Michele, The Real McCoy Contributor
Care Simulators (ECS) bite the bullet at Fort McCoy so Soldiers don’t
Sgt. Maj. Robert Bennett (right)
treats a leg wound on a mannequin. Bennett of the 370th Medical
Group of Columbia, Ohio, was at McCoy working on a site survey
for an upcoming medical exercise. Combat Medic Instructor James
Jeleniowski watches Bennett’s training. (Photo
by Tom Michele)
ECS provides an anatomically correct, feature-rich mannequin, which
allows for the physical demonstration of various clinical signs
including bleeding, breathing, blinking eyes and convulsions.
can be programmed to live or die, explicitly through the actions of
the combat medic trainees trying to keep ECS alive. This, in turn,
helps combat medics learn to provide proper care to Soldiers injured
on the battlefield. ECS can be programmed to have an arm or leg blown
off from an improvised explosive device (IED) from a simulated action
on a battlefield. ECS can virtually depict a bullet, blast, fire or
any variety of injuries as it lays on the ground on a training range
or floor of a classroom structure at Fort McCoy.
or outdoors, day or night, summer or winter, combat medic students are
called to care for the wounded Soldier … or simulated wounded
Lamoreaux, Medical Simulation Training Center (MSTC) site manager at
Fort McCoy, said ECS is the "new kid on the block" at Fort
McCoy. "He," and sometimes "she," is helping in
big ways to save the lives of U.S. Soldiers on the battlefield.
new kid bleeds, blinks, cries, screams, has a pulse in the neck, arms,
legs and feet, and it breathes, all according to how it is treated by
Soldiers racing to save its life.
breathes, as its chest raises and relaxes, very much like a
"human." Or ECS doesn’t breathe, due to injuries. The
student medic is responsible to instantly initiate life-saving rescue
procedures, such as cardiopulmonary resuscitation (CPR), to get ECS
breathing again, but more so to treat combat wounds. ECS has a dozen
or so electronic sensors attached to the inside of its body and
connected to and controlled by a set of computers in a control room 20
feet away from the battlefield site.
human physiology models at the core of the ECS provide appropriate
responses to treatment interventions, including airway and oxygenation
management, fluid administration, defibrillation and the
administration of drugs.
"This simulation training with these new ECS (Emergency
Care Simulators) is most important for Soldiers because the ECS
bleed and breathe and react to treatment from the student medic."
Medical Simulation Training Center
these systems deliver a realistic and objective training ground for
trainees to practice and perfect patient care without risk to real
training focuses on the most common causes of preventable death in
combat: extremity hemorrhages, collapsed lungs due to a punctured
chest (tension pneumothorax) and air entering the chest cavity and
blocked airways. Each ECS has different injuries, so the necessary
care and treatment varies. The virtual patients live or die based on
the care provided by the Soldiers doing the training.
apply tourniquets to severed limbs and treat blocked airways by
inserting a tube in the patient’s nose and down the throat to ensure
an open airway. Soldiers learn to recognize signs and symptoms and
then to render life-saving care, including treating for shock,
applying splints and administering saline and intravenous infusions.
said, "This simulation training with these new ECS is most
important for Soldiers because the ECS bleed and breathe and react to
treatment from the student medic. ECS are the next best thing to
working with a real, live person. Simulation training is one of the
fastest-growing fields in medical technology."
importance of all of this is that it is our job to prepare Soldiers
for combat, so they will save lives on the battlefield,"
Lamoreaux said. "Most casualties that are going to die, die
before they get to the first doctor. Ninety percent of life-saving in
combat is done by combat medics."
MSTC concept was developed to focus on the treatment that warfighters
provide in the "platinum 10 minutes" immediately after a
Soldier is wounded. The Army has worked to improve upon the civilian
sector’s concept of the "golden hour" of trauma where the
best way to guarantee survivability is to get the most critical care
to a patient within the first hour of injury. The Army has recast that
concept as the "platinum 10 minutes."
scope of practice for an Army combat medic is greater than a civilian
emergency medical technician," Lamoreaux said. "A combat
medic has more things to do and a greater and higher level of
MSTC mission statement reads, "To train Soldiers to have the
fullest ability and confidence to provide the highest standard medical
care in all aspects of combat trauma management during any mission in
any environmental and physical conditions." Lamoreaux added,
"MSTC’s mission is primarily to teach and validate combat
medics to be confident that they will reduce preventable combat
conducts training for the 68W combat medics and combat life-saving
classes for all Army military occupational specialties. MSTC is
separate from their brethren at Regional Training Site-Medical
(RTS-Medical) that conducts numerous other medical classes.
