TULSA, Okla.  –   Loud booms can be heard all over the training field located in Perry, Florida. Personnel are scattered all over the facility, covered in fake blood, dirt, and simulated injuries. Smoke is drifting in the air, wavering as Airmen from the 138th Fighter Wing run onto the scene.

This was no real deployed environment. Rather, it was members from the 138th MDG’s final test in achieving their Tactical Casualty Combat Care (TCCC) Tier 2 certification, the new standard that replaced Self Aid and Buddy Care.

The course was four days long, starting in the classroom as the students learned the proper order of treatment by using the massive hemorrhage, airway, respiration, circulation, head injury (MARCH) process, and went over techniques such as applying a tourniquet, splints, and needle decompression. After that, members participated in a more hands-on experience where the Airmen split into teams and encountered a variety of different scenarios that required in-depth medical knowledge of how to treat each unique injury. They practiced caring and evacuating under fire, stabilizing the patients, and tracking all of the care given. Once they gained confidence in facing these tasks, it was time for their final test which included a written portion and a simulated mass causality event.

Airmen had no clue what to expect at first. They were aware that this portion of their final test was more hands-on, just like they practiced. What they weren’t ready for was the smoke, fake rounds, yelling, and chaos as they saw their comrades on the floor, covered in fake wounds ranging from a light injury to fatal. During this evaluation, they put the techniques they learned in the days prior to the test. Using the MARCH system, they evaluated and triaged injured personnel, removed them from the dangerous scene, and prepared them to be evacuated to safety.

“They had grenade launchers, smoke bombs, there was yelling, and more patients than Airmen,” said Chief Master Sgt. Jason Luper, 138th Medical Group superintendent. “You’re automatically in a situation where the teams have to work together to get patients evacuated under fire.”

Staff Sgt. Shamus Klemme, 138th Civil Engineer Squadron firefighter, attended the class alongside the 138th MDG in order to take this knowledge back to the Tulsa Air National Guard Base in Oklahoma, where he can help others become certified in Tier 2 as well.

“We train like we fight,” said Klemme. “During the final test, they had non-lethal explosive ordinances going off with a lot of loud booms and smoke.”

Not only is Klemme an instructor in TCCC as a Drill Status Guardsman, but full time, he is a paramedic. TCCC Tier 2 training is different than that of being a civilian paramedic, Klemme said. But these skills, even at one of the lower levels, can give Airmen the ability to majorly alter the course of how things play out in a deployed environment, or even in civilian life. It’s entirely possible for them to encounter a car crash, and with this knowledge, they could save lives.

“It was a great training opportunity,” Luper said. “And it gave us a chance to get away from Oklahoma as a unit and have some great training, [which] obviously helps everyone. Everyone did a good job as far as communication, moving patients, and proper carrying techniques. [Definitely saw] areas where we could improve, but we saw the progress as we were going through it.”

Luper was one of the many NCOs in charge, responsible for assisting them and checking off each patient, while the younger enlisted personnel worked on caring and stabilizing their wounded comrades. Airman Zoe Spille, 138th MDG health services technician, was one of the many younger enlisted Airmen who participated in the training.

“I feel pretty prepared after this training,” Spille said. “If I encounter someone who can't breathe or if a car crashes I feel more competent in helping them than I was before because of this training.”

With training completed and their certification secured, Airmen of the 138th MDG can go on to use these life-saving techniques both in a deployed military environment or back on the home front.