Ready to Go: First Reserve group completes Ground Surgical Team training course

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  • By Bo Joyner

When American service members are injured in combat, Ground Surgical Teams are there to provide life-saving medical care close to the action. Working out of tents, cargo trailers or in the back of a truck, the six-member teams are trained to quickly set up a mobile operating room and perform life-saving surgeries designed to stabilize patients until they can be transported to a more permanent medical facility.

Teamwork is critical for GSTs as well as continually practicing the skills they will use to save lives on the front lines of combat. Recently, the first team of Reserve Citizen Airmen completed both phases of the Air Force’s new 21-day GST training course.

GSTs are comprised of a trauma surgeon, an emergency medicine physician, a nurse anesthetist, an intensive care nurse, an operating room technician and a medical service corps officer or NCO. Each team packs 14 duffel bags with 1.5 tons of emergency medical equipment. With the full equipment allowance, a GST can perform up to 10 emergency surgeries. With a smaller set of six bags, the GST is much leaner but still able to perform emergency resuscitation and surgery on up to three critically injured service members.

“The GST was developed as the next-generation concept in Air Force forward surgical care,” said Lt. Col. (Dr.) Jesse Wells, the emergency medicine physician on the GST from the Air Force Reserve’s 349th Medical Squadron, Travis Air Force Base, California, that completed Ground Surgical Team training in August. “The GST was designed to produce an even smaller footprint and be able to operate in more austere environments. Along with the development of this new capability came the development of a new training pipeline.”

In addition to Wells, the 349th MDS Ground Surgical Team includes Lt. Col. (Dr.) Sean Martin, trauma surgeon; Maj. Jason Vallot, intensive care nurse; Capt. Llewy Rimular, nurse anesthetist; Lt. Col. Jessica Arcilla, medical services corps officer; and Tech. Sgt. MaryLou Ancheta, operating room technician.

The first two weeks of GST training, held at Wright-Patterson AFB, Ohio, include a combination of lectures and intensive simulation exercises.

“The mannequins used for this specialized training have a pressurized reservoir of simulated blood that allows instructors to create external and internal bleeding,” Wells said. “The mannequin’s abdominal wall has simulated skin, muscle and fat that surgeons can cut through to reveal anatomically correct internal organs. This challenges GST members to perform emergency surgery with the same techniques used on injured soldiers.”

After completing the first phase of training, GST members travel to Camp Bullis, Texas, for phase two – a week-long field exercise. GST members start the week integrating with the Air Force Expeditionary Medical Support course, providing surgical and critical care resuscitation capability. After the EMEDS students graduate, training accelerates for GST team members. The final three days of phase two consist of intense day and night training in austere field conditions.

“The training was amazing,” Martin said. “Throughout the course, we were repeatedly under time pressure to transport all of our equipment to shelters of opportunity, set up an operating room, treat simulated patients and then pack everything up and move to a new location.”

Col. Barbara Marchiando, the Air Combat Command GST consultant for the Medical Readiness Training Center at Camp Bullis, said she was impressed with the performance of the first Reserve Ground Surgical Team as they received the training.

“This team worked very well together,” she said. “As a team, they had a great attitude throughout the challenging week of training. The fact they all came from the same unit, coupled with two of the team members having extensive trauma and field medicine experience both in their civilian jobs and the deployed setting, helped them become a cohesive team in a very short amount of time.”

Wells said Air Force Reserve Command does not have any GST deployments planned at this time, but the team from Travis is ready to go and fully qualified for the mission. For more on Air Force Ground Surgical Teams, check out the video at

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