Medical evacuation and training during Ranger School

Infantry Magazine, Spring, 2002 by Marc Captain Cloutier

It's Day 9 of the 10-day field training exercise (FTX) conducted at the 6th Ranger Training Battalion (RTB), the final exercise of Ranger School. For the past eight days the Ranger students have averaged only two hours of sleep per day. A platoon of 40 Ranger students walks through the swamps along the Yellow River on the Florida Panhandle. The illumination is zero and the nearest road is an unimproved trail two kilometers away, with the Boiling Creek to their back. Suddenly a water moccasin bites one of the Ranger students. Without hesitation the Ranger Instructors (RIs) assess the situation and request a medical evacuation (MED-EVAC) helicopter for the student. Within 20 minutes the student is extracted from the swamp and is at the Eglin Air Force Base emergency room for treatment.

Today, the 6th Ranger Training Battalion, responsible for the Florida Phase of Ranger School, is expertly supported by aircrews from the XVIII Airborne Corps. The battalion trains MEDEVAC systems and scenarios at least 15 times a year. This training is broken into four different categories: MEDEVAC systems rehearsals, quarterly MEDEVAC training, annual interagency mass casualty (MASCAL) exercise, and student MEDEVAC operations..

MEDEVAC Systems Rehearsals. Systems rehearsals are conducted on the fourth day of each Ranger Class--11 times over the course of a year. The first system to be tested is a jungle penetrator (JP) hoist of a 200-pound dummy off a safety boat on the Yellow River. Before any student conducts waterborne training, this rehearsal is conducted to verify that aircrews, flight medics, boat operators, Ranger medics, and tactical operations center (TOC) personnel can safely extract a casualty from the swamps.

Following the hoist rehearsal, one RI walking team, consisting of four instructors, initiates part two of this systems rehearsal. Each cycle, a new FTX day is tested. It may be an airborne operation, a waterborne accident, or any number of simulated injuries in remote areas of the Eglin training area. This rehearsal tests MEDEVAC procedures at all levels. An evaluator records significant events, a medical evaluator records actions taken by the RIs to treat the casualty, arid the battalion 5-3 evaluates the primary instructor (PI) team on actions taken upon notification of a MEDEVAC. As in all Army training, an after-action review (AAR) follows the event, involving commanders, air crews, walking teams, medics, and evaluators so that lessons learned can be captured and new procedures developed, if necessary. One of the most difficult types of evacuation, and the most common in a swamp environment, is the JP hoist--an event we always try to incorporate into the systems rehearsals.

Quarterly MEDEVAC Training. Quarterly MEDEVAC training allows company commanders to train multiple walking teams in the procedures for treating and evacuating a casualty. It also gives air crews invaluable and realistic training. Quarterly MEDEVAC training focuses primarily on the use of the JP hoist or SKEDCO litter hoist from the swamps. Instructors and crews train both day and night scenarios involving a casualty requiring immediate extraction. This training realistically replicates hazards that might occur during upcoming cycles. Hypothermia treatment and evacuation is the focus before winter cycles, and heat stoke and snakebites are most common before spring and summer cycles, but there are always added injuries or surprises to prevent complacency on the instructors' evaluation and treatment of the casualty.

Annual Interagency MASCAL Exercise. Once per year, the 6th RTB hosts an interagency MASCAL that involves all agencies in the Eglin community, including local hospitals, law enforcement, and fire and rescue personnel. The MASCAL scenario is developed to be the worst case the 6th RTB would have to encounter and overcome. The scenario is driven by unforeseen factors that cause all elements of the local safety network to be activated and trained.

The annual MASCAL exercise gives several separate agencies an opportunity to conduct MEDEVAC taming. In addition to Ranger assets, joint MASCAL exercises involve local emergency medical services from two counties, the local fire department, five local hospitals, the news media, and Eglin AFB's Disaster Control Group.

Student MEDEVAC Operations. Ranger School is designed to train small and large combat arms unit leaders and, more importantly, give them the tools and ideas to take back to their parent units and use in training their own soldiers.

In addition to ambushes, raids, and waterborne operations, 6th RTB sends the Ranger graduate back to his unit capable of incorporating MEDEVAC training as an integral part of battle-focused training. Each of three Ranger training companies routinely conducts MEDEVAC training scenarios during the ten-day FTX. The treatment and evacuation of simulated casualties occurs without notice to the student chain of command, and often requires evacuation by use of the jungle penetrator. Ranger instructors assist students in the proper procedures for a JP extraction, as the procedure itself is difficult and potentially hazardous.