Source: United States Navy (Medical)
CAMP PENDLETON, Calif. – Naval Expeditionary Medicine Warfighter Development Center (NEMWDC) conducted an Integrated Expeditionary Resuscitative Surgical System (ERSS) and En-route Care System (ERCS) course that incorporated Point of Injury (POI) and Role 1 care providers, whose involvement highlights the critical first link in the continuum of care during combat scenarios, Dec. 10-17.
The training was part of an Operational Readiness Evaluation (ORE) to assess the Expeditionary Medicine system capabilities. The ERSS, a seven-member mobile medical team providing surgical care for critically injured patients supporting military operations, and the ERCS, which ensures medical assessment, treatment, and care during patient transport to higher-capacity medical assets, were put to the test in hyper-realistic scenarios.
“This training replicates the unpredictable and resource-constrained environments our medical teams will face in the future fight by simulating real-world challenges like rapid relocation under threat and providing care ashore or at sea,” said Capt. Kevin Bailey, commanding officer of NEMWDC. “It’s about preparing them to operate effectively, testing the teams’ adaptability and decision-making under pressure while maintaining the highest standards of care.”
In a simulated desert village at Bravo Range 1, Camp Pendleton, ERSS Team 11, based at Camp Lejeune, N.C., initially set up their medical operations in a government building at the center of the village. However, a bomb threat forced an immediate relocation to a small, dark, makeshift building. Simultaneously, a firefight erupted as security forces investigated reports of enemy presence within the vicinity. Two service members were injured by an improvised explosive device (IED) explosion and sustained multiple gunshot wounds. Under heavy fire, two Basic Reconnaissance Corpsmen (BRC), along with security support, responded to assess the patients’ status and provided immediate care at the point of injury, including applying tourniquets, performing CPR, and bandaging wounds. Once stabilized, the simulated injured patients using high-fidelity manikins, were transported by ERCS Team 48, a reserve component based at Camp Pendleton, to the ERSS team location. One patient required immediate surgery, while the other was triaged in the emergency room.
The village scenario was just one of many environments featured in the course.
“This group needs to be able to go anywhere and conduct surgery, resuscitation, and damage control,” explained Capt. John Vincent, an anesthesiologist and subject matter expert (SME) from Expeditionary Medical Facility Alpha, Camp Pendleton. “During the training, we operated on a ship, in the woods, and within a simulated village. We also conducted early morning and nighttime operations, rotating through various locations to adapt to changing conditions. Navigating these environmental challenges is a critical aspect of the training.”
The training also included a helicopter simulator to recreate the natural distractions seen in real-world scenarios, such as darkness, dust, turbulence, and noise.
In addition to other elements, the village scenario introduced a simulated local national injured in a car accident. As the patient was brought in for treatment, he grabbed a weapon lying nearby, reminding the team of the critical need for operational security in such settings.
After stabilizing the two critical patients, the teams coordinated the patients’ transport to higher-echelon care via military ambulance and air transport. The entire exercise unfolded amid simulated firefights, bomb explosions, and the physical demands of maintaining team security, ensuring a highly immersive training environment.
Participants were evaluated on their ability to work as a cohesive unit, communicate internally and with higher authorities, and make critical decisions with limited resources. Specific metrics included the effectiveness of their triage protocols, timeliness of care under simulated hostile conditions, and the clarity of their communication during critical handovers.
“These scenarios are not about individual skills but about how the team integrates to manage patient casualties and execute the mission,” said Cmdr. Damian Storz, executive officer for NEMWDC.
Capt. Benjamin Hoagland, SME from EMF Alpha, Camp Pendleton, praised the integration between ERSS and ERCS teams.
“Despite many participants working together for the first time, they demonstrated seamless collaboration, which is critical in austere environments,” Hoagland said.
Lt. Cmdr. Megan Ayres, a general surgeon for ERSS Team 11 emphasized the course’s value in preparing teams for deployment.
“This training helps us shift from a resource-rich hospital mindset to prioritizing care in resource-poor settings,” Ayres said. “It’s also crucial for team cohesion—working together under stress reveals how our personalities and skills mesh.”
As the Navy continues to adapt to future conflicts, the integrated ERSS and ERCS course remains a cornerstone of readiness. The hands-on, high-fidelity training ensures Navy Medicine personnel are equipped to deliver life-saving care in the most challenging environments.
Ayres reflected on training’s impact and shared an enduring takeaway from the training.
I’m just reminded of the exceptional people in Navy Medicine,” Ayres said. “The system is sometimes challenging at times, I’m continually amazed by their dedication, hard work, and commitment to the mission of improving patient success.”
NEMWDC, located at Camp Pendleton, is a center of excellence for unit level training for medical capabilities, enhancing combat trauma skills and certifying expeditionary medical platforms for future operations.