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Camp plans for flight line emergency; Sailors use cloak of night to transport injured Marines

Marine Corps News

Release Date: 5/10/2004

Story by Cpl. G. Lane Miley

LEMONIER, Djibouti - (May 5, 2004) -- Flashing red lights and sirens broke the silence of the sultry African night here May 5, as personnel from U.S. Marine Forces Central Command-Djibouti and Combined Joint Task Force-Horn of Africa conducted a mass casualty drill under the full moon.

During the exercise, MARCENT-Djibouti's Expeditionary Medical Unit tested its capabilities to dispatch a medical crew on board a plane, retrieve multiple injured personnel and then further test the EMU's ability to offload and triage the victims at the camp's clinic.

Lt. Cmdr. Christopher E. Schmidt, an emergency room nurse practitioner, said the sailors put together a team with emergency aviation experience to fly out, triage and treat the injured while in flight.

The drill began with a call to CJTF-HOA's Joint Operations Center requesting medical assistance following a simulated combat incident that resulted in eight casualties. A Marine KC-130 was dispatched with EMU medical assets to retrieve the injured. The call was then relayed from the JOC to MARCENT-Djibouti's Quarterdeck about an hour out from the plane's arrival. From there, the Command Duty Officer sounded a verbal alarm over the camp's public address system, alerting doctors and corpsmen from the EMU to report to their battle stations. At the EMU they were advised of the inbound injured personnel and given a chance to prepare the facility for the coming patients.

"I've pulled a lot of emergency phone calls with air traffic control, so I'm used to the checklist," said Staff Sgt. James B. Thacker, who served as the MARCENT-Djibouti Command Duty Officer during the drill. The York, Pa., native took the call at the Quarterdeck and dispatched emergency vehicles to the flight line. He arrived here recently and will serve as MARCENT's air traffic control chief. He previously worked with the Provost Marshall's Office, which also gave him experience dealing with emergencies.

An emergency medicine physician and an emergency medicine nurse on board triaged the downed troops, situating the Marines on stretchers inside the bird according to their injuries, with the worst injuries near the plane's back door for immediate offload.

Corpsmen from the EMU and volunteer Marine litter bearers headed to the flight line as soon as the call came in to transport their fallen comrades to the EMU. The flashing red lights atop Kellogg, Brown and Root fire trucks and the EMU's ambulances cut through the thick, hot night across the camp.

When the first responders arrived, they could hear the loud screams of mock casualties echoing from the plane. As Chief Petty Officer Michael T. Shull rode to the flight line in the ambulance, he said he really enjoys the fast pace of the drill and honing the sailors' skills. He said having the volunteers dressed for the occasion with simulated blood and other special effects makeup helps make the scenario more believable and gets everyone involved moving more quickly. The Maple Grove, Minn., native served as the triage officer for the event and wore a reflective yellow belt so the treatment team would recognize him as the "go-to man" on the ground.

"I love this. I'm a submariner [by trade], so I'm used to doing a million things at once," the 19-year Navy veteran said.

As the EMU personnel unloaded their patients from the ambulances, they assessed them once again to see if they incurred any further injuries en route to the facility. On board the plane each patient was tagged with a colored card describing their injuries, but as they were unloaded at the EMU each of the patients was looked over again before going in for surgical or more intensive care.

This allowed the various elements of the EMU to provide medical intervention and adjust patient flow as some of the patients may require a higher level of surgical care. If a higher level of care was required it could incorporate the camp's Aero-Medical Evacuation Team, who would transport the more critical patients, once stabilized, to a facility where a higher echelon of care is available.

Air Force Lt. Col. David C. Wetlesen. the CJTF-HOA air component chief for current operations and director of the rescue coordination center said the drill was a great learning experience. The Colorado Springs, Colo., native said it opened more options for assisting people and prepared the service members here for further mass casualty exercises.

"It was an outstanding integration of a KC-130 aircraft, its crew and EMU personnel, who would fly out to a casualty site," said Wetlesen.

Along with integrating the aircrew and medical team, the drill brought together personnel from CJTF-HOA and MARCENT-Djibouti who acted as casualties.

Marine Sgt. Patrick G. Kirlew, a patient who suffered a severed leg and abdominal pain for the drill, said he was glad to be able to help the EMU prepare for a real life emergency.

"It feels good being able to help them. I'm helping make sure they're ready, and that's a good feeling," said the New York native who works for the comptroller here. He said in a real situation they will be ready. "From practicing on me, they're going to help somebody else."

During the drill, Schmidt and Lt. Cmdr. Diane M. Gilliland quizzed their young physicians with additional injuries to see how they responded off the cuff. They also challenged them to use some of the EMU's newest medical equipment. One such piece of equipment was the Focused Abdominal Sonogram for Trauma, which they used on Kirlew. Schmidt said the FAST system checks the patient's abdomen for blood. It can help the doctors detect internal bleeding, other trauma in the abdomen and can even check the patient's heart.

Schmidt said the drill was also a good test of the camp's logistics capabilities. The sailors called on KBR for lighting and tested their own ability to recall all EMU personnel and litter bearers.

Schmidt said the EMU has conducted numerous casualty drills during his time here and plans on doing more, increasing the number of casualties and integrating more MARCENT-Djibouti and CJTF-HOA personnel to streamline the camp's processes for the future.

Safety was one of the sailors' main concerns, both for the drill and in a real emergency, Schmidt said. He said having four-man teams on the stretchers was imperative.

As the patients were carried into the EMU, they were seen and treated according to the injuries listed on their colored cards and the visible injuries they had.

Schmidt, a Gulf Breeze, Fla., native, described how makeup was used on the patients to simulate traumas the EMU personnel might see from actual battlefield injuries.

"We try to provide the most realistic training and show them injuries they could see on the battlefield," said Schmidt. "For the most part everyone did well."

He said the sailors got hands on experience with blunt, blast, penetrating and thermal trauma. He said these injuries are likely to occur from gunshot wounds or explosions -either from the initial blast, the heat it would give off, shrapnel it could create or the impact from being thrown away from the blast.

Gilliland, a Jacksonville, Fla., native said the exercise went really well, especially with as many moving parts as were involved.

"Our team did really well. They were overwhelmed, but they pulled together and refreshed many skills that can be used in the future to save lives," said Gilliland, an emergency medicine physician and flight surgeon. "They made a lot of good points, honing skills so that in a real situation people can feel safe and secure that we would be able to take care of them."

After the drill was complete, Seaman Adria D. Miles, a corpsmen at the EMU, said she was ready for anything. The Memphis, Tenn., native said she and the other sailors have already conducted many drills, and she expects them to do more.

Gilliland said the EMU personnel can anticipate more exercises.

"They can expect more drills so the soldiers, sailors, airmen and Marines we are here to serve can know we are well practiced and will be standing ready should the need arise," Gilliland assured the service members here.

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