With the JW GROM medics – on how parachute jumping to a wounded operator is only the beginning, and how medical assistance in the special forces is provided – talks Ewa Korsak.

During the NATO Exercise Vigorous Warrior in Romania, you jumped to help a wounded soldier. Why? Usually, even in battlefield conditions, the injured person is transported to a place where they can get medical assistance.

Bartek: In conventional armed forces it is justified. There is a whole system of medical assistance on a battlefield, including evacuation. A wounded person is taken to one medical station, and later, if needed, to another one. There are a lot of soldiers, it would be hard for medical personnel to directly reach everyone who needs help. It can’t be like that in the special forces. Operators execute tasks in small groups, far from the frontline, often in inaccessible places, such the mountains. We can’t send an ambulance to get them, and medical evacuation also is often impossible. That’s why we have to be ready to be there when they need us.

“Doktor”: I once heard a discussion between the experienced medics at the NATO Special Forces and Allied medical experts forum at SHAPE. One of them, a Canadian, said that doctors and paramedics are so valuable in the special forces that they can’t be put in danger and allowed to retrieve wounded operators. Another one, an Israeli, replied that a doctor’s blood is the same color as an operator’s blood. I agree with that. We’re there to help the task force operators in any situation, and not demand that they deliver a patient – their wounded friend – to us >>on a plate<<.”

But why a parachute? Wouldn’t it be enough to descend from a helicopter?

“Doktor”: It is a great option, but not necessarily when the situation on the ground is tense, the soldiers are in the middle of action. Not only does a helicopter make a lot of noise, which would definitely reveal the operators’ location, but it is also very dangerous to keep it hovering, since it becomes an easy target. A parachute is quiet. There is very little chance that the enemy will notice it. We fly onboard an aircraft, we jump out at the altitude of 4,000 meters, and we land even several kilometers away from where we actually jumped.

Is everyone on the GROM’s medical team a parachutist?

“Doktor”: Yes, but obviously not everyone has the same amount of experience. For some of us, the jump performed during Vigorous Warrior was the first one after a long break. There is a commemorative photo which was taken inside the CASA right before the jump, and you can clearly see the stress on some of the faces [laughs]. It is natural, of course, and it takes some training to adapt. But it wasn’t the first time the medical team was doing parachute jumps.

Bartek: We had jumped, for example, during an exercise in Africa.

“Doktor”: However, the task executed during Vigorous Warrior in Romania was the first one that we had to do without the support of an operator-medic. It is extremely important for us that when operators are engaged in combat action, we can provide help on our own.

What did the jump look like?

“Doktor”: Well, first we were given details on where the wounded soldier was, we even had pictures of the place. The jump itself was performed at the altitude of 4,000 m. I jumped first, others followed. The jump is nothing complicated, you just have to take a step forward [laughs]. The first difficulty was that we had to land in random, mountainous terrain. Another one was that we had only ourselves to rely on. Previously, we always had the support of an operator-medic, a task force member. Nonetheless, everything went well.

What did you find after you landed?

“Doktor”: We immediately found our wounded soldier. Normally, we would employ the search and rescue [SAR] procedures to identify the injured person, but they were omitted in this particular exercise by the decision of the organizer. We worked with actors, not mannequins, so we were informed about the injured person’s blood and pressure parameters, and so on, by a kind of narrator or episode supervisor. Obviously, the person who played the casualty, could not change their pulse, for example. That’s why we could react basing on information given by the supervisor. We started working, first implementing the TC3 [Tactical Combat Casualty Care] rule.

Did you have enough equipment on you to provide help? Is it possible when jumping with a parachute?

Bartek: Yes. We can take not only equipment, but also a... specialist. Once we practiced a situation where we took an anesthesiologist with us, a person who was neither a parachutist nor a GROM soldier. He jumped in tandem with one of us. We can also take an operating table, since it is quite small when folded. When we have it, we are able to organize a mobile surgical team. We can perform surgery onboard an aircraft or in a random room. Quick configuration of the equipment and we are ready to go.

