History of the 154th Medical Group

Back to business for Med-Det 1

154^th Wing Public Affairs – Hawaii Air National Guard | Story by Staff Sgt. Orlando Corpuz | Thursday, July 1, 2021

Medical specialists from the 154^th Medical Group Detachment 1, took their expertise on the road to participate in a California disaster response exercise April 16-18.

Held in Concord, Calif., primarily on the grounds of a U.S. Navy military installation, exercise Sentinel Response tested the skills of the medical team reacting to a simulated radiological explosion in which mass casualties were sustained.

The three-day exercise stress tested the coordination efforts between California State, Bay Area County, and National Guard elements responding to scenarios in which a wide array of responses was required. Exercise participants were required to respond to everything from hazmat containment, rescue operations, and medical triage and treatment.

For the 154^th Medical Group, Detachment 1, in a year where COVID-19 hampered or shut-down many of the training exercises it would have normally participated in, Sentinel Response represented a ‘getting-back-to-business’ of sorts to the mission sets and capabilities it had originally been designed for.

“From a training standpoint, the pandemic threw our normal training ops and routines for a loop,” said Lt. Col. James Faumuina, 154^th Medical Group Detachment 1 commander. “The pandemic didn’t allow for many of the didactics and field training events we would have normally been participating in a normal year. Add to that, many of our Airmen were involved with our state’s COVID-19 response efforts. So what you really had was a situation where it was challenging to train for our normal mission, and that’s what Sentinel Response gave us.”

The exercise was executed as parts of the nation were slowly easing back on some of the pandemic mitigation efforts that had become routine for many. Still, COVID-19 was on the minds of exercise planners and participants and strict pandemic guidelines were followed.

“Safety was first and foremost,” said Faumuina. “We’re not completely out of the pandemic shadow so many of those pandemic mitigation efforts were still followed. Many times our unit was in generally outdoor areas. And for those scenarios which required a little tighter physical response, masks were still the norm.”

The navy grounds which the exercise was conducted at, with its large areas and variety and number of structures allowed exercise planners to concoct challenging yet realistic scenarios. Vehicle collision rescue, hazmat threat reaction, confined space rescue, breach and stabilization, decontamination, and medical treatment were some of the challenges first responders faced.

Integration was a priority for the Hawaii Airmen as the exercise’s military presence involved counterparts from the California Air National Guard’s 144^th Medical Detachment 1 and a heavy dose of California Army National Guard soldiers.

“In large and complex dom-ops disaster response, you are going to have a multitude of personnel coming together from a multitude of organizations and jurisdictions and you’re going to have to merge that effort very quickly,” Faumuina said. “The military effort such our unit and our counterparts from the 144^th can come in and supplement that civilian response, either with a plus-up in effort or to contribute our capabilities that may not necessarily be available to incident command.”

According to Faumuina, integration or lackthere-of can make or break disaster response.

“That complexity is going to require an organized and coordinated effort,” Faumuina said. “You’ll see civilian incident command coordinating the efforts of county, state, and federal response outfits all coming together. Integration will be key, and I’m not just talking integration amongst the military element, we’re talking integration up and down the chain of response. That integration is not easy and that’s why exercises such as these are important.”

While the main body of Det 1 was training in California, an eight hour drive away, a team of Hawaii ANG medical experts were completing annual required certification and training in Nevada.

“This really was a comprehensive effort by our medical Airmen,” Faumuina said. “Many of our team members were able to stretch out those response muscles in the field, and a segment of our folks were able to finish didactics and retain their certifications.”

– 2021 Fall Pupukahi pp.11

Hawai‘i Airmen practice river rescue with Coast Guard, regional partners

154^th Wing Public Affairs – Hawai‘i Air National Guard | Story by Staff Sgt. Orlando Corpuz | Thursday, August 25, 2022

With its mountainous terrain and varying bodies of water, the Lake Tahoe topography proved more than a match at challenging the joint team as they hiked in elevation, braved white water rapids, and endured high speed boat maneuvers, all in the name of honing skills needed for medical treatment and rescue.

From June 7-9, Lake Tahoeʻs challenging landscape was the scene of joint training as Hawai‘i Air National Guard medical professionals converged with the U.S. Coast Guard – a first for the Hawai‘i medical Airmen – and FEMA partners to learn new skills, hone existing ones, and create lasting connections in training scenarios that would test professional skills as well as physical endurance.

