124th FRSD — Proctor Console

PRE-ARR

124th FRSD — Simulation Role Cards

Role 1

Forward Surgeon

Lead surgical decision-making — DCS vs definitive repair
Perform damage control laparotomy / thoracotomy as indicated
Direct team priorities and surgical sequencing
Communicate with anesthesia re: hemodynamic limits
Call time-out, verify allergies, laterality, blood type
Authorize massive transfusion protocol (MTP)
Document operative findings; brief post-op handoff

Role 2

Anesthesia Provider (CRNA / MDA)

Secure airway — RSI, video laryngoscopy, surgical airway if needed
Manage hemodynamics: vasopressors, permissive hypotension target
Titrate anesthesia — ketamine-based TIVA preferred in austere setting
Coordinate blood product administration with surgeon
Monitor temp, coags, ABG — prevent lethal triad
Call anesthesia time-out before induction
Brief ICU team on anesthetic and hemodynamic course

Role 3

OR Circulator (RN / 68W)

Open sterile supplies and maintain sterile field integrity
Administer medications as ordered; document all drugs/doses/times
Activate MTP — coordinate blood bank communications
Perform instrument, sponge, and sharps counts
Communicate with NCOIC for logistical needs
Record operative events and patient status changes
Prepare post-op orders and handoff documentation

Role 4

OR Scrub Technician

Set up and maintain sterile field
Pass instruments anticipating surgical steps
Manage suture and implant preparation
Perform instrument and sponge counts with circulator
Maintain irrigation and suction systems
Alert surgeon to any sterile field breaks

Role 5

DCR Team Lead / Flight Medic

Receive casualty — TCCC handoff, MIST report
Hemorrhage control: TQ conversion, wound packing, junctional devices
Establish IV/IO access; initiate blood products per MTP
Secondary survey: expose and assess head-to-toe
iSTAT / point-of-care labs: BMP, ABG, lactate
Warm patient: bear hugger, warmed fluids
Prepare patient for OR handoff; accompany to table

Role 6

ICU / Post-Op Nurse

Receive post-op handoff from OR team
Execute post-op orders: fluids, vasopressors, vent settings
Continuous monitoring: SpO2, ETCO2, MAP, UOP, temp
Reassess neuro status and wound/drain output hourly
Coordinate lab draws and imaging interpretation
Identify and escalate signs of post-op deterioration
Maintain MEDEVAC paperwork and patient tracking

Role 7

NCOIC / Team Sergeant

Patient tracking: assign patient numbers, maintain log
MEDEVAC coordination: 9-line, LZ setup, timing
Blood bank and supply logistics
Communications: higher HQ, receiving facility, air assets
Triage support during MASCAL events
Enforce infection control and OR cleanliness standards
After-action documentation and lessons-learned capture

Role 8

Triage Officer

Perform START / SALT triage on all incoming casualties
Assign T1/T2/T3/T4 categories; reassess every 5 minutes
Direct patient flow to treatment areas
Coordinate with surgeon on OR priority sequencing
Maintain MASCAL board accuracy
Escalate category changes to NCOIC immediately