U.S., Polish First Responders Train Together for Mass Casualty Scenarios

The morning started a little differently than usual on a military airfield just outside of Powidz, Poland. Soldiers with 1st Infantry Division (1st ID) gathered at one of the Polish Military’s 33rd Airbase hangars to do something more in the role of an actor versus a Soldier. Soldiers each received a sheet of paper, detailing an injury they had sustained, along with some cues for how a person with that particular injury would likely be acting after an accident. To assist further in their role, they later received makeup.

Moulage, as it’s known by medical personnel, is the art of making fake injuries look real using makeup, fake skin and protruding bones, and fake blood. Soldiers received things ranging from light bruising in areas where even light bruising could indicate a medical concern, all the way to obvious life-threatening head wounds and full upper body burns.

U.S. Army Spc. Leon Carson, a human resources specialist with the 258th Human Resources Company, 1st ID, was one of those roleplayers.

“I’ve done this a few times, but not on this scale,” said Carson.

He said the use of live roleplayers, rather than training dummies, is important. He continued, “It helps the medics and our NATO brothers-in-arms, the Polish armed forces, come together, pick up people who are actually moving, who are actually speaking, and actually know their own injuries, and try to interpret the situation.”

The medics were responding to a simulated aircraft crash, which Carson was referring to. The scenario involved two aircraft colliding in midair, and the wreckage contained survivors found across the airbase.

It was a joint U.S.-Polish (USPOL) mass casualty exercise, including U.S. Army medics and physician’s assistants with the 928th Medical Company (Area Support) (MCAS) and 1st ID, alongside Polish military and civilian firefighters and medical personnel.

“We had four different crash sites set up,” said U.S. Army Sgt. Adam Slaman, a medic with the 928th MCAS. “For that simulation, that plane split into two…had some shockwaves go through and grounded another bird as well.”

Slaman’s role as an observer, controller, trainer was to make sure that the scenario was realistic enough, the roleplayers were believable, and most importantly that the medical personnel completed their objectives.

“Our job was to see how our medics respond, and how the Polish respond,” he said. “To see how we can work together and how we can best help in case there’s an emergency like this.”

He’s enjoyed working with his Polish counterparts.

Slavin said, “They’re a lot of fun to work with. There’s a bit of a language barrier but I think that adds to the fun of it,” adding that he’s working on his Polish, and some of his Polish counterparts know some English. “But they’re basically like ‘Hey let’s go out here, let’s get this done, and let’s go home’ and I highly appreciate that out of them.”

Once the crash sites were identified and reported, Polish firefighters arrived on the scene in minutes. Smoke grenades were employed to simulate fires, and they were put out immediately by a team of firefighters from the nearby town of Słupca.

Military firefighters came in close behind to aid in the rescue operations in a decommissioned military aircraft, now used for training events just like this one.

The teams began extracting the walking wounded first, and carrying those with more serious simulated injuries either by hand or on stretchers to their makeshift triage area.

Even amid the chaos, with the rolepayers screaming in pain and a speaker in the aircraft making still more noise, the language barrier seemed non-existent. On the scene of a crash, it’s not quite as important to find out where the pain is coming from, rather to find where the wounded are. They helped everyone out of the immediate danger zone so they could be attended to by more highly trained medical staff.

In the triage area, Polish Armed Forces medics tended to the wounded based on their visible moulage injuries and separated them to be moved out. Both Polish and U.S. military ambulances raced to the scene to bring the survivors to medical facilities and save lives.

Spc. Lauren Hennig, a combat medic with the 928th MCAS, said that it’s a team effort, even inside the Field Litter Ambulance (FLA).

“We’re an evac (evacuation) team, and I’m only the driver right now,” Hennig said. “We get grid coordinates, my TC (truck commander) plots them out, and I get us there.”

She noted that everyone on the team, regardless of their role that day, is a medic. “We get out and help triage and get everyone loaded up,” Hennig said.

“It’s really vital that we get casualties from the point of injury to a higher echelon of care because, as a medic, if all I have is my aid bag the only thing I can really do is stabilize,” she said. Her evac team, along with three others from the 928th MCAS and 2 Polish Army ambulance teams, brought the patients to one of two places: A Polish military Role I clinic for the less wounded, where they were treated for their simulated injuries and discharged, or brought to the Role 2 facility, which is the 928th MCAS’s forward medical capability, which they used for the exercise. A Role 2 military medical treatment facility provides advanced emergency healthcare, resuscitation, and often damage control surgery closer to the front lines than a main field hospital.

At the Role 2, doctors, physician’s assistants, and medics with the 928th MCAS and 1ID simulated treatment for all of the injuries they were brought, as well as common complications that come with these types of situations. Sometimes crash survivors can become confused or agitated, and one role player became combative and tried to leave. He was subdued with a simulated sedative, and medical staff continued treating his injuries. Others unfortunately, as can happen in real life, did not make it. This is part of the realism in USPOL exercise that helps ensure the medical professionals can and will keep moving in the right direction when a situation is at its worst.

The Role 2, while very capable, isn’t a fully fledged hospital. So sometimes patients need to be moved to an even higher level of care. This was also practiced today with the help of 1st ID’s aeromedical unit. Pilots and flight medics specifically trained for medical evacuation (MEDEVAC) flew in, landed, and received patients with simulated injuries that were above the capability of the Role 2.

For the purposes of USPOL, they carried patients around the airfield and brought them back. In an actual emergency, they would bring them to either a local hospital or the nearest military medical facility able to receive and treat them.

The USPOL exercise was an enormous success, not only showcasing the skills and passion of the 928th MCAS and 1st ID medical personnel, but the capabilities and professionalism of their Polish allies. Most importantly, it showed that both groups are capable of working together seamlessly to save lives.

“It is absolutely vital that we are learning how to coordinate and cooperate with the Polish medical teams and get these patients taken care of,” said Hennig. “It gets more people back home, and it’s always about making sure we have higher survivability in these worst case circumstances.”

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