Combat medic training evolves to save lives

A day before the terrorist attacks on Sept. 11, 2001, Army senior leaders put into place a plan to overhaul the service's combat medic training.

Officials wanted to replace Cold War-era health care specialists, who worked mainly in hospitals as nursing assistants, with more qualified, combat-oriented medics for line units.

Little did they know events the next day eventually would send the force to war in Afghanistan, or that now, seven years later, the new breed of combat medics, many fresh from their initial training, would be called upon on two fronts to save countless lives on the battlefields.

Though they still officially are called health care specialists, today's medics bear little resemblance to those who were trained by nurses. In their place are medics trained by combat veterans with a battle-focused curriculum that has evolved alongside the fight.
"Our medics shouldn't be working in hospitals. Our medics should be saving lives on the battlefield," said Army Lt. Col. (Dr.) Paul T. Mayer, director of combat medic training at Fort Sam Houston in San Antonio said.

The "68 Whiskey" military occupational specialty is the second-largest in the Army, with nearly 38,000 medics spread across the active and reserve components. Only the infantry specialty has more Soldiers in the force.

The Department of Combat Medic Training trains 8,000 new medics a year, with class sizes that stretch to nearly 500 students. A
new iteration of training starts every two weeks, and, at any one time, as many as 2,500 students are working their way through the
program.

"Our challenge is to turn a brand new Soldier into a medic, and we have 16 weeks to do that," Mayer said.

About 60 percent of those who graduate are deployed to the battlefield within six months of graduation, he said. So, during the past
few years, officials at the school have revamped the program. The course still includes civilian emergency medical skills, but the focus now is on training for battlefield medicine, said Donald Parsons, the department's deputy director.

"We have gone back and looked at how people die on the battlefield - what types of wounds they get, what types of injuries that are killing Soldiers - and that's where we focus our attention on training our medics," Parsons said.

For the most part, despite increased technology in weaponry, the types of injuries suffered in war pretty much have stayed the same, Mayer said. Soldiers die on the battlefield primarily from three causes: they bleed to death as the result of severe trauma, an object penetrates their chest and blocks their breathing, or they suffer a head injury that results in a blocked airway, he explained.

The vast majority of those who die in battle do so because their injuries are catastrophic and they would not survive, regardless of how quickly medical care is applied, Parsons said. But there are a small percentage of injuries that could be survivable if the right care is provided quickly.

"What can we train our medics to do to keep these Soldiers alive long enough to make it to the combat support hospital?" Parsons asked, noting that care in those hospitals is comparable to that in the United States. "Our focus is to be able to treat those
preventable causes of death at the point of injury and get that Soldier alive back to that hospital."

The school trains medics to recognize those types of injuries and then treat them, Parsons said, through a dynamic curriculum that constantly is updated with input from the battlefield.

Medics now learn how to perform surgical cricothyrotomies, which involve cutting an emergency airway in the patient's throat. They also learn how to insert a needle into the chest to relieve air pressure on the heart caused by a wound that has penetrated the chest cavity and collapsed a lung.

The school also has leveraged technology in its teaching tools. The school has one of the largest collections of human simulation systems, Mayer said. Mannequins with pulses and breathing systems are modified with simulated trauma wounds, and are integrated into the training to give the students a better idea of the wounds they eventually will treat for real.

The school also has two "blood labs" in which the students sharpen their skills as soldier medics. One lab simulates the scene of a suicide bombing in a market place, and the other simulates a bombing in an office building.

The school also is expanding its field training facility at nearby Camp Bullis. Plans are to expand the training facility and modify it to resemble a forward operating base, Mayer said. Gates, checkpoints and guard towers are planned to give it more of a combat-environment feel.

Mayer said the school will continue to expand, evolve and incorporate lessons learned into its training. Meanwhile, Soldier medics are proving themselves daily in combat, and more Soldiers are returning home alive because of their efforts, he said.