SOFIA, Bulgaria -- The knowledge exchange was part of exercise Thracian Sentry 2023 and made possible through the National Guard's State Partnership Program, which has been in place for 30 years. For the exercise's medical element, the armed forces from both nations learned and practiced their "role one" medical procedures, which included the first line of battlefield medical care.
"We are really focused on that combat environment," said Capt. Bryce Bishop, a nurse with the 118th MDG. "We're looking at anything, trauma-related scenarios, traumatic amputations, gunshot wounds, and blast injuries."
The exercise helped certify the Tennessee Guardsmen in Tactical Combat Causality Care, while the Bulgarians used it to prepare for an upcoming NATO battlefield medical care evaluation.
"It's vital to continue doing this so (the U.S. troops) can strengthen the relationship and also learn the [tactics, techniques, and procedures] that the Bulgarians have to follow from a NATO perspective," said Sgt. 1st Class Georgi Georgiev, a member of the Illinois Army National Guard aiding as a translator for the exercise. "Because they don't necessarily match with the U.S. ones."
The medical personnel trained in an advanced battlefield simulation center with smoke and high-tech mannequins. They also simulated an austere environment with field tents and frontline medical supplies. However, the simulation that made the biggest impression occurred in the virtual realm.
"With the virtual reality set, the initial response is that we can do training anywhere, anytime," said Georgiev. "And the biggest thing is that we can prepare people that are going on missions without having to wait for them to be put into the situation."
"I thought that the virtual reality training was probably the thing that stands out the most; I've never seen that or even knew it existed before coming over here," said Staff Sgt. Rebecca Baggett, an aerospace medical technician with the 118th MDG. "So that was a really neat tool to get to see used, and I could see the application being very useful."
These exercises illustrated the differences in how the U.S. and Bulgarian armed forces conduct frontline casualty care.
"Them just kind of teaching us different tactics and different approaches to what they're doing, it's really interesting, it's really humbling," Bishop said. "They have a really high skill set, it's not a rudimentary military, we're learning just as much from them as they are from us."
Bishop said there are fewer Bulgarian medical personnel overall, so they rely on their doctors and nurses to fulfill duties typically conducted by EMTs, physician assistants, and medical administration. However, this allows Bulgarian medical troops to have well-rounded knowledge and experience, which can be advantageous in a frontline situation.
The 118th MDG and Tennessee Guardsmen helped the Bulgarians practice ambulance offloading, litter carrying, and "stopping the bleed" procedures, which will help interoperability with other NATO allies if needed.
The joint exercise and overcoming challenging scenarios also helped foster the relationship between the two allied nations.
"It's a privilege to be here," said Bishop. "We're looking forward to this continued partnership, and hopefully, we get to come back next year for their NATO certification checkoff."