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Hawaii guardsmen validate life-saving skills in NGB exercise evaluation

Search and extraction Airman and Soldiers from Hawaii’s Chemical, Biological, Radiological, Nuclear, and High-Yield Explosive, Enhanced-Response-Force-Package Team (CERFP) conduct a briefing during an evaluation exercise March 9, 2019, at Kalaeloa, Hawaii.

Search and extraction Airman and Soldiers from Hawaii’s Chemical, Biological, Radiological, Nuclear, and High-Yield Explosive, Enhanced-Response-Force-Package Team (CERFP) conduct a briefing during an evaluation exercise March 9, 2019, at Kalaeloa, Hawaii. The joint team’s primary duty is to search for patients, provide lifesaving interventions, and transport them to all-hazards-triage-response team members. Search and extraction members are trained to operate in confined space, high/low angle rescue, breaching/breaking operations, and shoring operations. (U.S. Air National Guard photo by Senior Airman John Linzmeier)

Capt. Maria Erc Guisadio-Abis, 154th Medical Group’s Detachment 1 Operations Team chief, transmits mission-essential information zone during an evaluation exercise March 9, 2019, at Kalaeloa, Hawaii.

Capt. Maria Erc Guisadio-Abis, 154th Medical Group’s Detachment 1 Operations Team chief, transmits mission-essential information zone during an evaluation exercise March 9, 2019, at Kalaeloa, Hawaii. The Operations Team's primary mission is provide Operational support and Command and Control. (U.S. Air National Guard photo by Senior Airman John Linzmeier)

Hot-zone team members from Hawaii’s Chemical, Biological, Radiological, Nuclear, and High-Yield Explosive, Enhanced-Response-Force-Package Team (CERFP) process simulated casualties through a non-ambulatory decontamination zone during an evaluation exercise March 9, 2019, at Kalaeloa, Hawaii.

Hot-zone team members from Hawaii’s Chemical, Biological, Radiological, Nuclear, and High-Yield Explosive, Enhanced-Response-Force-Package Team (CERFP) process simulated casualties through a non-ambulatory decontamination zone during an evaluation exercise March 9, 2019, at Kalaeloa, Hawaii. Upon completion of the training, members of the National Guard Bureau Joint Interagency Training and Education Center presented the validation to the Hawaii National Guard Adjutant General. (U.S. Air National Guard photo by Senior Airman John Linzmeier)

Members of the 154th Medical Group’s Detachment 1 treatment team, Maj. Tim Hiura, Lt. Col. Nathanial Duff and Capt. Ernette Visitacion, provide lifesaving interventions during an evaluation exercise March 9, 2019, at Kalaeloa, Hawaii.

Members of the 154th Medical Group’s Detachment 1 treatment team, Maj. Tim Hiura, Lt. Col. Nathanial Duff and Capt. Ernette Visitacion, provide lifesaving interventions during an evaluation exercise March 9, 2019, at Kalaeloa, Hawaii. The treatment team's primary mission is to stabilize casualties by providing immediate lifesaving interventions in preparation for transport to the appropriate next level of medical care. Casualties passed through a decontamination zone prior to being treated and were prepped to receive higher-medical care. (U.S. Air National Guard photo by Senior Airman John Linzmeier)

Staff Sgt. James Almero, 154th Medical Group Det. 1 all-hazards-triage-response team member, receives assistance in donning personal protective equipment prior to his rotation into the ‘Hot Zone’ March 9, 2019, at Kalaeloa, Hawaii.

Staff Sgt. James Almero, 154th Medical Group Det. 1 all-hazards-triage-response team member, receives assistance in donning personal protective equipment prior to his rotation into the ‘Hot Zone’ March 9, 2019, at Kalaeloa, Hawaii. The AHTR team's primary mission is to provide patient triage as well as lifesaving interventions for patients prior to going through decontamination. Members enter contaminated areas, also known as ‘hot zones,’ in back-to-back rotations. (Air National Guard photo by Senior Airman John Linzmeier)

KALEALOA, Hawaii --

More than 120 Airmen and Soldiers from the Hawaii National Guard applied their life-saving skills during a mass-casualty, evaluation exercise March 9, at Kalaeloa. 

