French, U.S. Militaries Conduct Mass Casualty Exercise

French medical personnel treat U.S. Army Pvt. Jake Dailing, 1/18th Infantry Battalion, Bravo Company, at a forward medical post during a mass casualty exercise May 14, 2014, at Base Aérienne 188 “Colonel Massart,” Djibouti. French Medical Personnel Treat U.S. Army Pvt. at Forward Medical Post During a Mass Casualty Exercise May 14, 2014

French medical personnel treat U.S. Army Pvt. Jake Dailing, 1/18th Infantry Battalion, Bravo Company, at a forward medical post during a mass casualty exercise May 14, 2014, at Base Aérienne 188 “Colonel Massart,” Djibouti. The exercise is a biannual training event between French and American services to practice saving lives during mass casualty incidents.

French emergency personnel lift U.S. Army Pvt. Jake Dailing, 1/18th Infantry Battalion, Bravo Company, onto a stretcher inside a French C-160 Transall during a mass casualty exercise May 14, 2014, at Base Aérienne 188 “Colonel Massart,” Djibouti. French Emergency Personnel Lift U.S. Army Pvt. Onto a Stretcher Inside a French C-160 Transall During a Mass Casualty Exercise

French emergency personnel lift U.S. Army Pvt. Jake Dailing, 1/18th Infantry Battalion, Bravo Company, onto a stretcher inside a French C-160 Transall during a mass casualty exercise May 14, 2014, at Base Aérienne 188 “Colonel Massart,” Djibouti. The exercise is a biannual training event between French and American services to practice saving lives during mass casualty incidents.

French medical personnel treat U.S. Army Pfc. Aaron McCarty, 1/18th Infantry Battalion, Bravo Company, at a forward medical post during a mass casualty exercise May 14, 2014, at Base Aérienne 188 “Colonel Massart,” Djibouti. French Medical Personnel Treat U.S. Army Pfc During a Mass Casualty Exercise

French medical personnel treat U.S. Army Pfc. Aaron McCarty, 1/18th Infantry Battalion, Bravo Company, at a forward medical post during a mass casualty exercise May 14, 2014, at Base Aérienne 188 “Colonel Massart,” Djibouti. The exercise is a biannual training event between French and American services to practice saving lives during mass casualty incidents.

Emergency Medical Service and Expeditionary Medical Facility (EMF) personnel offload U.S. Army Pfc. Trenton Jefferson, 1/18th Infantry Battalion, Bravo Company, during a mass casualty exercise May 14, 2014, near the EMF on Camp Lemonnier, Djibouti. Emergency Medical Service and EMF Personnel Offload U.S. Army Pfc. During a Mass Casualty Exercise.

Emergency Medical Service and Expeditionary Medical Facility (EMF) personnel offload U.S. Army Pfc. Trenton Jefferson, 1/18th Infantry Battalion, Bravo Company, during a mass casualty exercise May 14, 2014, near the EMF on Camp Lemonnier, Djibouti. The exercise is a biannual training event between French and American services to practice saving lives during mass casualty incidents.

U.S. Navy Petty Officer 2st Class Brandon Brown, Combined Joint Task Force-Horn of Africa Expeditionary Medical Facility hospital corpsman, left, applies moulage to a “victim” during a mass casualty exercise May 14, 2014, at Base Aérienne 188 “Colonel Massart,” Djibouti. U.S. Navy Petty Officer 2st Class, Left, Applies Moulage to a “Victim” During a Mass Casualty Exercise

U.S. Navy Petty Officer 2st Class Brandon Brown, Combined Joint Task Force-Horn of Africa Expeditionary Medical Facility hospital corpsman, left, applies moulage to a “victim” during a mass casualty exercise May 14, 2014, at Base Aérienne 188 “Colonel Massart,” Djibouti. The exercise is a biannual training event between French and American services to practice saving lives during mass casualty incidents.

Staff members of the Expeditionary Medical Facility (EMF) at Camp Lemonnier treat Pvt. Jake Dailing, 1/18th Infantry Battalion, Bravo Company, during a mass casualty exercise May 14, 2014, at the EMF on Camp Lemonnier, Djibouti. Staff Members EMF Treat Pvt., During a Mass Casualty Exercise

Staff members of the Expeditionary Medical Facility (EMF) at Camp Lemonnier treat Pvt. Jake Dailing, 1/18th Infantry Battalion, Bravo Company, during a mass casualty exercise May 14, 2014, at the EMF on Camp Lemonnier, Djibouti. The exercise is a biannual training event between French and American services to practice saving lives during mass casualty incidents.

U.S. Army Pvt. Jake Dailing, 1/18th Infantry Battalion, Bravo Company, receives medical care during a mass casualty exercise May 14, 2014, at Base Aérienne 188 “Colonel Massart,” Djibouti. U.S. Army Pvt. Receives Medical Care During a Mass Casualty Exercise

U.S. Army Pvt. Jake Dailing, 1/18th Infantry Battalion, Bravo Company, receives medical care during a mass casualty exercise May 14, 2014, at Base Aérienne 188 “Colonel Massart,” Djibouti. The exercise is a biannual training event between French and American services to practice saving lives during mass casualty incidents.

