By Sgt. Kerensa Hardy
First published in
SFOR Informer#113, May 16, 2001
Camp Butmir - The helicopter could be seen coming
in to land. Then something went terribly wrong, the tail end went
up in the air and then the whole thing came crashing down.
Once the smoke cleared and the dust settled, passers-by could
see bodies strewn about the ground on the outside of the helicopter
and screams of pain and agony could be heard coming from inside
Within minutes, sirens of emergency vehicles could be heard approaching
the scene to rescue the victims.
the scene was not a real one, but a Mass Casualty (MASCAL) Exercise
that was part of Adventure Express/Dynamic Response, an exercise
that involved troops all over BiH. Soldiers and medical teams
from all three multinational divisions (MNDs) in BiH came together
on May 3 to take part in this necessary training.
of the things we have to practice on a regular basis is the reaction
to mass-casualty scenarios," said British Maj. David Morris,
MND-SW Medical Operations. "And what we have here is a scene
involving a CH-53 helicopter which had difficulties coming in
to land, crash-landed on site and we have a total of 28 casualties.
Obviously, what we want to see is what responses there is to that."
That's when the mass-casualty plan went into action. A fire crew
was first on site - within two or three minutes - to put out the
flames and begin tending to the injured. Whenever helicopters
are scheduled to arrive in any given place, fire teams are always
on standby in the event of an accident, Morris explained.
senior medical officer was on site six minutes after the crash
to co-ordinate all the treatment activity.
"There are 28 casualties, lots of medics, lots of ambulances;
we need someone in charge to decide what's going to happen,"
The next step was triage. There are three triage categories -
P1, P2 and P3. Holding areas were set up for the victims according
to their injuries. The most seriously injured fell into the P1
category. Those with the next most-serious injuries were considered
P2. The walking injured were placed in the P3 area.
casualties were separated into triage categories while outside
away from the crash site. Once they were evaluated, they were
moved to an indoor holding area. The physical fitness centre was
transformed into a makeshift emergency room. There, the patients
were treated and stabilised until they could be transported to
an actual medical facility.
The triage process seemed to take an eternity - especially to
the casualties with broken bones, severe burns and bleeding wounds.
"What we're trying to get here is some real time space and
time issues," Morris said. "They've been told not to
just write things down, but to do it in the time that it would
(actually) take." The patients must be stabilised before
they can be evacuated.
are too many casualties for the facilities here on base to look
after them, particularly with the (priority one patients),"
Morris explained. "So what they'll have to do is pass on
information to the Joint Operations Cell and CJ MED, and they
will contact all the other military facilities within the area
- not just within this division, but in other divisions as well.
And they will all be put on alert and they will notify how many
casualties they can take."
One of the final steps was co-ordinating the evacuation for the
casualties to the various facilities. All that takes quite a lot
of planning. Once all the arrangements were made, all the casualties
were evacuated to several medical facilities and that was the
end of the activity at Camp Butmir.
How did the exercise rate?
"I think this is an absolutely terrific exercise," said
US Col. Rhonda Cornum, Task Force Eagle medical commander, who
just observed. "I think that it certainly looked real. This
is the first time in Dynamic Response I've seen us involve every
nation, every medical facility and all the MNDs."
Soldiers and medics from the United Kingdom, Canada, United States,
Germany, Romania, France, Slovenia, Turkey and The Netherlands
were involved, just to name some of them. The local community
even got involved. A Hitna Pomoc team arrived on the scene with
ambulances and emergency equipment to evacuate patients. Hitna
Pomoc is a civilian medical centre that is based locally.
just invaluable," Cornum said. "Just meeting each other
and planning together has been very useful. Recognising other
people's capabilities and realising that there is a lot of capability
out there, which people, if they stay in their own little corner
of the world, would never know about."
Morris expressed extreme satisfaction with how the training turned
out. The fast response was a result of obviously effective training
that constantly takes place.
"There is ongoing training," Morris said. "Every
division has regular, what we call, Blue-Light Exercises and every
new battle group coming in and every new unit is required to do
one of those exercises within the first two weeks of arrival."
Every division has standard operating instructions to follow during
"It's something that they do for two reasons," Morris
continued. "Obviously so that if something happens for real
then we can get people out there quickly and secondly soldiers
on the ground want to know if something happens that they're going
to be looked after.
"So this kind of exercise also demonstrates to the troops
that they're in safe hands."
chief of CJ MED stood and observed the entire exercise and said
he also was pleased with what he saw. "It went excellently,"
said German Dr. (Navy Capt.) Wolfgang Kattwinkel. "The casualties
were taken away from the crash site within minutes.
"The evacuation plan continued and everyone was taken care
of. It was very good."
He added that this exercise is the first one where patients were
evacuated to facilities across division boundaries.
Kattwinkel stressed the importance of MASCAL training.
"In this international environment, exercises like this are
vital," he said. "We all know that people change very
often, so you have to - again and again - train to keep up the
knowledge of how things like this work."
Related link: Training