Thursday, November 8, 2018 • APG News B5 Army medics train to prevent ‘lethal triad’ on the combat field By Will Ravenstein Fort Riley
FORT RILEY, Kan. — On today’s battlefield, Soldiers can be injured hun- dreds of miles from medical treatment facilities. They have to rely on the ability of Army medics to get them safely to higher-level care. “Self-aid buys you seconds; Combat Life Saver buys you minutes; the medics buy you hours and the doctor can give you days,” said Command Sgt. Maj. Uriah Popp, Womack Army Medical Center senior noncommissioned officer at Fort Bragg, North Carolina. “We have to be able to sustain life from the point of entry through evacuation or delayed evacuation to get you to a surgeon to be able to have the patient survive the situation or the wounds to get them surgical intervention.” Popp was present as the Soldiers in the first course of Prolonged Field Care worked a training program at the Medical Simulation Training Center at Fort Riley, Kansas, Oct. 26. The weeklong program enhances the knowledge medics gain during Advanced Individual Training at Fort Sam Houston, Texas, to provide them with the ability to use equipment found in an aid station like ventilators, suction and whole blood drawing equipment, said Sgt. 1st Class Anthony Denning, noncommissioned offi- cer in charge, Medical Simulation Train- ing Center, U.S. Army Medical Depart- ment Activity. “A lot of the concepts they receive here will help them in any scenario that they are in,” Denning said. “A lot of it’s based on the type of equipment they will have. But U.S. ARMY PHOTO BY WILL RAVENSTEIN, FORT RILEY PAO out in the field, they understand the lethal First Infantry Division medics assess a casualty during the Prolonged Field Care Procedure class at the Medical Simulation Training Cen- triad and how they need to set up and ter Oct. 26, 2018. The week-long course taught medics how to treat a casualty for an extended period of time due to lack of air support prepare their casualty to be received by an to evacuate the casualty. aid station.” The priority for the medics to learn was nearly 25 percent were deemed poten- done -- they are going to have to reassess went unchecked for too long, the evaluator controlling patients from entering what tially survivable. interventions already done, vital signs and was able to simulate different conditions they refer to as the “lethal triad.” “So, it’s like 964 patients deaths could maybe if they are not satisfied with to make the patient worse, like collapsing a “[The] lethal triad is a combination of have been prevented through proper interventions already done, correct the lung or having the patient’s heart rate start coagulopathy, acidosis and hypothermia,” intervention at either point of entry interventions and make sure any life to slow down. Denning said. “That’s going to lead to a through the medic level,” Popp said. threats are addressed,” Denning said. “And The patient responded positively as quick fatality, which we are trying to Since its inception in 2015, the program then they will start documentation of vital treatments were administered, whole prevent.” has been implemented at most of the signs to make sure they are tracking blood transferred and medications given. Popp said an Army identified gap for direct reporting units of I Corps and the trends. Hawk said he was impressed with the prolonged field care exists due to a loss of 18th Airborne Corps, and it is currently “The difference between this and the training aids were better than what he air superiority or evacuation platforms. expanding through III Corps, Popp said. normal scenarios we do is that the normal used when he first entered the Army, a fact “A lot of the work for this course was “Prolonged field care, by definition, is combat scenarios are hard and fast,” he that impressed him. done through Special Operations Pro- holding a patient past the doctrinal added. “We try to stress them. With this, “I’ve been in for 13 years and in the day longed Field Care working group,” Popp timeline of two to four hours for priority it’s more of an extended period of time. It we had the ‘Rescue Randy’s’” he said. said. “So, essentially what we did was take patients,” Popp said. “What it really gets might be hard and fast at the beginning, “Those were the big dummies that some components of the Special Opera- after is mitigating the lethal triad. That’s but they get into a routine, checking vitals weighed 180 pounds. So you had to ask the tion Medic Course combined with the what’s important, that’s what’s going to and tracking trends.” instructor, ‘do I see equal rise and chest research and recommended protocols, kill the patient. If you don’t mitigate that, it The mannequin used for training is fall, do I hear breath sounds,’ those sort of procedures from the Prolonged Field Care decreases the prognosis of the patient.” hooked up to a laptop from which an things. To provide that feedback directly working group and then current clinical evaluator can control everything from to the end user is amazing. The technology practice guidelines for prolonged field Culminating event breathing to making sound effects, as if the is insane.” care through whole blood administration patient were coughing or moaning in pain. Hawk, Denning and Popp all said they …One of the things that we are working to, The medics entered the room with a As the evaluation went on, the medics hoped the medics all left the training with [with] the goals of the Military Health mannequin on a litter as if the patient had were only able to get the vitals of the greater confidence in their ability to System, is to decrease morbidity and just arrived to the aid station. From there, patient from the evaluator at the comput- perform the procedures to extend pa- mortality on the battlefield.” they re-evaluated the patient’s condition er, as they are unreadable by their tients’ chances of survival. Popp said of the Operations Enduring and moved forward with treatment. equipment. Fort Riley is one of the first locations and Iraqi Freedom deaths through 2011, “It will already have some treatment If treatment procedures were missed or within III Corps to receive this training.
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