An Cosantóir

An Cosantóir May / June 2024 www.military.ie/magazine 28 | T he EU Military Assistance Mission in support of Ukraine (EUMAM-UA) was set up on 17 October 2022. Its objective is to strengthen the capacity of the Ukrainian Armed Forces to defend Ukraine's territorial integrity within its internationally recognised borders and to deter and respond to possible future military offensives by Russia and other potential aggressors. 24 EU Member States have offered training modules and personnel. The training is supported by the provision of equipment for military purposes to the Ukrainian Armed Forces. This equipment is provided by Member States and funded by the European Peace Facility. Since then, individual collective and specialist training has taken place in various locations around Europe. On 21 February, the Government approved the participation of up to 30 Defence Forces personnel at any given time in the EU Military Assistance Mission in support of Ukraine. Since then, the Defence Forces have engaged extensively with the EU's Military Planning and Conduct Capability (MPCC) in Brussels, which is the Operations Headquarters and where we have one (1) DF person deployed, with a view to identifying suitable opportunities for training to the Ukrainian Armed Forces (UAF), based on the training needs identified by the UAF. In June 2023 CMU personnel were tasked with providing medical training for UAF Personnel under EUMAM-UA. EUMAM works closely together with its EU partners providing military training support to the UAF. The Defence Forces has deployed a number of specialised Mobile Training Teams (MTT) such as Tactical Casualty Combat Care, De- mining and Clearance, and Drill Instructor to locations in Germany, Poland & Cyprus. The Tactical Combat Casualty Care MTT training is located in the 3rd Medical Regiment Barracks, Donrnstadt, Germany. The MTT training team consists of 6 personnel from CMU - 1 x Liaison Officer, 4 x TCCC Instructors and 1 x Interpreter. TCCC is a tiered system of care delivery, based on the different levels of training, namely: • All Service Members (ASM) (2 days) for all line personnel • Combat Lifesaver Course (CLS) (5 days) each section or equivalent size has one CLS person per section • Combat Medic (CM) (14 Days) for medical providers in Medical & SOF units • Combat Paramedic (CP) (21 days) for medical providers who perform in an advanced medical role to keep wounded soldiers alive. TCCC was designed to ensure increasing level and quality of care within the ''golden hour''. As the time frame of care delivery increases, the latest weaponry is utilised, and evacuation timelines deteriorate, TCCC training is ideal for this type of conflict once all levels can function with appropriate trained personnel. When compared to the Defence Forces Military First Responder Course (MFR), TCCC is treating Military Casualties in a military environment, while the MFR Course is focused on a civilian feeling unwell. For military service members who are wounded on the battlefield, the most critical phase is the period from point of wounding until the arrival at a Medical Treatment Facility (MTF), providing the casualty survives long enough to reach the care of a combat trauma surgeon. Survival depends on the level of medical treatment provided by line personnel at point of wounding and medical personnel with additional skills to carry out lifesaving interventions at different phases of care which are: • Care Under Fire • Tactical Field Care • Tactical Evacuation Care Limited interventions are carried out in Care Under Fire while the casualty and unit are under effective hostile fire. Suppression of hostile fire and moving the casualty to a safe position are major considerations at this point with the only medical intervention being to control major hemorrhage with the application of a tourniquet. Major lessons have been learnt by the Ukrainian Army on the use of tourniquets that were left on for a prolonged time which had a devasting effect on casualties. Tactical Field Care allows time to carry out an examination of the casualty using the MARCH acronym, this allows time to access the casualty for other injuries and carry out any basic medical interventions to increase the chances of survival. Tactical Evacuation Care is the unregulated movement of the casualty from point of wounding to a medical treatment facility. Movement can be stretcher carried out or placed in a non-medical vehicle. The level taught to Ukrainian soldiers is the Combat Lifer Saver module. Usually this is a 5-day course, but it was decided to conduct the course over 9 days due to the increased time required for translation of lectures and skills practice. Because of the nature of the student's immediate deployment on return to Ukraine, extra training for practicing skills and exercises was also allocated. There is an adage in tactical planning; 'Don't fight TACTICAL CASUALTY COMBAT CARE ARTICLE BY RSM DAVID O'CONNOR PHOTOS BY RSM DAVID O'CONNOR EUMAM-UA & IRISH DEFENCE FORCES M — Massive bleeding A — Airway R — Respirations C — Circulation H — Head/hypothermia P — Pain A — Antibiotics W — Wounds S — Splinting Soldiers treating a gunshot wound under DF medics supervision Ukrainian soldiers working as a team to treat the casualty

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