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MASCAL evaluates abilities, readiness of MNDs

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 the wreckage.
Within minutes, sirens of emergency vehicles could be heard approaching the scene to rescue the victims.
Fortunately, 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.
"One 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.
A 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," he said.
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.
The 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.
"There 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.
"It's 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 the exercise.
"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."
The 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 and Exercises