The soft chime echoed through the cabin of the commercial jetliner, alerting passengers to the impending announcement from the flight crew. But this was no standard announcement about arrival times or weather conditions.
“If there are any passengers with medical training, please report to a crewmember immediately,” echoed the voice of a flight attendant over the loudspeaker.
A passenger was experiencing an adverse medical event. His skin had turned a sickly shade of pale green, and he was cold and clammy to the touch. The Federal Aviation Administration had been contacted, and there was already discussion of diverting the plane to a closer airfield to get the man to emergency medical assistance.
“The flight attendant thought he had had a seizure, and the passenger himself was struggling to respond and couldn’t remember anything from the last thirty seconds or so,” recalled Sgt. 1st Class Lakeya Spicer-Lynch, a combat medic and Brigade Medical Readiness noncommissioned officer in the South Carolina Army National Guard who was a passenger on the plane that day last January.
She had been flying from Greenville, South Carolina, to Dallas-Fort Worth, Texas, when the request for medical assistance came on over the loudspeaker.
“A crew member was coming down the aisle looking for anyone with medical experience,” she said. “So I raised my hand and he came over to me. I told him, ‘I’m an Army medic,’ and he said – ‘Let’s go!’”
Spicer-Lynch is one of nearly 275 medics in the South Carolina Army National Guard and, as such, is the recipient of a new era of training and readiness exercises that the SCARNG has prioritized for their medics.
“Our medics, fundamentally, have the skill set to save lives,” said Master Sgt. James Crosland, the senior combat medic in South Carolina and the acting first sergeant of state Medical Command’s Headquarters and Headquarters Company. “And they have the training to deploy to an austere environment, and to save lives again – and we’re very passionate about that mission.”
While in some ways that mission hasn’t changed much through the decades for the medical professional citizen-soldiers of the SCARNG, the past few years have seen substantial investment into the training, certification, and ongoing professional development that the state’s combat medics go through.
“Over the past five years, I would say that our instructors and our leadership here brought that program to a new level that is well above the national average,” said Crosland. “The Army EMS director came down about three years ago, in fact, and rated [our] program one of the top three in the nation. And I can safely say that our program today is much, much better now than it even was three years ago.”
Highlights of South Carolina’s innovative medical readiness training and combat medic skill development include the use of perfused cadavers in cadaver-lab training, the addition of military working-dog medical considerations to training, and the adoption of high-tempo culminating training events that simulate real-world combat conditions, including medical evacuation exercises with rotary wing aviation teams on Blackhawks and Chinooks.
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In the cadaver labs, the perfused cadavers that South Carolina has added to its training stack are actual human cadavers that have had their veins re-filled with a blood-like substance that allows instructors and students to simulate major combat injuries and physical trauma in conditions as close to “real life” as possible.
“We were one of the first units in the country outside of a pre-MOB (premobilization) or IET (initial entry training) environment to actually have a perfuse cadaver lab,” said Outen, the combat medic state manager for the SCARNG. “And as far as I’m tracking, we were the first state in the entire NGB (National Guard Bureau) to have a perfuse cadaver lab for our medics to attend and train at. And since these are real bodies that we’re pumping simulated blood back through, these are the most realistic injuries our medics can see outside of a real patient.”
SCARNG’s combat medic training doesn’t end in the cadaver lab, though. They are also seeing military working dog training incorporated into their curricula now, including combat life saver for canines, and their training also increasingly reflects the realities of the global political tensions between peer and near-peer state-level potential adversaries.
“We’re thinking about the possibilities of future conflicts where we may not have air superiority, for example,” said Outen. “Meaning we’d lose the capacity to send up a nine-line and get a bird over in 10-15 minutes.”
To prepare for these new possibilities in the operating environment of the future, he said they are “teaching medics advanced methods in prolonged field care, like helping them learn how to sit on patients and keep them stable for potentially many hours at a time.”