Maj. Dennis Klatt uses his
stethoscope to listen to the breathing sounds made by a medical
mannequin at the Regional Training Site-Medical Clinical Skills
Lab at Fort McCoy. (Photo
by Tom Michele)
training we provide is so the combat medic will provide critical
treatment at the point of injury, that being on the battlefield,"
Lamoreaux said. "That increases the survivability of the wounded
Soldier. This much more modern training is shown in the 90 percent
survivability rate of combat-injured Soldiers. That is compared with
just fewer than 70 percent in World War II and about 75 percent in
Korea and Vietnam."
with a high-fidelity patient simulator in a realistic environment is
going to increase confidence and ability when medics go to work under
fire," Lamoreaux said. "United States military medicine,
from the 68W combat medic, to nurses and surgeons at frontline
hospitals, is arguably the best in the world. But replicating
confusion of combat, where even the coolest heads can lose their
bearings, is difficult."
has been in service with the Army since 2005. The set at McCoy is the
first at the Wisconsin installation and was delivered in time for the
knows something about what he is teaching. As a master sergeant
serving as a medic with the 160th Special Operations Aviation Regiment
in Afghanistan, he was aboard a Chinook helicopter transporting U.S.
Army Rangers that was shot down by enemy forces March 3, 2002. For his
actions under direct enemy fire, he was instrumental in the survival
of his comrades and subsequently was awarded the Silver Star Medal.
staff includes Maj. Dennis Klatt, a registered nurse, who serves as a
senior supervisor, and a noncommissioned officer-in-charge, three
instructors and an administrative assistant. Klatt’s role is split
between his MSTC duty and being a clinical coordinator at RTS-Medical.
in the medical equipment Soldiers’ carry with them has contributed
to the Soldiers’ ability to help themselves and others. The medical
kits now include equipment to ensure continued breathing for those
with chest wounds, various bandages and a new tourniquet that can be
applied with one hand.
breathing passages open and stemming blood loss has led to increases
in survivability. The Army is sending new medical products to theater
operations, such as Combat Gauze and WoundStat as additional methods
of reducing blood loss.
ECS mannequin has a brother mannequin in the medical simulation
training arena at Fort McCoy, according to Klatt. That brother is
Sim-Man Mannequin and there are a family of them at RTS-Medical. A
combat support hospital (CSH or "cash") situation is set up
with five individual hospital patient bays in one of the regular
barracks buildings in the 1100 block at McCoy.
is similar to ECS," Klatt said, "It’s just used
differently for different missions. These medical simulators have come
a long way in recent years." Each Sim-Man "patient" has
different injuries and is on a cot with close to all of the medical
tools and supplies surrounding each of them, just like at a CSH.
Student medical personnel rush in to care for the patients that also
have some of the electronic sensors to read how the student is caring
for them and reacting accordingly, either continuing to live, or to
also has the capability of having intravenous injections administered.
The needle is inserted into specifically soft areas on the body.
also is connected to a computer that includes readouts of vital body
signs, such as pulse, oxygen level, and respirations.
ECS and Sim-Man are very similar in both their capabilities and
realism, the MSTC uses the ECS for pre-hospital and combat scene
environments while RTS-Medical uses the Sim-Man for a clinically based
are procedures and protocols that have to be followed in treating
wounds and medical conditions," Klatt said. "It is very
similar to putting together a bicycle or desk. If you skip a step the
bike may fall apart or a patient may stop breathing if the medic fails
to check an airway."
simulation, we can make that mannequin stop breathing so that the
medic knows that he missed that step," Klatt continued. "We
also have the capability to view the scenario on video, so that a
thorough after-action-review can be conducted. It can be very
difficult to train these medical procedures when using notional
scenarios. The computerized mannequins give us the ability to have the
patient react by controlling the breathing, heart rate and blood
pressure. It is as realistic as possible to an actual battlefield or
combat support hospital situation. "
are absolutely committed to saving every Soldier wounded in action;
this is what motivates us and guides our training," Klatt said.
"If a Soldier on the battlefield knows that there is a
well-trained and competent medic only a few meters away, they can feel
confident in accomplishing their mission at hand."
is a public affairs specialist for Eagle Systems and Services Inc.,
contractor for CONUS Support Base Services.)