BANGOR, Maine – Airmen from the Maine National Guard’s 101st Air Refueling Wing Medical Group recently sharpened their tactical combat casualty care, or TCCC, skills during an extensive hands-on training with local emergency medical professionals.

The training focused on advancing fundamental TCCC skills to a mastery level, incorporating high-stress and sensory-deprivation techniques to better prepare MAINEiacs for downrange missions, where modern threats like drones can turn any location into a frontline battlespace in a flash.

Dr. Jonnathan Busko, an emergency physician at St. Joseph Healthcare and EMS physician with the Kennebec County MD3 physician field response team, led the course alongside a team of physicians and experienced paramedics from the civilian sector.

“Today, we’re taking the fundamental skills of TCCC and practicing them to mastery, and going beyond by adding high stress sensory deprivation techniques,” Busko said.

Many service members have limited opportunities to practice these critical skills to this level. Busko highlighted research showing that without routine use, proficiency in TCCC interventions fades significantly within a year – a reality this course can help mitigate.

“Being able to perform the immediate lifesaving interventions is critical,” Busko added.

The course builds on prior TCCC training, emphasizing repetitive practice of MARCH, which stands for Massive hemorrhage, Airway, Respiration, Circulation, Hypothermia, standards and protocols. Participants used realistic low-fidelity simulations and pig tissue models such as larynxes, tracheas and lungs for practical hands-on airway and hemorrhage control practice because they closely mimic human anatomy.

They also performed Extended Focused Assessment with Sonography for Trauma, or eFAST; soft-tissue assessment with point-of-care ultrasound, or POCUS; and ultrasound-guided peripheral IV access. These ultrasound skills are valuable extensions of core TCCC training, especially for MAINEiacs who may deploy to austere or contested environments during a contingency. They provide rapid, portable diagnostic and procedural capabilities when traditional imaging or resources aren’t available.

Mastery requires dedicated repetition and practice regardless of prior medical experience, Busko said.

“No matter what your medical background, these particular learning areas are ones that members have to practice and practice and practice until they’re second nature. Once you’ve perfected and are good at this skill, it doesn’t matter whether you’re a tech or you’re a mechanic in your civilian job. If you’ve mastered these skills, you’re the one that’s gonna save the life,” Busko said.

Instructors emphasized their passion for the dynamic partnership.

“We love to teach,” Busko said. “As a friend of mine said, ‘I will teach anyone, anywhere, anytime how to save a life.’”

“I really enjoy working with the Air Guard. It is a great group of very excited students, and people for whom this has the potential to be real at any time,” Busko said.

Col. Howard Jones, 101st Air Refueling Wing Medical Group commander, highlighted the real-world importance of the training.

“We have discovered during contingencies that our medics have been leaving their civilian sector jobs to perform in conditions they’re not used to,” Jones said. “Working with community EMS providers, this course serves to leverage the knowledge of wilderness providers and better prepare our medical forces for service. They practiced the skills that they are going to be expected to execute with the equipment needed and left the course better trained and fully equipped to perform lifesaving care, whether it was in a remote environment in a conflict or in an environment more like what we are accustomed to operating in.”

Participants departed with equipment and a structured 12-month training cycle plan to maintain proficiency in these perishable skills.

Busko stressed the need for continued leadership support.

“It’s really important for anyone, no matter what their specialty is ... that there be a concentrated effort by their leadership to get them the practice, training that they need, because these skills can fade,” Busko said.

This collaboration between the 101st Medical Group and civilian medical professionals strengthens community partnerships while ensuring Airmen are equipped with the advanced, perishable skills needed to deliver life-saving care and enhance mission success in any environment.