French emergency personnel carry U.S. Army Pfc. Trenton Jefferson, 1/18th Infantry Battalion, Bravo Company, to a forward medical post by emergency responders during a mass casualty exercise May 14, 2014, at Base Aérienne 188 “Colonel Massart,” Djibouti. French Emergency Personnel Carry U.S. Army Pfc. To a Forward Medical Post by Emergency Responders During a Mass Casualty Exercise

French emergency personnel carry U.S. Army Pfc. Trenton Jefferson, 1/18th Infantry Battalion, Bravo Company, to a forward medical post by emergency responders during a mass casualty exercise May 14, 2014, at Base Aérienne 188 “Colonel Massart,” Djibouti. The exercise is a biannual training event between French and American services to practice saving lives during mass casualty incidents.

French and U.S. service members participate in a mass casualty exercise May 14, 2014, at Base Aérienne 188 “Colonel Massart,” Djibouti. French and U.S. Service Members Participate in a Mass Casualty Exercise

French and U.S. service members participate in a mass casualty exercise May 14, 2014, at Base Aérienne 188 “Colonel Massart,” Djibouti. The exercise is a biannual training event between French and American services to practice saving lives during mass casualty incidents.

U.S. Army Staff Sgt. Kurt Landry and Petty Officer 3rd Class Darien Gipson remove an exercise participant’s boots during a mass casualty exercise May 14, 2014, in the Expeditionary Medical Facility on Camp Lemonnier, Djibouti. U.S. Army Staff Sgt. Kurt Landry and Petty Officer 3rd Class Darien Gipson remove an exercise participant’s boots during a mass casualty exercise

U.S. Army Staff Sgt. Kurt Landry and Petty Officer 3rd Class Darien Gipson remove an exercise participant’s boots during a mass casualty exercise May 14, 2014, in the Expeditionary Medical Facility on Camp Lemonnier, Djibouti. The exercise is a biannual training event between French and American services to practice saving lives during mass casualty incidents.

Twice a year -- once in the spring and once in the fall -- French and American military doctors at Camp Lemonnier and neighboring French air base, Base Aérienne (BA) 188 “Colonel Massart,” practice saving lives during mass casualty incidents.

After months of planning, their biannual event culminates in several hours of exercise. Following the event, leaders discuss advancements from previous exercises and ways to further improve.

“It is very important that we build relationships, it is a part of the Combined Joint Task Force – Horn of Africa’s and Camp Lemonnier's lines of effort, building Joint Interagency, Intergovernmental, Multinational partnerships,” U.S. Army Capt. Daryl Hopkins, Combined Joint Task Force-Horn of Africa medical logistics planner, said. “What we learn from these exercises is not only benefits us today, but especially for those that come after us, that they will have a process that has been validated.”

For the scenario held May 14, 2014, response personnel were tasked to triage, care-for and transport 14 wounded Soldiers after a simulated explosion on a French C-160 Transall at BA 188.

“We begin now,” said French Col. Michel Ruttiman, Service de santé des armées (French Defense Health Service), to Hopkins near the aircraft.

Ruttiman, who served on the fire brigade in Paris for 10 years -- four as an ambulance physician and six as chief of medical operations – watched and annotated medical personnel’s progress.

“I used to manage this kind of situation in Paris, we used the Red Plan – for around 15 victims,” Ruttiman said during the exercise. “Today it was very good. The Soldiers and the emergency medical service worked together to extract the victims from the plane and managed to organize the hangar into a forward medical post.”

The first patient was loaded onto an ambulance at the forward medical post within an hour from the incident, which Ruttiman said was within time to save victims’ lives.

Hopkins, one of the exercise’s lead planners, said language and communication methods are always a challenge. These exercises allow the medical teams to practice prior to real events when they must coordinate without delay.

“The primary goals of this exercise are to test the triage capabilities of the French medical teams, communications between the French forces and U.S. forces -- specifically in regards to initial medical response and augmentation -- and finally, the provision of medical care to casualties,” Hopkins said.

“All areas were noted as areas for improvement in previous drills,” he continued. “This drill showed great improvements in initial response and medical care with some improvement in communications, as well.”

Hopkins said the differences between the two countries’ response is minimal, but that the U.S. will provide stabilizing care to a victim, then move them to a hospital or facility, while the French provide more definitive care at the point of injury.

“Fifteen years ago we had two different kinds of casualty management,” Ruttiman said. “Now we are beginning to do the same. In France or Germany we put our physicians forward and U.S. physicians are beginning to work closer to casualties. Also, we know the U.S. physicians very well – as friends -- and it makes it easier to work together.”

The following day, medical staff conducted a hotwash from which they generate solutions and improvements for next time.

“It was a good exercise with good action from the soldiers, fire and medical teams,” said General de Brigade Pierre Lecureux, Direction Inter Armées du service de santé (Director, Armed Forces Joint Medical Service). “The triage site was a success because there were no difficulties or important problems. There was good cooperation between American and French teams.”

While this exercise is over, the physicians and medical staff from the neighboring bases continue to work together in local operating rooms, caring for local Djiboutians as well as French and American service members, while planning for the next exercise with the goal of continual improvement in combined disaster response.

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