“This training is important because it is an opportunity to collaborate with our FEMA Region IX partners from Nevada and California and to continuously train our skill sets to be operationally effective,” said Lt. Col. Ian Beltran, 154^th Medical Group Detachment 1 commander. “Also, our exercise planners coordinated training with the U.S. Coast Guard to crosstrain and to share expertise, this is truly an event of sharing and collaboration.”

A large geographic area, FEMA Region IX encompasses the states of Hawaii, Arizona, California, and Nevada and has a multitude of landscapes. As regional partners, should one state become overwhelmed and in need of help during times of disaster, partner states could lend assistance, essentially ʻbeefing upʻ response efforts.

A key to this interoperability is a clear understanding of the challenges that different regional environs can pose. While the three-day exercise had the Airmen split into two separate training tracks, both groups had ample opportunities to learn new skills and put them into play.

At Coast Guard Station Lake Tahoe, a morning Field Training Exercise (FTX) provided opportunities to practice and exchange knowledge on various trauma care skill sets. The FTX also saw Airmen and Coast Guardsmen hiking through the surrounding mountains, where exercise planners staged several medical rescue scenarios challenging the joint team to respond.

“The training on the Tahoe Rim Trail was particularly valuable I feel, as it was both realistic and challenging,” Beltran said. “The hike had the effect of physically taxing the rescuers while providing an element of unpredictability, which could be experienced in real-world rescues.”

On day two, the joint team took their skills to the waters of Lake Tahoe. With Coast Guardsmen taking the lead, the team worked through various water rescue situations and engaged in high speed boat maneuvers to execute rescues in an effort to bring simulated victims to shore where they could be treated and triaged.

“It was excellent to see the group integrating,” said Beltran. “This is only the beginning of our partnership with the Coast Guard, and hopefully, weʻll be able to develop this relationship further cause I feel it brings value to both groups.”

While Airmen toiled on Lake Tahoeʻs waters and shorelines, several miles away, another group of HIANG Airmen braved white water rapids on the Truckee River as they teamed up with counterparts from the California and Nevada Air National Guards for Swift Water Rescue training. The course focused on the fundamentals of survival in moving water, swift water swimming, shore, boat, and in-water rescue.

“When I joined the Hawai‘i Air National Guard, I never thought Iʻd be learning any sort of water rescue,” said Staff Sgt. Danielle jordan Demello, 154^th Medical Group medic. “It wasnʻt even on my radar when I joined, truthfully. We had the opportunity to take the course a couple of years ago, so this is a recertification class for me, and I’m happy to be doing this cause it’s a skill-set that you can easily see would be valuable back home.”

Though Hawai‘i medical Airmen primarily focus on land-borne operations, learning new skills was a vital theme of the three-day training exercise.

For Beltran, the training is part of a larger effort to enhance the medical unit’s capabilities.

“I foresee our operation will provide a full spectrum of medical response in support of not only domestic operations, but to also support the USAF ACE Concept with medical support during contingency operations.” Beltran said.

– 2022 Fall Pūpūkahi pp. 9

Hawai‘i Air National Guard Medical Professionals Excel at National FEMA Urban Search and Rescue Course

154th Wing, Hawai‘i Air National Guard | Story by Tech. Sgt. John Linzmeier | Sunday, July 7, 2024

Members of the 154th Medical Group Detachment 1 (DET1) successfully participated in the 2024 Federal Emergency Management Agency (FEMA) Urban Search and Rescue (USR) Medical Specialist Course, from June 1-7, held at the Livermore-Pleasanton Fire Training Center in Livermore, CA.

The annual course is hosted by California Task Force 4 in the East Bay area of Northern California and brings together some of the most experienced Urban Search and Rescue (USAR) professionals from around the nation to hold lectures and navigate through a plethora of hands-on training in a realistic field-training environment.

Lt. Col. Hiura, 154th Medical Group (MDG) DET1 mission commander, said that the course is a rare and privileged opportunity to train alongside USAR Task Forces from all over the nation, with the 24 Hawai‘i Air National Guard (HIANG) members joining in as the only military participants.

