FORT CAMPBELL, Ky. -- Fake blood spewed, smoke billowed, strobe lights flashed, and two high-tech dummies with limbs blown off lay on the ground.
"Medic, somebody call a medic!" a woman shrieked as the sound of gunfire erupted from the shadows.
In rushed an out-of-breath Private First Class Merinda Karn with aid bag in hand for a test of her medic skills.
As the insurgents in Iraq step up their attacks, the Army has increased the intensity of its training of battlefield medics. That has meant moving the training from classrooms to more realistic settings and teaching medics to keep fighting the enemy -- even if it means sometimes delaying treatment of the wounded.
"One medic on his weapon returning fire can make the difference between the enemy staying and continuing to fire on us, or saying 'Whoa, I got to go,' " said Captain Brad Tibbetts, the officer in charge of the Alfred V. Rascon School of Combat Medicine at Fort Campbell. "That's one thing we teach them -- when to delay and when you can't."
This year, about 500 medics and others who work in small, isolated units will undergo training at the school. They attend the class partly to refresh skills they acquired during a 16-week course at Fort Sam Houston in Texas, where all new Army medics take civilian emergency medical technician classes and study battlefield techniques.
Much of the training at the Fort Campbell school is conducted using strikingly lifelike dummies controlled by computers. The dummies "bleed," breathe, blink, and have a pulse.
Nearly 90 percent of Americans wounded in Iraq are surviving, compared with 73 percent in Vietnam and 78 percent in the 1991 Persian Gulf War. Colonel Richard Agee, chief of staff of the US Army Medical Department and School, credited better body armor and better training of medical personnel.
Master Sergeant Luis Rodriguez, the noncommissioned officer in charge of the training at the school, is a former medic who was hit by mortar fire in Iraq. He lost a leg, but the use of a tourniquet helped save his life. He said the first thing he tells the medics is that the enemy will fire at them even if they are rendering aid, and they must be prepared to fight.
"The most important piece of equipment isn't your aid bag, it's your rifle," Rodriguez said. "We have to be aggressive, compassionate at the same time. But you have to bring the evil to the enemy."
Fort Campbell started holding the final test for the class in a dark room after 101st Airborne Division medics returning from Afghanistan said they had not been prepared to treat the wounded without light.
The 20-year-old Karn, who weighs about 140 pounds, was out of breath when she began the test because she had dragged a 185-pound soldier about 200 yards before dashing into the room.
She flunked the test because in the dark she failed to feel an exit wound in the back of her "casualty," and it "died."
Afterward, the lights came on in the room and taps played. An instructor discussed what she did wrong.
"I just wasn't as thorough as I should've been," Karn said, before leaving the room to write a letter to the "casualty's" parents, also part of the medic training.
Tibbetts said it is OK to make mistakes here.
"I guarantee she probably won't miss it again," he said. "If they learn it here, that's a good thing."