Airmen from the 86th Medical Group, Ramstein Air Base, Germany, participate in a multinational medical exercise drill during Vigorous Warrior 19, Cincu Military Base, Romania. (U.S. Air Force photo by 1st Lt. Andrew Layton)
While Robinson’s team is an integral piece of the day-to-day mission at Vigorous Warrior 19, a bulk of their contributions to the exercise will ultimately take place before and after the EMEDS is operational.
“One aspect of the EMEDS that’s really hard to fathom is how compact the system is,” Robinson said. “It’s designed to be transportable in ten pallet positions, so that the complete package, including equipment and staff, can be transported on one C-17 cargo aircraft.”
Robinson said that a particular challenge in transporting the EMEDS from the 86th MDG’s base in Germany for Vigorous Warrior was that the exercise’s remote location in rural Romania made the option of military airlift impossible. This required the normal transportation pallets to be re-configured for movement on European-style cargo vehicles. Robinson and his team responded to the challenge with a typical “can-do” spirit.
“We ended up re-packing everything into sixteen European pallet positions,” Robinson said. “It’s more than forty tons of equipment, not counting the forklift, which is 26,000 pounds by itself. The generators are the heaviest things we have at 6,900 pounds each.”
Once established, the EMEDS’s efficient flow of patient care was plainly visible as the field hospital began receiving “patients” Sunday with the exercise’s initial scenario inputs.
After undergoing initial triage at the Role 2 site, Romanian soldiers, acting as casualties in realistic moulage, were processed through the EMEDS emergency room where they received an evaluation for surgical needs. Once in the surgery room, a team of experts including internal medicine specialists, an orthopedic surgeon and an anesthetist stood by to respond depending on the diagnosis.
Under NATO’s system of medical care, battlefield patients would be initially treated with basic life-saving care at a Role 1 facility. From there, they would commonly be transported by ambulance to a Role 2 field hospital for the type of emergency room and initial surgical care provided by the EMEDS.
In addition to the ER room, surgery room and patient holding area, the EMEDS has a command and control section, where administration and coordination takes place for follow-on treatment at a Role 3 specialist care center, normally maintained at major bases and installations at the theater level. Under NATO, a Role 4 center would later provide definitive specialized treatment, likely in the patient’s country of origin.
“As all of this is being done, tracking and documentation is taking place to document what point each patient is at in the process,” Hess said. “There’s also coordination for evacuation and to always answer the questions, ‘how do we stabilize this patient, and how do we get them to the next level of care?’”
Vigorous Warrior 19 provides a dynamic space for providers to rehearse this process, in which every second can make the difference between life and death. Uniting more than 2,500 providers from 39 countries, the exercise is so far the largest medical readiness event in NATO’s history.
Hess says that while the exercise will be highlighted by cooperation between multinational civilian and military counterparts, with the goal of increasing interoperability across nationalities, he expects the 86th MDG team to take away plenty of practical wisdom about the implementation and setup of the EMEDS, as well.
“A number of the Airmen on this trip have not deployed before, so this is their first time operating with the EMEDS package in an expeditionary setting,” Hess said. “This is the perfect opportunity for them to become more familiar with the workflow that the EMEDS provides and how to set it up most effectively, not only for the patient, but also to allow the staff to work with the patients more efficiently.”
This year marks the fifth iteration of Vigorous Warrior, which has grown significantly from its beginning in 2011 with five countries. The exercise is organized by the NATO Centre of Excellence for Military Medicine, headquartered in Budapest, Hungary.
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