In South Carolina, the biannual 68W Sustainment Course that all SCARNG medics have to complete every two years provides the state’s medical leadership with a perfect opportunity to showcase the latest in their advanced training and techniques. In recent years, the state has made a push to use the two-week course to simulate conditions as close to real combat as possible, and it all comes to a head at the end of the second week with the Culminating Training Event (CTE).
At the CTE, medics are given an operations order, and then have to quickly spring into action, working together to determine how they will work their battalion aid stations and more.
“This is where our medics have to show us that they can perform their skills in a stressful environment,” explained Crosland.
And that environment is meant to be as close to real-world as possible.
“We’ll bring choppers down during training to go over how to properly load and unload patients in real-world settings, and they’ll call in real MEDEVACS and load those patients into those birds as well,” said Crosland. “That is an experience that most medics would never get until they deployed.”
While the state’s foremost priority is to prepare its medics for combat, and to keep them deployment-ready at all times, most soldiers in the SCARNG are, like many of their fellow guardsmen, citizen-soldiers with civilian lives and careers that take up the majority of their everyday professional lives.
Maj. Alex Wright is one such soldier. He is a civilian social worker, currently working as a suicide prevention coordinator in the Department of Veterans Affairs. But outside of this “day job,” in the SCARNG he is the company commander of the 251st Area Support Medical Company (ASMC), a unit preparing for an upcoming deployment later this year to Kosovo.
“It’s a NATO mission, so we’ll be treating more than just American Soldiers,” said Wright “And we’ll be working with other foreign militaries in support of Operation Joint Guardian, a peacekeeping mission that is playing a key role right now in the recent tensions between Kosovo and Serbia. When we assume the mission, we will essentially be Task Force Med for the entire deployment, providing command and control for all medical assets for Operation Joint Guardian.”
And while MAJ Wright’s component will include assets from the active-duty side of the Army, like veterinarians, optometrists, and physical therapists, the medical professionals of the 251st ASMC, including medics, nurses, behavioral health experts, and more, will form the core personnel base for the mission.
According to Wright, his Soldiers have already seen their medical skills honed at a higher and faster rate than usual in recent years, thanks in particular to the higher frequency of state active-duty activations and missions to support South Carolina communities during the onslaught of the COVID-19 pandemic. But a deployment gives them another unique and powerful way to advance their training and their skillsets, and he is excited to see his soldiers bring those skillsets back home to South Carolina, where a 68W combat medic is a medic through and through, whether they’re serving in uniform or just living their civilian lives out in their community.
“We’ve had SCARNG medics provide lifesaving aid to everyday citizens in all kinds of settings,” said Wright “Like the time one of our medics gave CPR to a guy in a Walmart parking lot who had collapsed with a heart attack. Our medics are medical soldiers through and through, and are always prepared to rise to the occasion to answer the call of duty. They’re consistent in this at all times.”
Answering the call of duty, whether in or out of uniform is the calling that drives the medical professionals of the South Carolina Army National Guard. It’s the call that drove Spicer-Lynch to raise her hand on that airplane last month – after which she applied lifesaving aid to the injured passenger at 35,000 feet, taking command of the situation, duct-taping an IV to the overhead compartment bin, and working with the FAA to keep their flight on track and get the passenger to safety and to additional medical attention after they landed in Dallas.
It’s the same call that animates Wright and drives him to balance his civilian work in veteran suicide prevention with the demands of an upcoming deployment. And it’s the same call that drives the state’s medical leadership to invest more and more each year in new and innovative training – the kind of training that produces the best medical professionals in our nation’s military, citizen-Soldiers whose training, expertise, and clarity under pressure can make the difference on the battlefields of today and tomorrow.
“We talk about the balance between civilian and military life often,” reflected Wright. “And we of course tell our medical professionals to be just as prepared to serve when the need arises in their communities as when it arises when they’re in uniform. But at the end of the day, our job is already done, because that sense of service is just ingrained in them. It’s embedded in their hearts.”
This article was written by 2nd Lt. Franklin McGuire.