Special Operation Forces medical Airmen train for combat Published April 9, 2025 By Airman 1st Class Raul Mercado Air Force Special Operations Command HURLBURT FIELD, Fla. -- In a dark room, the crackle of simulated gunfire and distant explosions filled the air as Airmen worked methodically to treat simulated wounds on mannequins. With only the glow of night-vision flashlights, they stabilized simulated casualties in a high-stress environment designed to replicate the chaos of combat. This scenario aims to prepare doctors, physician assistants and independent duty medical technicians, embedded within Special Operations units across the Air Force Special Operations Command enterprise, for potential challenges of providing medical care in austere, unpredictable environments. This training, conducted three times a year, is part of a Special Operations Forces Medical Skills Development program hosted at Hurlburt Field, Florida. “They stress you and push you past your comfort levels,” said an AFSOC physician assistant and course participant. “They want to help expose those weak points early on so we can work on them before going on real-world missions. It sets us up for success.” Resilience under fire: SOF Medical Airmen train for combat U.S. Airmen assigned to Air Force Special Operations Command perform an intubation using a GlideScope during a Special Operations Forces Medical Skills Development exercise at Hurlburt Field, Florida, Nov. 4, 2024. A GlideScope provides a clear view of the airway to insert an endotracheal tube for proper ventilation and maintaining an open airway. (U.S. Air Force photo by Airman 1st Class Raul Mercado) Photo Details / Download Hi-Res Resilience under fire: SOF Medical Airmen train for combat A U.S. Airman assigned to Air Force Special Operations Command administers simulated blood during a Tactical Combat Casualty Care exercise at Hurlburt Field, Florida, Oct. 9, 2024. This life-saving intervention is critical because it directly replaces lost blood volume to maintain vital organ function and potentially prevent shock by restoring oxygen delivery to the body. (U.S. Air Force photo by Airman 1st Class Raul Mercado) Photo Details / Download Hi-Res Resilience under fire: SOF Medical Airmen train for combat U.S. Airmen assigned to Air Force Special Operations Command stabilize a casualty and document patient care during a Tactical Field Care exercise at Hurlburt Field, Florida, Oct. 7, 2024. Accurate documentation of patient care is essential for tracking treatment, informing medical decisions and ensuring continuity of care as the patient progresses through different levels of medical support. (U.S. Air Force photo by Airman 1st Class Raul Mercado) Photo Details / Download Hi-Res Resilience under fire: SOF Medical Airmen train for combat U.S. Airmen assigned to Air Force Special Operations Command perform a surgical airway procedure on a simulated burn victim during the Special Operations Forces Medical Skills Development program at Hurlburt Field, Florida, Oct. 9, 2024. This critical, last-resort procedure supports the Air Force’s commitment to ensuring medical personnel are prepared to provide life-saving care in austere and high-stakes environments. (U.S. Air Force photo by Airman 1st Class Raul Mercado) Photo Details / Download Hi-Res The training unfolds over 33 class days, beginning with the basics: trauma assessment, Tier Four Tactical Combat Casualty Care and casualty evacuation. According to an AFSOC advanced medical training instructor, most participants come from clinical or hospital settings and the shift to chaotic field environments presents new challenges such as environmental factors, limited supplies, limited movement capabilities and limited communication capabilities. "We bring a wealth of experience to our training," said the instructor. "Much of it is drawn from real-world combat. Many of us have been deployed and carried out these procedures under actual operational conditions." After executing the basics, participants are then challenged to develop proficiency in advanced techniques like Prolonged Casualty Care, where medics must stabilize complex patients for over 24 hours while continuously adapting to evolving medical needs. Resilience under fire: SOF Medical Airmen train for combat U.S. Airmen assigned to Air Force Special Operations Command begin tactical field care on simulated casualties during a tactical combat casualty care exercise at Hurlburt Field, Florida, Oct. 9, 2024. TCCC was developed to reduce preventable deaths and improve survivability of combat trauma injuries. (U.S. Air Force photo by Airman 1st Class Raul Mercado) Photo Details / Download Hi-Res Resilience under fire: SOF Medical Airmen train for combat A U.S. Airman assigned to Air Force Special Operations Command inserts a nasogastric tube during a Special Operations Forces Medical Skills Development course at Hurlburt Field, Florida, Nov. 4, 2024. A nasogastric tube is used for hydration, feeding, relieving gastric distension and delivering medications to patients. (U.S. Air Force photo by Airman 1st Class Raul Mercado) Photo Details / Download Hi-Res Resilience under fire: SOF Medical Airmen train for combat U.S. Airmen assigned to Air Force Special Operations Command transport a simulated casualty patient during an exercise of the Special Operations Forces Medical Skills Development program at Hurlburt Field, Florida, Oct. 9, 2024. This process demonstrates the Air Force's focus on rapid and efficient casualty evacuation; it ensures wounded patients receive advanced medical care as quickly as possible in any operational environment. (U.S. Air Force photo by Airman 1st Class Raul Mercado) Photo Details / Download Hi-Res Resilience under fire: SOF Medical Airmen train for combat U.S. Airmen assigned to Air Force Special Operations Command transfer a simulated casualty patient during a Tactical Combat Casualty Care exercise at Hurlburt Field, Florida, Oct. 9, 2024. Tier Four TCCC is the highest advanced-level training and is designed for combat paramedics and medical providers. (U.S. Air Force photo by Airman 1st Class Raul Mercado) Photo Details / Download Hi-Res According to the physician assistant and participant, the PCC portion of the program includes the most challenging aspects of medical care such as using ventilators, a variety of medications and drip calculations all while having limited resources on hand or delay in resource support. “Ultimately, you have very sick patients that you try to keep alive until they can be evacuated out,” said the physician assistant. “This course is essential to our success when looking at future challenges we face.” Equipped with this intensive training and a deeper understanding of casualty care, the physician assistant expressed they came out better prepared to face the demanding realities of their role. “The medical team is a crucial piece within Special Operations. We may not be kicking down doors, but we are taking care of the people who are,” said the physician assistant. “This training will allow us to get through those high-pressure situations in a calmer, more prepared state.”