With more and more European partner nation Special Operation Forces participating in International Security Assistance Force operations, having medical personnel available to save lives in austere and often dangerous environments is of critical importance.
Medical personnel, regardless of nation, must be trained to perform to the same standards. As a result, U.S. Special Operations Command Europe developed and conducted a Tactical Combat Casualty Care Train-the-Trainer course to enhance the SOF capability and interoperability of the participating nations, and incorporate one recognized standard for managing trauma on the battlefield.
Over a two-week period in May at Zemunik Air Base at Zadar, Croatia, 17 medics from Croatia, Germany, Hungary, Latvia, Lithuania, Romania and Ukraine received expanded medical and trauma care training from U.S. medical personnel from 1st Battalion, 10th Special Forces Group (Airborne), and 352nd Special Operations Group.
SOCEUR’s goal in organizing the course was to provide its partner nation SOF medics with the knowledge and skills required to instruct others in providing medical care in a combat environment, following the guidelines and protocols of TCCC.
Although TCCC started as an initiative by U.S. Special Operations Command, it is now used by all the U.S. military services. It is also used by most allied countries and has been credited as a major factor in U.S. forces having the highest casualty survival rate in our history, according to the U.S. Army Institute of Surgical Research.
On the battlefield, wounded personnel may be treated by medical personnel from a different nation, so having one international standard for tactical field medical care is of vital importance, said Lt. Col. Mark Ervin, SOCEUR surgeon.
“With the diverse coalition contributing to ISAF, it is possible that a casualty will be seen by a combat first responder, medic, CASEVAC crew and physician who all come from different countries,” Ervin said. “A standardized protocol of field trauma care, such as TCCC, ensures the injured combatant that despite the differences in language, everyone caring for him will be able to perform the most appropriate procedures and communicate using the ‘language’ of TCCC.”
Training objectives included tourniquet application/hemorrhage control, needle decompression, splinting, nasopharyngeal airway insertion, MEDEVAC request/9-Line and rotary wing/loading procedures. Also, the participants had to be able to evaluate each other, design their own scenarios and perform other instructor skills so that they would be able to teach them in their own units.
The participants were exposed to enemy fire (the number one factor that determines when and how much care can be provided), darkness, terrain, environmental factors, limited medical equipment, evacuation times and platforms (aerial). They were evaluated for their ability to make timely life care decisions under duress.
“Exposing students to a stressful environment while making them follow the guidelines and theories of TCCC is the only real way to see if they can follow those guidelines while dealing with what could be a very difficult tactical situation,” said Master Sgt. Will A. Ward, a lead instructor of TCCC and noncommissioned officer in charge of Medical Operations, 352nd SOG.
“I really wanted to focus on giving the partner nations the same quality and level of training that we get for our initial training,” Ward added. “This includes the same intensity. I remember the first time that I had to perform TCCC guidelines in the dark, in a room simulating aircraft sound, temperature controlled at 105 degrees, and with an instructor who was more than happy to ‘hurry me along’ if I was going too slow. Those lessons helped when I had to perform in theater, so I want to [impart] that [to] them.”
As the host of the TCCC course, Maj. Mladen Gavrich, Chief of Medical Department, Croatian Special Operations Forces Battalion, said the TCCC brought a new dimension to casualty care training that the Croatians had never experienced.
“We’ve never trained like this before, especially placing our medics in stressful conditions,” Gavrich said. “The training gave our medics a realistic picture of what could go right or wrong when treating a casualty on the battlefield — especially when taking fire with someone’s life is depending on them.”