NMRTC Patuxent River and NAS Pax River ‘SAR Dogs’ Partner for Combat Casualty Readiness Exercise

What began as a quiet foot patrol along a tree-lined trail quickly shifted into tactical friction as simulated gunfire erupted, forcing Navy Medicine personnel to treat and evacuate casualties under simulated combat conditions. Only after securing and triaging each patient did ground personnel transmit 9-line requests to call in Search and Rescue (SAR) helicopters for tactical evacuation. The dynamic trauma lane scenario served as the cornerstone of the Annual Proficiency Expeditionary eXercise (APEX), testing joint medical readiness and Tactical Combat Casualty Care (TCCC) integration.

Hosted by Navy Medicine Readiness and Training Command (NMRTC) Patuxent River under the leadership of Capt. Ken Radford, the APEX brought together clinic personnel and the Naval Air Station Patuxent River Search and Rescue unit (SAR Dogs) in a close operational partnership. Designed to elevate joint combat readiness, the evolution required pausing routine patient care operations for the day across NMRTC Patuxent River and its outlying components—Navy Medicine Readiness and Training Unit (NMRTU) Dahlgren, NMRTC Detachment Indian Head, and NMRTC Detachment Joint Base Andrews. This rare operational posture enabled physicians, physician assistants, nurses, independent duty corpsmen, and hospital corpsmen to dedicate uninterrupted hours to practicing life-saving skills under realistic battlefield conditions. The coordination offered Military Treatment Facility (MTF) personnel vital, rarely experienced exposure to Tactical Evacuation Care (TACEVAC) protocols and live rotary-wing patient handoffs.

The exercise featured five training areas, with five participant groups rotating through four static skill stations and a dynamic trauma lane. Operating under simulated gunfire and armed cover from a security element, teams located and treated four distinct casualties: two mannequins with significant physical trauma, a live role-player with physical trauma, and another live role-player presenting with acute mental health needs. At the static stations, personnel practiced core Tier 3 TCCC skills, including cricothyroidotomies, intravenous and intraosseous vascular access, needle decompressions, and suturing.

“Designing APEX was about bridging advanced technical skill with the demands of a stressful tactical environment that mimics combat,” said Hospital Corpsman 1st Class Tyler Kelly, a Surface Force Independent Duty Corpsman who coordinated the static station curriculum and dynamic trauma lane scenarios. “We focused the static stations on advanced-level Tactical Combat Casualty Care skills, giving providers the opportunity to mentor teams through complex procedures. In the trauma lane, we demonstrate that these situations are chaotic and difficult; we are building their confidence to trust in their training even in a stressful situation. Just as importantly, we integrated an evacuation platform to address the often-overlooked transition from Tactical Field Care to Tactical Evacuation Care. The SAR team at Pax was critical in demonstrating how teams on the ground need to move patients safely and communicate effectively. By blending advanced instruction with tactical scenarios, we ensure our Sailors do not just know the medicine—they know how to execute it under fire and sustain that care through evacuation.”

Building on a smaller-scale joint event held with the SAR Dogs in March, NMRTC Patuxent River leadership connected with Lt. Noah Becker to expand and plan the much larger scope of the APEX. The initial collaboration kicked off months of detailed work to align exercise mechanics with real-world operational tactics. On the day of the exercise, Becker led the safety brief before directing execution on the ground and across the flight timeline, ensuring communications between medical triage elements and incoming aircraft mirrored tactical operational tempo. Ground crew transmitted standard 9-line MEDEVAC requests to call in aircraft support, prompting multiple dynamic helicopter landings throughout the day. Once on the ground, the aircrew deployed SAR Medical Technicians (SMTs) to assess patient packaging, take turnover from ground corpsmen, and prepare for tactical evacuation.

“The APEX event is the culmination of months of hard work and training for both the Station SAR unit and the Clinic staff,” said Cmdr. Deidre Coulson-Tucker, NAS Patuxent River Air Operations Officer and NAS Patuxent River Station SAR Officer in Charge. “This exercise allows for our SAR Medical Technicians to show the other clinic staff the breadth of their expertise and embodies the SAR motto ‘So Others May Live.’”

The success of APEX reflects a broader, deliberate strategy across the command to deliver and sustain a whole, ready Naval medical force. Operating under a dual-hatted structure, the command manages routine primary care and beneficiary health services as Naval Health Clinic Patuxent River under the Defense Health Agency, while simultaneously maintaining warfighter readiness, overseas suitability, and operational deployability as NMRTC Patuxent River under Navy Medicine. Because the vast majority of the command’s daily focus is dedicated to direct patient care as a Military Treatment Facility, high-yield training opportunities for expeditionary readiness cannot be left to chance. Instead, readiness training must be deliberately prepared, executed, and integrated into the command's operational schedule.

“The APEX combat casualty readiness event is our signature culminating training event,” said Capt. Ken Radford, commanding officer of NMRTC Patuxent River. “Our Pax River officers and corpsmen used skills we’ve developed over the prior year to perform TCCC in stressful combat-related scenarios to ensure they are a ready medical force to care for those in harm’s way. A training event on this scale is not possible without incredible planning and execution. HM1 Alcius and HM1 Kelly took ownership of this training event and it would not have been possible without their dedication and support.”

To bridge clinical care with combat readiness, Capt. Ken Radford directed early Wednesday afternoon clinic closures across all sites, establishing dedicated time for all-hands readiness training. Focused on Tier 3 TCCC skills, the initiative grew from a January pilot in Medical Homeport led by Cmdr. MaryPat Tobola. Hospital Corpsman 1st Class Erlande Alcius and the Staff Education and Training department helped guide instruction from the start, expanding "Warrior Wednesdays" command-wide in April to establish the steady operational rhythm that culminated in APEX.

“Stepping out of the clinic and into the field proved just how far our teams have come since we launched 'Warrior Wednesdays,'” said Hospital Corpsman 1st Class Erlande Alcius, leading petty officer for the Staff Education and Training department at NMRTC Patuxent River. “Building TCCC into our regular operational rhythm gave everyone a shared muscle memory. The APEX was the ultimate test of that baseline—showing that when stress and chaos are introduced, our providers and corpsmen fall back on their training without skipping a beat. None of this would have been possible without our incredible command instructors and preceptors, whose encouragement and instruction at the static stations helped ensure our personnel will be better prepared before stepping into the field.”

The APEX also served as a practical learning experience for future leaders. Observing the evolution were cadets from the Air Force Junior ROTC program at Chopticon High School, accompanied by their instructor, retired Master Sgt. Kim Hoh. Watching corpsmen and SAR aircrew navigate tactical movement, triage, and live-actor treatment offered the cadets a firsthand look at joint expeditionary medicine and military operational readiness in action. “It was a great experience seeing how medical personnel received hands-on trauma training they might not experience every day,” said Chopticon Air Force JROTC Cadet Capt. Peyton Moore. “For me, it encouraged me to continue down the medical path.”

The successful execution of the APEX was made possible through extensive coordination across Naval Air Station Patuxent River tenant commands and base installation partners. Command leadership expressed gratitude for key support from NAS Patuxent River Commanding Officer Capt. Robert Chandler, whose authorization ensured the necessary installation space and operational assets were available for the readiness evolution. Special appreciation was extended to the NAS Patuxent River Morale, Welfare, and Recreation staff, in particular Mr. Mardy Millen, for facilitating the use of the West Basin Marina for the entire event. Leadership also recognized the vital support provided by base partners, including the installation Security Department's Masters-at-Arms for supplying the rubber training rifles used throughout the tactical scenarios.

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