To get the feel of real trauma, troops practice on pigs

Los Angeles Times

VALLEY CENTER, Calif. — Two enlisted Marines were kneeling on the ground, quickly stuffing gauze into a gaping wound in a pig’s belly to stop the bleeding. Another was doing a “blood sweep” to find other wounds.

An officer, just inches from the snout, was monitoring the pig’s breathing and keeping its thick tongue from blocking the airway. At the other end of the 150-pound swine, a Marine corporal had inserted a thermometer into the animal’s anus.

“Come on, buddy, stay with us,” Capt. Doug Verblaauw whispered to the heavily sedated pig, dubbed Gen. Dude.

Gen. Dude would not survive the day. Nor would the 19 other pigs used in last week’s “live-tissue” training for 28 Marines and a dozen Navy doctors. The carcasses later were sent to a rendering plant.

But the Marines had the experience of pushing intestines back into living bodies, applying tourniquets and heat packs to gushing wounds, clearing tongues and other obstructions from airways and working under pressure when time is blood and indecision is death.

Camp Pendleton has used pigs in the training of Navy corpsmen and infantry Marines since 2006. But the training takes on new significance as the U.S. focus shifts from Iraq to Afghanistan.

In Iraq, U.S. forces have a highly developed system of transporting casualties from the battlefield to medical stations by vehicle or helicopter. In Afghanistan, the distances are vast, roads are minimal and helicopters often are not readily available.

The result is that more frontline troops need to be trained to treat traumatic wounds.

Under a $1 million contract with Deployment Medicine International, based in Gig Harbor, Wash., 1,300 Marines and sailors at Camp Pendleton will receive trauma training this fiscal year, some of it using pigs.

The company, whose instructors are combat veterans, has annual contracts worth between $6.5 million and $10 million and uses about 2,900 pigs a year.

The use of the pigs is strongly opposed by animal-rights groups. Nine members of Congress sent a letter to the Army in June asking that the program be stopped.

But military leaders say the pigs provide an invaluable conclusion to a program that also uses classroom lectures, mannequins and computerized simulators.

“You can’t quantify it, but we firmly believe that this training saves lives,” said Navy Cmdr. Bryan Schumacher, a surgeon for the 1st Marine Division.

Working on a living creature has an emotional effect. “You just don’t have that visceral feeling when you’re dealing with a simulator,” Schumacher said.

Marines are told to regard the pigs as wounded comrades. They are encouraged to give their pig a name.

The pigs are 2 to 3 months old and range from 140 to 200 pounds. Stretched out, they can reach 5 feet from snout to hoof. Each costs about $1,000.

Before the training begins, the pigs are sedated. Veterinary technicians monitor the pigs to make sure they remain asleep.

Using scalpels, instructors inflict increasingly serious wounds on the pigs and watch as the Marines scramble to keep their pigs from dying. In the final exercise, the pigs are shot in ways that approximate injuries a Marine might suffer, with some of the shots severing limbs.

The part of the trauma course using pigs occurs after three days of lectures and simulations at the base. It used to be held at a police training facility in Escondido, but it was moved to avoid controversy.

Now it’s on a farm in San Diego County owned by a retired Marine who is an Escondido police officer. “I’m not a public entity, I don’t care about political pressure,” said Dave Bishop, the owner. “They can protest outside my gate all they want.”

To view the training exercise, members of the media had to agree not to photograph the pigs or use instructors’ full names. The lead instructor, known as Kato, is a veteran of combat in Vietnam, Iraq and Afghanistan.

For three days, he drilled the Marines with Kato’s Rules, starting with rule No. 1: The main cause of death on the battlefield is massive bleeding, and many of those deaths are preventable with quick response. Another rule: If one tourniquet is good, two is better. And yet another: Constantly reassess your patient, check his breathing, never give up.

“A lot of these guys have never really seen blood and could freeze up the first time they do,” said corpsman Mark Litz said. “What good is a Marine or corpsman who’s frozen up in combat?”