Its world-class instructor cadre includes physicians, rescue firefighters, paramedics and veterinarians who have deployed in response to the Oklahoma City bombing, Sri Lanka Tsunami, Haiti Earthquake, Hurricane Katrina, the Tsunami that struck Tōhoku in Japan, events of 9/11, the recent 2022 Surfside apartment collapse in Florida and many other disasters.

Students became proficient with patient packaging and extrication in confined spaces, ingress and egress of collapsed structures and medical management of crush injury. They also practiced emergency surgical airways, intubation, ventilator management and field amputations on real tissue samples.

This marked the third consecutive year of having DET1 members attending as students, having three enrolled, and its second year with DET1 members participating as instructors. Maj. Jason Habu, 154th MDG DET1 Search andExtractions Rescue Operations officer-in-charge and one of the two instructors from DET 1, emphasized how the course’s realism and intensity mirrored real-life disaster scenarios.

“The class was a physically intense experience where you’re crawling around in a live rubble pile extricating live patients,” said Habu. “Imagine exerting yourself trying to reach a patient, then having to treat and extricate them while being drilled by an medical doctor on how and why you are providing certain medical treatments.”

Further integrating into this year’s course, 19 other members from DET1 also attended to fulfill the needs of an on-scene Disaster Medical Assistance Team (DMAT). This mobilized unit provides pre-hospital treatment and rapidresponse medical care during public health and medical emergencies.

Master Sgt. Kyra Santos, a 154th MDG DET1 aerospace medical technician and DMAT participant, stated that standing up this capability was only possible because the men and women of DET1 bring a wide variety of medical and emergency response backgrounds from their civilian and military roles, ranging from administrative support and medics to nurses and physicians.

Portions of the course included a simulated mass casualty scenario, where attendees extricated and treated simulated patients using live actors and mannequins. These patients were then transported to the DET1 treatment team for triage, treatment, and stabilization.

The training utilized rubble piles made from live materials, adding an element of realism with the potential for shifting as simulated victims were egressed. This level of authenticity was so realistic that an actual USAR rescue team was on standby during the training to respond in case of a realworld collapse.

In addition to the realistic scenarios, the training schedule was designed to match the intensity of a real incident. Students and instructors alike put in 12–16-hour days, often starting at 7:30 a.m. and finishing close to midnight.

This grueling schedule culminated with a final 18-hour exercise, with a scenario that involved a simulated 8.4 earthquake that resulted in structure collapse with multiple casualties and survivors requiring extrication, medical management and transport.

“This course was challenging to our Hawai‘i Air National Guard (HIANG) members because, out of a class of 36, our three were the only military members,” said Habu. “The class is usually only open to USAR Task Force Team Members, which typically include firefighters and physicians. Our members stick out like sore thumbs, but their great attitudes and hard work made them successful. Because of these attributes, we have been invitedback to participate in this training as students and adjunct instructors, which is an honor for us.”

Currently, the State of Hawai‘i does not have an assigned FEMA USAR Task Force and DET 1 is helping to fill this void in the event of a disaster or catastrophic event that involves Search and Rescue operations. Detachment 1 is one of 17 Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNE) Enhanced Response Force Package medical units in the U.S. and the first to have five certified FEMA USAR Medical Specialists.

DET1’s mission is to deliver scalable responses to chemical, biological, radiological, nuclear, explosive, and disaster medical emergencies worldwide. Holding this training event alongside civilian emergency response counterparts significantly enhanced their capabilities and preparedness, as such collaboration is crucial because teamwork and coordination are expected in real-world crises.

Hiura said that DET1 has been fostering a strong relationship with the FEMA USAR Training Coordinator for more than seven years to ensure seamless integration and joint preparedness efforts.

“Attending these specific courses allows our members to learn the latest life-saving measures and guidelines from medical professionals who are the subject matter experts in this field,” said Hiura. “Many of these skills learned are perishable if not used or practiced. I believe our DET1 Airmen will be more prepared to make a difference in saving lives if Hawai‘i experiences a major disaster.”

– 2024 Spring Pūpūkahi pp. 20-21

Hawai‘i Guard, Philippine Armed Forces unite

By Tech. Sgt. John Linzmeier

154^th Wing, Hawai‘i Air National Guard

CAMP O’DONNELL, Philippines — Hawai‘i National Guard medical professionals completed their fourth annual Tactical Combat Casualty Care (TCCC) exchange with partners from the Armed Forces of the Philippines (AFP) at Camp O’Donnell May 18-30.

