BlackFive

March 28, 2005

Learning to save lives
Marines get special training to back up corpsmen

By Laura Bailey
Times staff writer

Hospital Corpsman 3rd Class James Pell was rushing toward a badly injured Marine on a Fallujah rooftop last fall when an insurgent popped out of a house and unloaded his AK47 in the doc’s direction.
Pell was hit 11 times and fell two stories onto a nearby rooftop. At least one of the bullets ripped through an artery in his leg, causing massive bleeding.

With no other corpsman on site, a young grunt with India Company, 3rd Battalion, 5th Marines, started working on Pell.

Lance Cpl. James Powers was not a corpsman, but within five minutes, as Pell drifted in and out of consciousness, the Marine applied pressure bandages and tourniquets, secured Pell’s breathing and subdued the bleeding.

Because Powers took part in the Corps’ Combat Lifesaver program, the grunt was able to save the doc.

“He did a good enough job that I’m still standing here talking today,” Pell said from Camp Pendleton, Calif., on March 17. “If he hadn’t been there working on me, I definitely would have bled out right away.”

The Corps wants more guys like Powers — quasi-corpsmen who can patch up wounds on the battlefield when the real docs might not be around.

And as the Corps prepares for this spring’s mega-rotation into Iraq, it’s training more of these mini-medics than ever before.

Camp Lejeune, N.C.’s 2nd Marine Division — heading into Iraq this spring and fall — already has at least one “combat aidsman” per squad. But the goal is to train 4,000 combat lifesavers, an aidsman in every fire team, said Lt. Cmdr. Richard Crabb, medical planner for the division.

When it’s all done, one in four Marines with the division will be able to save a life.

The division is sending hundreds of Marines through their five-day training every month. So far, Crabb said, 1,700 Marines have made it through the course.

And officials say the aidsmen have already put their newfound knowledge to the test.

“The program is absolutely phenomenal. It saves a lot of lives, in my opinion,” said Lt. Cmdr. Brian Hutchison, medical planner for 1st Marine Division at Camp Pendleton.

He said combat lifesaver-trained Marines responded to three out of four of his division’s casualties since the Iraq war began two years ago, either acting as first responders or assisting the corpsman on the scene.

One in six Marines in the California-based division has received the training, Hutchison said.

I Marine Expeditionary Force began experimenting with the training years ago, but it wasn’t until the buildup for Iraq that it kicked the program into higher gear.

The Army, with fewer medics per unit, has been training its troops in similar programs for years. And in the late 1990s, I MEF’s 7th Marines began copying the program.

When 1st Marine Division leathernecks adopted it in the run-up to the Iraq war, they dropped the Army’s program from five days to three. They yanked instruction on water purification and preventive medicine so they could focus on what line units needed most.

“We concentrated on what the actual war fighter would need … Basically, it’s real hands-on stuff for out there in the field when the bullets are flying,” Hutchison said.

Those items include training on triage, hemorrhage control and airway management, to name a few.

Members of II MEF began putting together an unofficial program three years ago on a smaller scale, then officially mandated that Marines from every squad take the course last year.

Also at 2nd Marine Division, aidsmen will start taking special medical bags with them to Iraq. These bags have three times the amount of bandages, dressings and other items that the standard Individual First Aid Kit has. Additional medical items include surgical gloves and a self-adhesive dressing for sucking chest wounds. Eventually, every fire team will get one of the bags, Crabb said.

Setting the standard

The training programs differ throughout the Corps, based on what divisions think they need. On Okinawa, Japan, for example, Marines incorporate field exercises into the course, while at Camp Lejeune, the training is confined to hands-on practice in the classroom.

Officers at Training and Education Command at Quantico, Va., said they are working on long-term plans to standardize the program throughout the Corps.

“We owe the operating forces a service-level solution to this,” said Maj. Bill Clark, the action officer for the program.

