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Setting adds realism to in-country mass casualty exercise

Joint Task Force Triple Nickel Public Affairs

Published: 01:53PM April 4th, 2013

BAGRAM AIRFIELD, Afghanistan — Medics rush among multiple patients, evaluating, treating and preparing them for evacuation.

“Shrapnel to the lower extremity. Vital signs are stable right now. I put on a tourniquet and dressed up the wound,” a medic reported.

“Is she breathing?” asked another.

“Rapid breathing, but she was screaming at me in pain.”

For these medics from Headquarters and Headquarters Company, 555th Engineer Brigade, Joint Task Force Triple Nickel, it was an intense, chaotic day in eastern Afghanistan.

But it was also just a training exercise — fake blood, fake wounds, fake screams.

The scenario was a simulated mass casualty incident outside the brigade headquarters of the command element for the U.S. Theater Engineer Brigade.

Medics and other Soldiers of HHC, 555th Engr. Bde., from Joint Base Lewis-McChord, conducted the MASCAL exercise at Bagram Field, Afghanistan, March 24, to prepare the unit for real emergencies on base.

Company and brigade leaders observed as the team carried out critical lifesaving procedures in response to seven simulated casualties with various injury levels.

They retrieved and prepared medical equipment, received and assessed the wounded, began essential lifesaving care, categorized and positioned patients by urgency, continually tracked and reported casualty status, then prepared them for evacuation to higher-level care.

“It felt overwhelming,” said Spc. Joshua Adams, medic and triage officer. “There’s so much going on at once, you’ve got to slow down and process everything.”

That’s no small task in a situation that demands a decisive response to several medical emergencies unfolding at once, especially while enemy threats are close.

This was the first time Adams served as the triage officer, responsible for casualty tracking and overseeing treatment.

“It was good to see how (the medics) react to the stresses of being in a MASCAL,” he said.

Adams considered the training a valuable opportunity to develop his leadership skills. For all the Soldiers involved, the value and realism of the training were apparent.

Added stresses were mixed into the scenario. Staying “in character,” Spc. English Mclemore played a belligerent casualty, arms flailing and yelling nonsensical things like “Barbecue DFAC!”

Some of the first-responders became casualties themselves — a previously unannounced part of the training plan.

“It’s important in this instance that we did it so the Soldiers weren’t ready for it,” said Capt. Matthew Pride, HHC commander, “including having some of the casualties being the combat lifesavers we identified to respond to the event. So that was a big surprise and is something that rings true to real life.”

Overseeing the exercise was Maj. Khalid Jaboori, JTF Triple Nickel’s brigade surgeon. He helped ensure the training was realistic.

“Obviously there’s that initial shock when you see a patient for the first time,” Jaboori said. “Once the training kicks in, it goes into automatic mode.”

For medic Pfc. Alicia Baum, this was her first MASCAL training exercise while deployed.

“It was a good chance to see how things were organized and how it’s going to go down in a real situation,” Baum said.

Leaders said these exercises will be ongoing, as the company continues to prepare for real emergencies.

“It’s important for all our Soldiers to rehearse their battle drills and stay proficient in all their tasks,” Pride said. “Because you’re in a combat zone, training doesn’t cease. You always rehearse-rehearse-rehearse, and that’s a critical function of being battle ready.”

The medics are already looking at how to build on the training.

“The biggest thing that could help is communication,” Adams said. “I could talk more with the medics and have them closer to me, so I can better control how they’re treating patients and keep better accountability of casualties.”

Jaboori looks forward to applying these lessons learned.

“I know there’s a lot of things to work on still,” Jaboori said, “but this is why we do training, (to) see what our deficiencies are, and correct those, before there’s a real event in which they need to use their skills.”

JTF Triple Nickel, headquartered by the 555th Engr. Bde., serves as the U.S. Theater Engineer Brigade in Afghanistan, with about 5,000 Engineer Soldiers, Sailors, and Airmen operating across the country. For more information, visit