The Subject Matter Expert Exchange (SMEE), facilitated by the Department of Defense National Guard Bureau State Partnership Program, helped 85 medical and non-medical personnel develop critical life-saving skills.

For the first time, an AFP instructor corps was qualified through the training to teach follow-up courses, a significant step toward developing a standardized medical training curriculum aligned with U.S. standards.

The training was tailored to support AFP participants at the Peacekeeping Operations Center, which is responsible for preparing personnel for United Nations peacekeeping missions, with a focus on stabilizing volatile regions through the use of military strength.

“This initiative has been greatly enriched by the collaboration between the Peacekeeping Operations School, the Peacekeeping Operations Center and Subject-Matter Experts from the Hawai‘i National Guard through the Joint United States Military Assistance Group-Philippines,” said Philippine Army Maj. Gen. Pedro C. Balisi Jr., Armor Pambato Division commander. “Their invaluable insights and shared commitment to advancing combat casualty care have deepened the training experience, fostering an exchange of best practices that will elevate our operational capabilities to new heights.”

The two-week SMEE was divided into two five-day programs. From May 18-22, Hawai‘i National Guard staff trained 36 AFP nurses and training managers as TCCC instructors, equipping them to deliver future courses. The 20-module curriculum covered topics such as hemorrhage control, airway and breathing management, shock recognition, hypothermia prevention, eye injuries, fractures, burns and wound treatment. Training included lectures, hands-on practice and videos, culminating in a mass casualty field exercise on the fifth day to validate instructor readiness.

From May 26-30, the newly certified AFP instructors taught 49 members of the AFP’s Quick Reaction Force (QRF), including Army Rangers, infantry, artillery and combat engineers, with Hawai‘i National Guard medics evaluating their performance. The QRF acquired critical combat life support skills, ensuring readiness for potential deployments in peacekeeping and combat operations. The week ended with another mass casualty exercise, testing participants’ ability to practice their skills in realistic combat scenarios.

Each week’s field training exercise FTX replicated combat zone stresses, with participants assigned roles as patients, medics, security teams or litter teams navigating complex terrain.

The multinational instructor team incorporated intense simulated stressors, such as explosive charges and patients inflicted with photo-realistic injuries while under attack from a hostile ambush, giving the students a sense of multidirectional chaos. This immersive approach rigorously tested TCCC skills, honing trainees’ ability to deliver rapid, life-saving responses under the heat of a contested battle space.

“One of the most critical lessons TCCC imparts is conditioning medics to keep treating patients under extreme pressure,” said U.S. Air Force Maj. Sanders Sandoval, 154^th Medical Group Detachment 1 TCCC officer-in-charge. “Amid the chaos of gunshots, IEDs [improvised explosive devices] and intense yelling, we saw high performers staying focused, treating patient after patient. In combat, you get one shot to save a life, and that’s the standard we train for — operators who never freeze, who seize every moment to save as many lives as possible.”

TCCC, a cornerstone of military medical training, emphasizes combat life support techniques to address life-threatening injuries before patients are relocated to a hospital. It covers care under fire, tactical field care and tactical evacuation care, enabling medics and non-medical personnel, such as infantry and combat engineers, to significantly reduce fatalities in conflict zones.

This milestone event highlighted the Hawai‘i National Guard’s dedication to mutual learning and interoperability with the Armed Forces of the Philippines, equipping participants with essential combat life support skills for both combat and peacekeeping missions.

“Marking 25 years of the Hawai‘i-Philippines State Partnership,” Sandoval said, “we are committed to fostering a sustainable model for medical training and evacuation capabilities. Through shared goals, our leaders and warfighters strive to grow together, aspiring to integrate advanced TCCC techniques into standard operating procedures to prepare for future challenges.”

By certifying AFP instructors and training the Quick Reaction Force, this TCCC Subject Matter Expert Exchange strengthened the partnership, fostering trust and advancing a shared vision of readiness for United Nations peacekeeping and regional security, ensuring both forces are prepared to save lives in high-pressure environments.

– 2025 Pūpūkahi | Volume 55 | No. 3 pp. 18-19