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Military Health System

Multinational trauma course aims to standardize battlefield care

Image of Two soldiers, one laying on the ground and the other giving him medical attention. U.S. Army Staff Sgt. Noel Ang, an instructor with the International Trauma Combat Casualty Care course at Landstuhl Regional Medical Center, checks a self-applied tourniquet on a Bundeswehr (German Armed Forces) soldier in late Sept. The international course, which included Service Members from four Nations, was aimed at providing unit-level health care providers life-saving instruction to increase survivability at the point of injury. (Photo by Marcy Sanchez, Landstuhl Regional Medical Center.)

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Nearly 30 service members from United States and Allied armed forces across Europe participated in an International Trauma Combat Casualty Care course at Landstuhl Regional Medical Center (LRMC), in Germany in late September-early October.

The international course, which included service members from four nations, was aimed at providing unit-level health care providers life-saving instruction to increase survivability at the point of injury.

“The course teaches battlefield medicine,” said Army Sgt. Ryan Williams, a combat medic with Landstuhl Regional Medical Center’s Education Division. “Anywhere from tourniquets all the way up to chest seals and goes through the MARCH algorithm.”

MARCH, an acronym for Massive hemorrhage, Airway, Respiratory, Circulation and Hypothermia, is an algorithm taught during the course which has proven essential in lifesaving care.

“Following that sequence, helps us make sure we're stopping what's going to kill the patient first,” explained Williams. “(Combat Medics) and most medics (from other countries) are the first ones on the scene. Recognizing what to do until casualties are able to Medevac to hospitals or the higher echelons of care is essential to surviving.”

In addition to soldiers and airmen, international partners included German, British and Czechian armed forces. Course instruction included an international cadre to ensure proficiency across the allied nations.

According to the TCCC handbook, the course of instruction has saved hundreds of lives during conflicts in Iraq and Afghanistan, citing the importance of the prehospital phase of care in reducing combat fatalities. The concept, developed in 1996 by special operations forces, are evidenced-based and battlefield proven to reduce deaths at the point of injury. Not only does the course introduce students to battlefield medicine best practices, it also serves to train participants in tactical combat components such as care under fire, tactical field care and tactical evacuation care.

“It's all about tactical field care,” said Janine Foncello, a paramedic in the German Armed Forces, or Bundeswehr.

For Foncello, a staff sergeant in the Bundeswehr, who was sent from her unit to absorb and later teach the medical practices and tactics to new recruits, the course prepares her for an upcoming deployment next year.

“It's very important for me to learn here,” explained Foncello. “(The Bundeswehr) wants to (improve) training for our Soldiers. To train and connect together with other nations is a diverse and nice experience.”

The international course marks the first time it has been taught at LRMC, which included multiple lessons covering everything from assessing a combat environment to requesting for medical evacuation of combat casualties.

“We’re bringing our partner nations in and getting on the same page and the same type of medical training across the board,” explained Williams, an instructor at the course. “It's important for our international partners as well as ourselves to make sure we're up to date on current medicine, that we're not moving backwards in time and learning the most advanced medical treatments to increase the rate of survival for our patients.”

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Last Updated: July 20, 2022
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