Page 17 - QARANC Vol 14 No 12 2016

204 (North Irish) Field Hospital Ade
Exercise
Integrated
Serpent 2015
The bright lights and temptations of Las Vegas were just a few miles away from the first phase of the two-week Annual Deployment Exercise held last October which was attended by over 100 members of 204 (North Irish) Field Hospital, an Army Reserve unit based in Belfast.
The first phase of the exercise was adventure training with a range of challenges to face. One of the most popular was a three-day-trek into the formidable Grand Canyon. Kayaking along the Colorado River was also available as well as mountain biking and rock climbing in Red Rock Canyon. Challenging as it was in the searing heat, it was a rare opportunity to conduct adventure-training activities in such a breath-taking environment.
The second phase of the exercise started near to San Diego, California, with clinical training at the Naval Expeditionary Medical Training Institute (NEMTI), Camp Pendleton, where the US Navy hold a large mobile hospital facility and conduct clinical field training. We commenced with a 24-hour hospital exercise in the US tented hospital that, whilst the Unit felt comfortable in their military roles, this tested them due to the unfamiliar environment and subtle difference in equipment. The scenarios presented, covered a whole range of those that we may experience on operations such as road traffic collisions (RTC) with multiple fractures and peritoneal hemorrhage, burns, gastroenteritis, cardiac presentations, mental health and managing paediatrics to name a few. The training continued, moving into what the US Navy call the Tactical Combat Casualty Care Course (TCCC) or more affectionately ‘Drag in the Dust’. This took the Unit to a different role of care; care under fire and in a tactical environment. The Unit experienced the US Navy’s course of algorhythmic and process based care, dealing with massive haemorrhage, insertion of cricothyroidotomy, gaining IV access under pressure and moving the casualty to a safer environment to continue care before evacuation.
What was incredibly important was that the organisation of this ADE incorporated experiences we could not provide for in the UK. A healthy relationship had been established with the Naval Trauma Training Center (NTTC) based at LA County Hospital in Los Angeles the year previously and we decided to continue and build upon this. This facility is the largest trauma centre in Southern California dealing with 1/3 of all regional traumas, and is the largest medical training centre in the U.S. There are 633 beds with approximately 7,000
Maj Kate McLaughlin treats a ‘casualty’ during the exercise at NEMTI
admissions per year. 60% of admissions are blunt trauma such as RTC and 40% are penetrating trauma (gunshots/ stabbings). LA County is a hospital on a huge scale, boasting 133 Emergency Department beds and 120 critical care beds.
The full clinical team at 204 was afforded the opportunity to visit LA County Hospital with a tour into the old hospital operating theatre and new hospital build guided by NTTC staff. In addition to this, two specifically selected groups of clinical staff made up of theatre, ICU, ED and pre hospital staff spent time joining the NTTC students on their course for a 2 and 4-day phase. This included attending ward rounds in ICU, OR and ED and the unique opportunity to work within the live tissue laboratory with perfused cadavers, which was produced and is unique to the LA County dissection laboratory. This type of experience can only be achieved somewhere such as LA County Hospital. This once in a lifetime experience was welcomed by the team. All who attended gained valuable learning and continual professional development. 204 Field Hospital will return in 5 years’ time to the USA where we hope to continue to work with our US Navy colleagues gaining new skills, facing challenges and experiences specific to the US environment and US Defence Medical Training.
Maj Kerry McFadden-Newman RNO 204 (North Irish) Field Hosp
THE GAZETTE QARANC 15
Rock climbing at Mount Charleston, Las Vegas
The morning flag raising ceremony at Camp Pendleton, California