Photo By John Freese | Specialist Jessica Olivares, of the 628th Firefighting Detachment, Sturtevant, Wis.,...... read more read more
FORT MCCOY, Wis. – Members from various units of the U.S. Army Reserve's 372nd Engineer Brigade attended a Combat Life Saver course on January 18, 2020. The course is aimed at better preparing ordinary Soldiers to render emergency first aid to their peers on the battle field, and can supplement the mission of Army Medics.
Almost all units in the U.S. Army Reserve have a support, rather than a combat mission. These are engineer, logistics, medical, communications and civil affairs units. On today’s complex battlefield, those missions can still place Army Reserve Soldiers in harm’s way. That is why the Army Reserve encourages its Soldiers to take combat life saver training. The skills it provides have resulted in more rapid, more effective care to their fellow Soldiers.
“It could be anything from a roll over in a vehicle, a gunshot wound, or any kind of shrapnel blow to the Soldier's chest,” said Sgt. Maria Vickers, of the 863rd Engineer Battalion, of Darien, Ill.
Vickers, the course’s lead instructor, explained that CLS teaches three phases of combat medical care. In the first of these, care under fire, a combat life saver works immediately on an injured Soldier to first ensure he or she can breathe, and then to stop or control the bleeding. Then they direct, drag, or carry that Soldier to cover from the continued danger of bullets or flying shrapnel.
This allows the combat lifesaver to work the second phase, known as tactical field care. Here the combat life saver makes continual reassessments of their fellow Soldier's condition. This includes quick determinations on consciousness, control of bleeding, a search for other injuries, and whether the patient can apply self-pressure to a bandage.
The CLS trained Soldier then transitions quickly to the third phase of combat medicine, tactical evacuation. Often times, land transit is too dangerous, too slow, or simply not available. CLS Soldiers are trained to communicate via radio to tactical operations centers in the rear for medical evacuation by helicopter. This is done with a carefully practiced but rapidly deployed message script of nine lines. This “9-Line” conveys the most vital information: Extent of the Soldier's injuries, age, blood type, enemy presence, and landing zone signal method. The message is performed in quick, succinct bursts and takes only moments.
The patient is placed by a trained method onto a folding, portable stretcher, and at least two Soldiers carry this to the waiting chopper, where the patient and stretcher are harnessed for their ride to the nearest combat support hospital.
The greater number of Soldiers having these CLS skills, the greater the chance of survival for each wounded Soldier. In situations where medics are unable to help everyone, having a CLS trained Soldier on hand can mean a faster response, decreased loss of blood, and can serve to expedite evacuation to Forward Resuscitative Teams at CHSs.
Under ideal conditions, all of this can occur in as little as 15 minutes from time of injury. While that may still be a rare achievement, in 2009, then Defense Secretary Robert Gates pushed the so called “golden hour” medical policy; a term already understood in civilian emergency medicine.
This tasked military medicine planners with getting wounded Soldiers to triage and care at CSHs within an hour of being wounded. That meant improvements to the efficiency and accuracy in communication and better overall immediate medical care skill for ordinary Soldiers, Marines, Sailors and Airmen. For the Army, Combat Life Saver training fit the bill.
The CLS program has helped to shape the golden hour timeline into a routine expectation for medical response. CLS care widely acknowledged to have drastically decreased mortality rates below those improvements already seen with the inception of medical air evacuation during the conflicts in Korea and Vietnam.
The largest improvements of all have come during the War on Terror. One recent study cited in the American Medical Association Journal Surgery shows the largest decline in mortality rates in the history of American conflicts. In Iraq and Afghanistan in the period 2001 to 2017, mortality rates of wounded personnel dropped an astonishing 44 percent. While improvements in body and vehicular armor are certainly contributors, it is the improvements to the overall medical care system which can claim the biggest credit, particularly a more prevalent CLS training regimen, and a greater number of personnel able to apply that capability.
“The Army requires at least one CLS trained Soldier per smallest unit,” said Mr. Kevin Urbick, with the Medical Center of Excellence at Fort Sam Houston, Texas, paraphrasing from Army Training Regulation 350-1. The number of CLS trained Soldiers Army wide is generally at about 20% of total strength for initial training, he added, and requirements for annual recertification, now tracked at the unit level, are soon to be centralized Army wide; but, the 20% figure tends to hold steady.
