SENNELAGER TRAINING AREA, Germany - "Ambulance inbound," a voice boomed, and troops from the United Kingdom's 2nd Medical Regiment immediately prepared to receive a German ambulance transporting a "victim" injured by an improvised explosive device here, Sept. 15.
As the patient - actor and real-life amputee Raymond Bays - alternated between yelling in pain and slipping into unconsciousness, the medics and doctors from the German army's Medical Regiment 22 and the 2nd Medical Regiment (based in Bergen-Hohne, Germany) worked in tandem to stabilize Bays until he was able to be transported to the Combat Support Hospital. There, he was treated by medical personnel from 30th Medical Command's 212th CSH out of Miesau, Germany, the 202 (Midlands) Field Hospital and the 335th Medical Evacuation Regiment, both based in England.
The scenario was part of Operation Rhino Serpent, a multi-national medical field training exercise comprised of more than 550 U.S. Army Europe, German Armed Forces and British Armed Forces active duty Reservists and volunteers. The exercise culminated in a 96-hour simulated event, where "deployed" British and German medics cleared the battlefield of casualties to a U.S. Combat Support Hospital staffed by U.S., British and German personnel.
"It's very important to train together so that when something happens - such as now, when an ambulance appears - everything runs smoothly. And in the next deployment, wherever that may be, we've got things worked out so there are no problems going in," said British army 2nd Lt. Graeme Hogg, 2nd Medical Regiment troop commander.
The exercise combined multinational healthcare with preparation for contingency and programmed operations in the fictional landlocked, poor and divided country of Curi, but can be anywhere in the world, said 1st Lt. Brian Thorson, the S4 for 212th CSH.
"The current operations that most U.S. units find themselves in is presently in Afghanistan. We're transitioning from an army at war to an army that is preparing for contingency operations. Essentially what that means for us is we need to be ready to prepare at any time, at any place, anywhere," Thorson said.
Careful consideration was made by planners to make the scenarios as realistic as possible, down to troops living and working out of tents, eating meals, ready-to-eat and having no communication with the outside world, Thorson added.
"These are all things that add to realism to training for future scenarios," Thorson said.
The realism of the environment - combined with the injuries sustained by victims, who ranged from Bays' IED blast to a British army private who presented with a large nail through her hand - made medical personnel unsure of when the next rush would be, or what it would entail.
"[At this point] I've treated IEDs, heart attacks, nausea, vomiting, broken legs and children, as well as military working dogs, which are treated as if they were Soldiers," said Capt. Nathan Beckerman, 212th CSH emergency physician.
Each patient was cared for as though the situation were real, but the available IVs, tourniquets and X-rays were not used due to safety reasons, Beckerman added.
With the exception of the animals and children, in which mannequins were used, all cases involved actors hired by Trauma FX, a company from North Yorkshire, England, that specializes in casualty situation makeup, amputee effects and more.
Managing Director Linzi Foxcroft said she often recruits injured combat veterans as actors, including Bays and Ruben Carvil, a Glendora, Calif., native and veteran of the U.S. Air Force, who has resided in England since 2007. With fellow artist Joanna Parvin, the two use realistic props, makeup and large amounts of fake blood to make the wounds appear as they really would right after occurring.
"It's a lot of fun. And what's really satisfying, is when people who've done tours come over and say, 'You know what? I worked with you last year, and it really helped me through the tour, and I had to actually treat somebody.' That's probably the most satisfying part of the whole job," Carvil said.
The actors stayed in character from the moment they were transported from the Trauma FX building in the ambulance to the time they were released, or when the mission was ended, whichever came first. In some cases, that meant the patients spent a few days in the mobile CSH, "recovering."
The CSH was a maze of tents hooked together to make rooms and hallways. Like most permanent hospitals, it included an intensive care unit, ICU wards, operating space, a pharmacy, lab, laundry and more, said Capt. Patrick Kadilak, officer-in-charge of the Emergency Medical Technician section, 212th CSH. It can be configurated into a 44-bed, 84-bed or 284-bed hospital, but was made into an 84-bed hospital for the exercise.
According to Thorson, the hospital can be completely set up in a matter of days, which is in line with the 212th's goal of deploying all personnel within 96 hours of being alerted.
"Whatever mission we receive in the future, with who[m]ever we're paired together, we know how to work through those issues now," Thorson said. "This is what we're training for, to become more and more independent."