1st FSSG's shock trauma unit prepare replacements with mass casualty exercise

CAMP TAQADDUM, Iraq -- The surgeons, nurses and corpsmen of 1st Force Service Support Group's Surgical Shock Trauma Platoon tested the skills of their replacements during a mass casualty exercise here Sept. 9, 2004.

The exercise is designed to test the replacement team's ability to evacuate, receive, prioritize, and treat wounded personnel while using blood and medical supplies resourcefully.

''We’re getting them to think through all the types of different things that can occur, so when it happens for real, they don’t encounter this for the first time,'' said Navy Capt. Harold Bohman, S/STP's commanding officer.

The S/STP provides immediate, lifesaving medical treatment for patients, including servicemembers, Iraqi Security Forces and enemy combatants in the Al Anbar province of Iraq. 

A mass casualty is defined as treating multiple shock trauma patients who require multiple medical resources, such as resuscitation and surgery.  In S/STP's environment, hordes of patients do not equate to a mass casualty classification.

The severity of the injuries, not the number of patients, determines if they're classified as a mass casualty, said Bohman, a Galesburg, Ill., native. 

Using patient records and digital photos, the veteran team trained and evaluated the new platoon on how to react to any casualty situation.  

The new S/STP members went through several mass casualty scenarios. Each scenario began with a radio call warning that a patient is inbound. Upon arrival, patients are taken to the emergency room where corpsmen, nurses and doctors determine which patients require immediate care.  Some are treated and returned to their units, while others must be stabilized, then flown to more advanced medical facilities in Iraq for further treatment.

During the exercise, the medical unit unexpectedly received three live patients – two service members and one Iraqi. This provided the oncoming crew an opportunity to apply their lifesaving skills in a real-world scenario. 

''It didn't matter whether the patients were real or not.  We got them into the operating rooms they needed to be in,'' said Petty Officer 2nd Class Timothy D. Harvey, an operating room technician with S/STP.

Members of the oncoming crew watched intently as the OIF-veteran doctors removed shrapnel and inserted intravenous fluid tubes into patients.

The outbound medical team has dealt with numerous mass casualties. Since May, S/STP's veteran crew, called the ''Alpha'' team, have treated an injured Iraqi family of eight, 12 sailors injured in Ramadi by mortars and a busload of released Iraqi prisoners struck by an IED.

Many members of the new medical staff, from naval hospitals in San Diego, Camp Pendleton, Calif., and Great Lakes, Ill., have never practiced medicine in the field.  Many corpsmen, like Harvey, have been trained as Fleet Marine Force corpsmen, but have little to no experience working in a combat environment.  They're forced to rely on the training they received at field medical service schools, the training of their predecessors and the experience of their senior staff members.

''I learned a lot, especially with the real patients,'' said Harvey, a 28-year-old, Wellston, Ohio, native. 

Last year, U.S. forces relied on a mobile shock trauma unit for immediate medical treatment during the push to Baghdad, allowing for easier evacuation of patients.

With the current phase of OIF lasting longer than the three-week Baghdad invasion, 1st FSSG has set up shock trauma facilities throughout I Marine Expeditionary Force area of operations.   The S/STP medical personnel here are on call 24 hours a day, ready to support more than 25,000 I MEF Marines and sailors.

Although mobile shock trauma units proved effective last year, the same concept would not work now because casualties don't come from a centralized battlefield.  Instead, they come from a much larger area and are more sporadic, said Bohman.

The platoon receives patients from hotspots like Ramadi and Fallujah, as well as various other locations where anti-Iraqi forces have mounted attacks against coalition troops.

The patients aren't the only ones who feel the effects of their injuries.  Long hours and a fast-paced work environment coupled with the exposure to severe, sometimes fatal, wounds can be emotionally traumatizing and stressful for the platoon’s staff.

The best defense against the fatigue and stress associated with S/STP staff is on-the-job experience, said Bohman.

''We know how to compartmentalize emotions, at least for the moment, to get the job done,'' he said.

By the end of the six-hour exercise, the evaluators were satisfied with the newcomers' performance.

''The Marines are in good hands with the new crew,'' said Navy Lt. Kathryn J. Lacher, 36, an Alpha team critical care nurse and native of Lakeland, Fla.

The new team of shock trauma specialists will have to conduct this exercise again in seven months, when II MEF, from Marine Corps Base Camp Lejeune, N.C., replaces I MEF next spring. 

Until then, the platoon's new staff can only hope the casualties they receive are few.

''I’d rather be bored than busy, because boredom means that no one is hurt,'' said Harvey.