Urbick also indicated that the link to treatment from CLS trained Soldiers and the decrease in mortality rates, while widely acknowledged, actually remains correlational, but not necessarily causal.
“It’s difficult to know exactly, because we can’t really track specifically where a CLS trained Soldier left off, and an Army medic may have taken over,” prior to a given wounded Soldier’s ambulatory evacuation. It could be that the CLS Soldier treated the patient all the way up until he was put on the chopper because the medic was too far away, too busy treating other wounded, or was the victim him or herself, he said.
Seeing Army medical care from the perspective of a system is imperative when working to improve it. That system includes advances in medical technology, knowledge, communication, and mobility, and goes to the smallest possible echelon. For instance, each Soldier, whether CLS trained or not, has the latest version of the Individual First Aid Kit as part of their personal equipment.
“The IFAK has everything needed to treat what’s called the ABCs,” said Lt. Col. Daniel Gray from the 88th Readiness Division Surgeon Office. Airway, breathing and circulation, are the keys. Controlling these three things goes a long a way to giving wounded Soldiers a better chance of surviving their wounds. The 7 x 5 x 3 inch kits contain an advanced tourniquet, an airway tube, tape, a hemorrhage bandage, gauze pads, and sometimes a clotting agent.
The Combat Lifesaver Kit, about the size of a small camera bag, contains additional items such as scissors, additional tourniquets and a thoracic decompression needle. Use of this last device, thoroughly trained in CLS classes, allows trapped air to escape the chest cavity—this in turn allows proper lung function and, critically, evens the respiration of a Soldier with a chest wound. But even the basic IFAK and better basic training in first aid are huge improvements over what Soldiers used to carry and do, Gray said.
For those undergoing the training in this particular session at Fort McCoy, there were many things to take away. High on the list was the ability, in stressful situations, to take calm and skillful action for those in need.
“It felt pretty good to learn a new skill,” said Spc. Jessica Olivares of the 628th Firefighting Detachment, Sturtevant, Wis.
“You watch it on T.V, and sort of know it that way, but when you actually do it, you really get to know it,” she said. She cited a greater confidence in knowing what to do no matter how stressful the circumstances.
Of course, CLS skills can be applied away from combat as well. The Army Reserve is home to units that do potentially dangerous work nearer their training stations.
Soldiers in the 372nd and other units under the 416th Theater Engineer Command, for instance, work as plumbers, electricians, and carpenters. There are heavy equipment operators, bridge building specialists, and, like most of those attending this current CLS course, firefighters. Army Reserve Engineers work with axes, power saws, electric lines, road graders or cranes. They raise buildings, lay roads, and put out fires.
While the Army and Army Reserve place a high priority on Soldier safety, Soldiers still have to perform dangerous duties. On any given training or at-home mission day, even the slightest error or equipment malfunction can put a Soldier at risk. In those situations, the emergency medical skills of their “battle buddy,” can mean the difference between life and death, and whether that Soldier returns home to family at the end of the day. Also, a CLS trained Soldier can serve as life-saver out in the world, away from things Army.
“Definitely applicable, in every aspect,” said Spc. Kamil Czerwonka of the 482nd Engineer Company, Sturtevant, Wis. In his civilian life, he is training for a career in law enforcement.
“You never know when you're going to need to use it, not just in the military, but when I become a police officer...when someone could get shot, or have an accident and I need to apply a tourniquet,” he said.
Olivares agreed.
“Like in everyday life, you might be driving and come up on accident at the side of the road, and you might be able to help (the victims) out,” she said, smiling.
Ultimately, for military units, CLS training is a force multiplier in two ways. It provides the best possible means to get Soldiers the care they need and return to duty, and it assists the capabilities of assigned army medics, who can't be everywhere all the time.
| Date Taken: | 01.18.2020 |
| Date Posted: | 01.30.2020 15:06 |
| Story ID: | 361067 |
| Location: | FORT MCCOY, WISCONSIN, US |
| Web Views: | 581 |
| Downloads: | 0 |
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