“Doktor”: Our equipment is miniaturized. In Romania we jumped with a container including basic medical equipment. We additionally took a cardiac monitor, a defibrillator, a respirator, and an oxygen concentrator. They are small devices, not very heavy. We also had blood transfusion sets. And weapons...

Blood transfusion sets?

“Doktor”: Yes, our casualty had two bullet wounds. He lost a lot of blood. We had to transfuse it.

How do you do that in combat conditions?

Bartek: As fast as you can [laughs].

“Doktor”: According to Polish legal regulations, blood can only be transfused by a doctor, so we have such powers. The most important part of the transfusion set is the plastic bag into which blood is drawn from the donor, and the test that allows us to determine the blood group. Blood can be drawn from another soldier, from a paramedic. It takes no more than a couple of minutes. We can also take it with us. We have a special mini-fridge for transporting blood and a device for heating it before the transfusion.

Bartek: Then it has to be transfused to a wounded person. We perform an intraosseous blood transfusion – we drill a hole in the tibia, insert a special needle, and that’s it. The transfusion is pressure-aided – you simply squeeze the bag with the blood.

“Doktor”: We don’t transfuse blood intravenously, since the veins of someone who has lost a lot of blood are sunken and hard to enter. The intraosseous method is much faster.

What if you can’t find a donor with a matching blood group on the battlefield?

“Doktor”: We try to find out as much as we can before the surgery and prepare for it well. According to experts, the 0- blood should be transfused in battlefield conditions, since it is compatible with all other blood types, and this is the blood we take with us. When we know that the wounded person is one of our operators, we instantly have all the info on him. But we try equally hard when we are saving the life of someone from outside GROM...

Like a hostage?

“Doktor”: Yes. After all, it is the unit’s priority task. During a hostage rescue mission, if there was a wounded hostage and a wounded operator, we would first save the hostage’s life. Let me return to transfusing blood. If the hostage was a so-called VIP, we would know his blood type, allergies, and similar things before the mission. We really try to be prepared for anything.

It must be complicated to plan such an operation.

“Doktor”: During Vigorous Warrior, we had ten minutes between the moment we were given the task and the moment the CASA took off. In that time we were able to prepare a clear outline of our operation: landing in a particular place, medical help, and evacuation, from the most optimistic scenario where someone flies in to retrieve us, to the worst one, where there is no transport and we either have to wait for hours, maybe even days, or escape with the wounded person, carrying him on our backs.

Are you able to execute a combat task while providing medical assistance?

“Doktor”: Medical personnel must have basic combat skills, because when we are already on the ground, among operators, we become a part of the team. There might be a critical situation when we have to forget our specializations and become, to put it bluntly, barrels that can be used for combat. Our medical team has such combat experience. Before GROM, we served in units such as the 6th Airborne Brigade or the 25th Air Cavalry Brigade. We also have experience from the missions in Afghanistan or Iraq. As a doctor, I took part in special operations together with operators.

I get the impression that your medical, as well as combat, experience, is so vast that this small episode during the Vigorous Warrior exercise was hardly a challenge for you.

“Doktor”: The training didn’t teach us any new medical skills, but this one jump was extremely important. It showed us that the rule we had adopted – that we are the ones who have to get to the wounded person, not the other way around – is the best rule. And it does make a lot of sense, since everything went very well. I also hope we proved to the task force guys they can count on us, because we will get anywhere when they need us.

Bartek: has served at JW GROM since 2012, earlier served at the 25th Air Cavalry Brigade. His medical specialization is orthopedic-traumatic surgery. He took part in a mission in Iraq. Today, he is the deputy chief of JW GROM’s medical team.

“Doktor”: has served at JW GROM for 13 years. He graduated from the no longer existing Military Medical Academy in Łódź. During missions in Afghanistan, he used his skills to save lives of allied soldiers and others. At present, he is the head of JW GROM’s medical team.