Clark said the command will begin to evaluate the different courses used throughout the Corps’ divisions and the Army’s course in order to institutionalize a permanent program and come up with a standard number of aidsmen per unit.

The idea behind the programs is to give every platoon’s corpsman extra help in situations with multiple casualties, said Chief Hospital Corpsman Terry Green, 1st Marine Division’s leading chief petty officer for medical training.

“It’s not uncommon to get hit by [a roadside bomb or rocket-propelled grenade] and suddenly you have four to five casualties right there,” Green said.

“Sometimes, you have one corpsman on the scene and you have four or five casualties. Those combat lifesavers can follow up the corpsman and be an extra set of hands.”

Green said the urban environment in Iraq can slow down evacuation time and extra help is crucial during that waiting period.

“If they get isolated in a building or a room, having a combat lifesaver in that room buys them an extra 15 minutes until a corpsman can get to them.”

The Combat Lifesaver program is essential now that Marines are in an urban fight as opposed to amphibious operations, Crabb said.

“We have been staffed to do amphibious operations. We are not staffed for urban combat, which requires much more medical attention,” Crabb said.

He said the need for more medical help is much greater in urban warfare because Marines can get pinned down in buildings and separated from their corpsmen, and because they can be more spread out.

“They could be strung out over a huge area in an urban combat environment. They could be covering a lot of ground, or they could be pinned down by enemy fire … and have to help each other right there,” he said.

Teaching the essentials

One of the many units set for combat this fall is 3rd Battalion, 6th Marines, which sent large numbers of Marines through aidsman training.

When Marines finish the program, they know a fraction of what corpsmen know fresh out of corpsman school, said Hospital Corpsman 2nd Class William Fetters, who trained the Marines from 3/6.

The idea is that corpsmen will be able to tell a combat lifesaver, “‘Hey, get this done,’ and they’ll do it,” he said.

Fetters said that although the training is nowhere near what a corpsman receives — five days versus six months — the Marines who take it come away with a strong knowledge of first aid and can stabilize a wounded Marine until a corpsman arrives.

After five days of practicing first aid on each other, Marines who took the course said they strengthened the knowledge of what they learned in boot camp with new techniques.

The Marines, almost all lance corporal infantrymen, learned how to prepare and insert an IV, apply pressure dressings and tourniquets, and use the new QuikClot blood-clotting agent to stop bleeding. They’ll also know how to deal with bullet and shrapnel wounds, open fractures, burns, heat exhaustion, sucking chest wounds, and how to ensure breathing with the use of oral plastic airway devices.

“It gets a little more in-depth than boot camp. We may not know everything, but we know enough. It makes it so we can take care of each other and do what we got to do,” said Lance Cpl. Ely Velazquez.

Velazquez said the most useful thing he learned was how to help Marines with gunshots to the legs and arms.

“I’m extremely confident that I could help them and get them right back in the fight,” he said.

Another Marine said the most important thing from the training was to remember to focus on the mission first.

“Concentrate on your job first. Concentrate on the mission. You don’t want to stop in the middle of a firefight to help someone out. That’s why we’ve got corpsmen,” said Lance Cpl. Patrick Goral.

He added that the first step Marines learned is to call the corpsman before doing anything.

Since the group of 3/6 Marines finished the course in February, they plan to review the material regularly by staying in touch with their corpsmen once a month and sharing their new knowledge with platoon mates.

One 2nd Marine Division leatherneck in Iraq said he has not yet used the training in a real-life situation, but feels confident he will remember it if the time comes.

That Marine also said he would feel safe in the hands of fellow Marines who took the course with him.

“I feel confident with my fellow Marines doing first aid on me if I go down. They passed the tests with flying colors. They can all do it easily,” said Cpl. Daniel Cantu with Tango Battery, 5th Battalion, 10th Marines, deployed to Ramadi.

“It’s a good class. I think every Marine who’s deploying here or to other places should be able to take it,” he said.

“It’s good training and it’s good knowledge for when you get out, too.”