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Advanced Combat Medical Experience Equips Students for Success in the Pre-hospital Environment

First-year students assess a “casualty” wearing a cut suit simulator as part of a combat casualty care scenario during USU’s Advanced Combat Medical Experience course. (Photo by Thomas Balfour)
By Zachary Willis

Military medical care in a combat situation must come at a pace that is unimaginable to most. In the midst of battle, casualties have to be assessed and stabilized long before injured service members ever see a hospital.

In a study of combat casualties from Iraq and Afghanistan between Oct. 2001 and June 2011, it was shown that more than 87% of all deaths due to combat injury happened prior to arrival at a medical treatment facility. Of those, more than 75% were non-survivable and more than 24% were potentially survivable. The vast majority of casualties (more than 90%) were due to hemorrhage.

three students look at something on a table
Students take part in combat casualty care response planning during the Uniformed Services University Advanced Combat Medical Experience course. (Photo by Thomas Balfour)

So how does Uniformed Services University prepare its students for fast-paced combat medical readiness? Since 2013, the Advanced Combat Medical Experience (ACME) course for first-year medical students at USU’s F. Edward Hébert School of Medicine has been one of the ways the university has addressed the need for these critical skills.

“The main goal of ACME is to develop and reinforce the knowledge, skills, and attitudes necessary to perform effective pre-hospital assessment and stabilization of combat wounded casualties,” said Navy Cmdr. (Dr.) Nicole Hurst, associate professor of Military and Emergency Medicine and course director for ACME.

students participate in a field exercise
First-year medical students participate in a tactical combat
casualty care scenario as part of the Advanced Combat
Medical Experience course. (Photo by Thomas Balfour)
Walking around the ACME field practicum site, you’ll see students in teams of four working to provide medical care to volunteers wearing cut suits portraying wounded patients. The advanced human-worn simulators give students the ability to perform real procedures, such as IV insertion and tracheostomies, on live subjects without actually touching the “patients.” At the same time, faculty and staff instructors pay close attention to the students to evaluate each team, grading them on their abilities to not only treat casualties under fire, but also prevent further casualties, and complete the mission.

“I really enjoyed ACME,” said Navy Ensign Ryan Craig, a second-year student in USU’s F. Edward Hébert School of Medicine. “It was a great escape from the classroom and it was the first time that we were applying what we learned with consequences, albeit simulated. I think, going forward, foundational exercises like ACME will remind us to keep up on our trauma skills because we could be called upon to use them at any moment.”

The ACME course continues to evolve as new technology and techniques become available, such as Go Pro camera observation of resuscitations, allowing for better self-evaluation and team evaluation of the resuscitations, and paintball as a means of teaching care under fire. And with that evolution, USU’s first year medical students will become even better equipped for success in fast-paced combat medical readiness.

“ACME was a reminder of what the greater mission of our medical school is, which is to prepare us to be medical officers ready to take care of service members at home and in harm’s way,” Craig said. His classmate, U.S. Public Health Service Ensign Naina Mangalmurti, agreed.

“I felt as though this exercise gave me a better understanding of the quick and clear-headed thinking that is necessary to save lives in the field,” Mangalmurti said. “I’ve come away with an even greater respect for our deployed medics and corpsmen.”