WEBVTT

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(suspenseful music)

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(ringing)

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(helicopters whirring)

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(ringing)

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(ringing

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- [Michael] Missions
are very uncontrolled,

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they're very unpredictable.

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- [Mark] Roadside bomb goes off

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next to a humvee,

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this individual may have head injuries,

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they may have pneumothoraces,
long bone fractures,

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so they may be showing up
neurologically unstable

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with very unstable vital signs.

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(helicopter whirring)

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- [Michael] So they're being
brought in with tourniquets,

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and maybe an IV and maybe not.

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- What we do is provide
the damage control surgery

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to get them to an actual facility

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that can provide them
long-term healthcare.

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(dramatic music)

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- The Ground Surgical Team is definitely

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one of the most dynamic areas
that you can be deployed in,

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because you can be everywhere

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from working inside a fixed facility,

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so a relatively secure location,

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all the way to being
relatively far forward

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and close to the fight.

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- It extends the operational capability

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of the Combatant Commanders.

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- Kind of the last, and separate mission

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is the humanitarian missions, as well.

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- The Ground Surgical Team
will be looking at spaces

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like a wooden shack,

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we're also looking at shipping containers,

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it could be multiple shipping
containers put together,

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it could be tents.

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We could also use any kind of buildings

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that have been abandoned

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or that we've taken over during missions.

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- We can set up anywhere
and then be light enough

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and mobile enough to
move to another location

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based on the tasking.

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- [Suzanne] We originally
had something that was called

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a Mobile Field Surgical Team, or an MFST.

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The Ground Surgical
Team really is a spinoff

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of that concept.

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The team got a little bit smaller,

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so instead of ten individuals

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it's scaled down to six.

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- [Barbara] A surgeon, ER Physician,

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a CRNA or an anesthesiology provider,

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a surgical tech, an MSC,

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and a critical care or trauma nurse.

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(helicopters whirring)

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- [Dylan] Our entire lives
are out of these 14 bags

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that weigh a total of 1.5 tons.

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- It can be moved by humvee,

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it can be moved by helicopter,

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it can be moved by cargo aircraft.

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- [Suzanne] And it's really more modular,

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so we can customize the bags

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based on the response that's needed.

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The team is capable of doing
up to ten surgical cases

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depending on the acuity of the patient

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without resupply.

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- You have limited medications
that you have to work with,

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limited fluids that you
have to choose from.

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- [Dylan] I mean, everybody
is moving in sync,

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everybody knows what we need to do.

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- [Robert] The more severe
the patients coming in to you,

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or the more patients you have,

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the more that teamwork is important.

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(dramatic music)

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- In the current construct,

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the Ground Surgical Team
training happens 12 times a year,

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but we train two teams with each class.

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- We try and bring them up to
one common level of knowledge

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and medical understanding of terminology,

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and then we test that by
putting them in situations

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where they probably didn't expect

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what was gonna come to them.

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- From what we've learned
from Afghanistan and Iraq,

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bringing it here and helping
prepare us for what we'll see.

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- [Suzanne] We can actually have a prior

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Ground Surgical Team
deployer come and speak

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to the students,

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and it gives the students the opportunity

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to ask a lot of questions
and hear the story

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of somebody that's actually
done this mission before.

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- [Mark] We stretch them
as hard as humanly possible

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in situations that pushes them,

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and we can see them
starting to break down,

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that way they can identify my team needs

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to communicate better when this happens.

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- [Suzanne] The team has to consider

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the strengths and
weaknesses of one another

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and how they can best apply that

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to the clinical situation.

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- [Barbara] The stress could mean

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heat, cold, sleep
deprivation, more patients

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than what they typically
would be able to handle.

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- [Michael] The training is
geared to getting us ready

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for the real world environment,

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which they're not gonna
come in one at a time,

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they could come in six at a time.

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(dramatic music)

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(rapid distant gunfire)

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- [Suzanne] The training pipeline

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for the Ground Surgical Team
is divided in two phases.

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So the first phase occurs here and now

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at USAF-SAM here at
Wright-Patterson Air Force Base.

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- [Barbara] This is
where they get introduced

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to what the team concept is,

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what their roles will be, how it fits in

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with the Combatant
Commander's perspective,

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how they will be utilized
in a deployed environment.

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- [Suzanne] As well as
medical simulations,

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in which the students are
provided with a variety

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of different types of patients.

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These mannequins have the
ability for the students

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to actually perform surgery.

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They can actually start an IV,

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they can actually infuse fluids.

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- [Michael] In the simulations,

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they're very chaotic.

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You can see a multitude of one
to up to five or six patients

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come in at one time.

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- [Suzanne] So students
really feel the intensity

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of the time that it takes
to complete these tasks,

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as well as seeing the real time feedback

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of their failure to do them as quickly

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as they think that they maybe
are doing them in their minds.

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- [Anthony] They're squirting blood,

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they're blinking, they're making noises,

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they're groaning at you,

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so for a simulation it's about as real

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as it can get.

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- So one of the things that we do

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is we add the component
of a live actor, as well.

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(painful wailing)

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And that allows us to add
a little bit more fidelity

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and a little bit more of
a dynamic environment.

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- [Anthony] We tell that patient

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to be a little bit problematic.

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We have cadre that are
watching from a sim lab

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that's in the middle of both nomads

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with tv screens so they can take notes

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of everything that they do.

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- [Suzanne] So it's
really kind of interesting

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to see students walk out of the simulation

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actually red faced and covered in sweat

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because they really were feeling

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the tense and emotional toll

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of the patient in front of them.

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(dramatic music)

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- [Barbara] Then they come
down here to Camp Bullis.

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They spend a week with
the EMEDS construct,

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because they provide the surgical support

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for the EMEDS facility.

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So they learn how to integrate

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with a larger team, and then
we spend a couple of days

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giving them intense,
stress-induced scenarios.

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- [Suzanne] Where they're truly operating

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in austere conditions out
in the field at Camp Bullis.

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- I think that it helps
get your hands going,

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get your mind kind of, helps
you develop muscle memory

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for when it actually occurs.

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(gunfire)

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- What do you got?

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- [Barbara] We do attempt to
recreate the battle environment

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with noise, because noise
is an additional stressor.

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It's difficult to hear,

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if you're worried about your own safety

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because you hear gunshots
in the background

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your stress level goes up

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and your reaction times change.

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(gunfire and helicopters whirring)

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- [Suzanne] We always
start a debrief by saying,

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"how do you feel that you did?"

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And most of the time the students

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just start spilling their guts,

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they're so excited with
all of the information

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that they've learned,

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that as instructors we often can sit back

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and just recognize that
the learning has occurred

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actively through their hands-on skills.

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(dramatic music)

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Everybody really has to step
out of their comfort zone,

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and in order to be successful,

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you have to know that
you have a strong team

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working alongside you to do that.

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- [Robert] So if I can
teach 12 people at once

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every two weeks to go down
there and save the lives

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of the people who are
fighting for our freedom,

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I want to make sure they
have every skill available

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to do that job.

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- [Mamie] I knew that this was
my skillset and my passion,

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and I knew if I brought that out there

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to the soldiers, the Airmen,
whoever we're serving,

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that I could do a lot of
good and bring people home.

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(bell chiming)