This advanced Role 2 scenario begins at the moment of MEDEVAC interface and pushes learners through the full sequence of trauma reception, surgical intervention, and onward evacuation planning.

Upon helicopter arrival, learners must first coordinate the litter team movement—a four-person carry detail trained to safely transfer both patient and litter from the aircraft into the facility. This movement demands not only physical coordination but also environmental awareness, especially in low-visibility or high-tempo operational settings.

Once inside, learners receive a verbal MIST report from the flight paramedic. This handoff includes the casualty’s mechanism of injury, known injuries, vital signs, and interventions already performed in flight. Trainees must interpret this report quickly, assess the patient’s current condition, and escalate care as needed.

The primary clinical task is to perform an emergency fasciotomy—a limb-saving surgical intervention to relieve compartment pressure and restore perfusion in the case of crush injury or compartment syndrome. This procedure requires anatomical precision, surgical confidence, and a deep understanding of when fasciotomy is warranted under combat conditions.

Following the intervention, learners must continue to monitor the patient, manage complications, and coordinate evacuation to a Role 3 facility for definitive care. This step reinforces triage priorities, medical communication protocols, and the tactical implications of resource allocation.

For simulation educators, this scenario is ideal for integrating surgical decision-making, medevac logistics, and interprofessional coordination. It allows teams to practice receiving trauma patients at the highest acuity level, with hands-on procedural training embedded in a time-sensitive operational context.

It’s a clear test of team readiness, procedural capability, and the ability to manage a casualty through a critical phase of the evacuation chain.