee."
Air National Guard (ANG) units from Tennessee, Alabama, Arkansas, and California joined the 118th MDG to benefit from the training and share their knowledge and experience. The mix of organizations and unique medical challenges each face within their areas of responsibility benefitted all involved.
"California [units] have a completely different geographical landscape, seasons, and natural disasters than the state of Tennessee," said Capt. Ian McEwan, 118th MDG administrative officer. “Given the same problem, they would have very different ways to tackle it. Stick them together, and you get a mixed product that not only gets the job done but can have lasting effects on the members involved."
Training began with two days of Tactical Combat Casualty Care (TCCC) and culminated in a hands-on day that put new skills into action during a mock mass casualty event. TCCC was developed to reduce preventable deaths while maintaining operation success by focusing on controlling massive bleeding, airway management, respiration and breathing management, evaluating and treating circulation, and preventing hypothermia.
"We started off with our medical provider course with a lot of in-class training to help refresh and review skills, and we then transpose those into second-day lane-training for muscle memory," said McEwan. "This includes setting up a security perimeter, clearing the area and locating patients, treating patients, and then extricating them out of a dangerous situation to a secure location where they can be properly treated and getting them out of there."
In addition to TCCC training, members learned the En-Route Patient Staging System (ERPSS). Medical organizations use this system during military operations, humanitarian assistance, disaster relief operations, and defense support to civil authorities. Additionally, it is used for temporary staging, casualty care, and administrative support during contingencies.
"The ERPSS mission is important because it's the part people never think about and assume it is there," said McEwan. "Most people think treatment. Got to save this person! Okay, that is done, and they are on to the next person, but what about the person they just saved? ERPSS is that mechanism that bridges the gap – the grey area most people assume is happening."
Training included several scenarios that pushed newly trained and seasoned Airmen to their limits. The primary scenario revolved around a simulated terror attack on a train, which resulted in a derailment that caused numerous significant injuries.
Resembling a scene from a horror movie, dozens of mock wounded with horrific injuries were strewn throughout the train. Medics put their training into action and first cleared the smoke-filled train of terrorists. They then quickly located the injured, accessed their condition, and stabilized their injuries before evacuating them to safety. For many of the Airmen involved, the training was an eye-opener.
"As a medical technician, I work in a clinic that's very controlled, very relaxed, and I can think clearly. In ERPSS it’s quite the opposite,” said Senior Airman Maria Deavers, 118th MDG medic. "There are possible gunshot wounds, explosions, smoke. It's very chaotic, and it takes a minute for someone like me to calm down in order to finish the mission."
The success of this exercise was evident in the 118th MDG’s ability to quickly absorb TCCC and ERPSS processes and procedures and positively influence the outcome of the real-world scenarios thrown at it during the exercise.
"This exercise was very important, especially for my junior enlisted. Some of them have never been on a deployment or even had a chance to participate in an exercise like this," said Gibbs. "I'm very proud of my Medical Group people and of the other groups that brought people. We've learned a lot from each other, and I value the relationships we've built that will not only benefit the 118th Medical Group back home in Nashville, but wherever we're called to in the future."
*** Special thanks to The National Disaster Search Dog Foundation for allowing the 118th MDG to use its facility for this training.***