AUDIE CORNISH, HOST:
Thousands of U.S. military medics are deployed around the world from war zones to hospitals. For the last five years, almost all of them have trained in San Antonio, where military medical training is evolving as warfare is changing. Texas Public Radio's Wendy Rigby reports.
WENDY RIGBY, BYLINE: To prepare medics to treat wartime casualties, the military devises ways to expose and prepare them for the kind of chaos they'll encounter in combat.
(SOUNDBITE OF EXPLOSION)
RIGBY: A mock bomb goes off.
UNIDENTIFIED MAN #1: Let's go. Let's go.
RIGBY: It's smoky. Lights flash. People shout. The bloody wounded are dying. It feels so realistic, almost like you're in the middle of an attack even though this is a safe training room in San Antonio.
UNIDENTIFIED MAN #2: What do you do?
DONALD PARSONS: So this is a marketplace somewhere in the Middle East. A suicide bomber came in and blew himself up, blew up a bunch of soldiers and civilians.
RIGBY: That's Donald Parsons with the Army's department of combat medic training.
UNIDENTIFIED MAN #2: You got pressure on there?
RIGBY: The war zone simulator recreates real-life pressure. The trainees can feel what it's like when seconds matter and lives are saved and lost.
MICHAEL EASTERLING: It was pretty cool. It was a lot of fun.
RIGBY: Twenty-two-year-old Private Michael Easterling is one of the medics, corpsman and technicians from all branches of the military training at the Medical Education and Training campus at Fort Sam Houston. On any given day, 5,000 men and women train here.
UNIDENTIFIED WOMAN: You are taking entirely too long.
RIGBY: The pressure is intense because the end game is so important. Advances in body armor and armored vehicles help save lives, but better trained and well-supplied medics also make a difference.
COLONEL KEITH MICHAEL JOHNSON: We're saving a heck of a lot more lives on the battlefield.
RIGBY: Figures from the Journal of Trauma and Acute Care Surgery back up what Army Colonel Keith Michael Johnson claims. During World War II, 19 percent of those hurt in combat ended up dying. In Vietnam, 15 percent died. In modern conflicts, the mortality rate has dropped to 9 percent.
PARSON: I came in the Army in 1969.
RIGBY: Donald Parsons was a medic in Vietnam. He was trained to civilian standards. Now his students learn trauma techniques through a military lens. Call it battlefield medicine.
PARSON: It's dramatically different than it is in treating trauma in the civilian community because it addresses the underlying tactical situation.
RIGBY: Starting in 2004, soldiers in the Army began to carry tourniquets in first aid kits. Medics used to be discouraged from using tourniquets, fearing an increase in amputations.
UNIDENTIFIED MAN #3: Let's go. Let's go.
RIGBY: Forty years ago, morphine was the standard painkiller on the front lines. In 2011, medics began to include other effective drugs in their kit, including fentanyl and ketamine, alternatives that don't carry the risks of slowing breathing or lowering blood pressure too far.
UNIDENTIFIED MAN #4: What's the dosage for TXA?
RIGBY: Transfusions in the field help the wounded who are hemorrhaging and in shock. In 2012, evacuation helicopters started carrying packed red blood cells and plasma to get life-saving therapy to the wounded sooner.
For service members like Private Easterling, stepping into this fake Middle Eastern marketplace in San Antonio makes the training they get in the classroom all the more relevant.
EASTERLING: This gives us the hands-on training that we need so that we get more prepared for when we eventually end up going out to the field and doing our jobs.
RIGBY: Army information gathered over the last 15 years from Iraq and Afghanistan shows if frontline military medical personnel can get the wounded to the hospital alive, 97 percent of them will live to tell their story. For NPR News, I'm Wendy Rigby in San Antonio.
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