The training entailed a series of chemical, biological, radiological, nuclear, and high-yield explosive scenarios under the observance of federal evaluators, who validates the response mission every three years. Upon completion, members of the National Guard Bureau Joint Interagency Training and Education Center presented the validation to the Hawaii National Guard Adjutant General, Maj Gen. Arthur Logan. 

In the event of a domestic crisis, the joint forces can be activated and combined at a moment’s notice to support civilian authorities as an enhanced-response-force-package team, also known as CERFP. 

According to, Lt. Col. James Faumuina, 154th Medical Group’s Detachment 1 commander, teamwork is paramount in every step of the way. 

“My focus is all about establishing the team concept before anything else,” said Faumuina. “In CERFP, we have doctors, nurses, EMTs, pharmacists, rescue/triage operators and [logistics specialists]. But all those titles go away when we respond, because we have to work together absolutely seamlessly. We don’t necessarily see ourselves as units or ranks – we are first and forefront a team.”

As part of the exercise, the CERFP first responders were alerted of a staged nuclear scenario before daybreak, followed by a rapid mobilization to the incident scene. Soldiers and Airmen donned hazmat suites to monitor contaminated areas while a near-hundred others set up their work stations. Within the hour, the flat and empty training grounds transformed into a bustling recovery center. 

Members of the Hawaii Air National Guard primarily focused on CBRNE and rescue medicine, expeditionary communications and mass field mortuary operations, while their soldier counterparts largely provided search-and-extraction and decontamination support. 

Exercise planners carefully designed the training to be as lifelike as possible to gauge how adequate and appropriate operators responded. At the far end of the decontamination zone, a crowd of voices could be heard screaming in agonizing pain. Volunteers with simulated injuries, such as graphic skin burns and missing limbs, were scattered throughout the contaminated area and crying for help.

An All-Hazards-Triage-Response team was dispatched, protected by gas masks and hazmat suits, to measure the initial impact. The niche of the HTR teams is to conduct mass-casualty triage in all domains of CBRNE, each operator is trained to the civilian certification of hazmat operator. The HTR specialists face the unique challenge of quickly assessing the medical status of each injured victim in order to maximize care with CERFP’s finite resources. 

“The amount of trauma and unknowns can be overwhelming when you arrive on scene,” said Capt. Jeremy Wong, Det. 1 HTR Team chief. “People are dealing with a lot of pain. They can be missing their babies, their limbs or their lives can be in danger. So we have to practice under all these variables. When it happens for real, the emotions are going to be even higher. We have to overcome these heavy emotions, so we can focus on the medical and get them to where they need to be safely.”

Waves of triaged victims were processed through a decontamination zone at non-stop rate, to include a flow of patients who needed to be carried in. Patients were treated for their individual injuries by a trauma and treatment team, comprised of doctors, nurses and physicians in a mobile-emergency room. 

As front line operators are exposed to high-risk environments, their vitals were continuously being monitored by a Medical Countermeasures team. The team is comprised of bioenvironmental engineers, a task force surgeon and a clinical nurse. Together, they ensure personnel are able to maximize their relief efforts while avoiding internal risks associated with an exposure to CBRNE. 

According to Faumuina, training is the lifeblood for members of CERFP. In comparison to most drill status Airmen, who maintain full-time jobs outside of the military, members of Detachment 1 spend an average of one month of additional on-the-job training on top of their annual training. Another added aspect is the high number of drill status airmen who work in their civilian employment as either first responders or emergency rooms.

Hawaii’s CERFP operates within the Federal Emergency Management Agency’s Region 9, referred to as the RIX, and is partnered with other guard units in California and Nevada. Their area of responsibility includes Guam, America Samoa, Hawaii, Arizona, Nevada and California. 

Members of RIX are constantly intertwined with one another’s training in order to learn from one another and discover how to best operate together. This was the case for Capt. Chance Pasley, 144th Fighter Wing medical plans officer from California Air National Guard, who observed the evaluation exercise. 

“This is a great opportunity to come out, observe, and apply what I’ve learned to my own unit in California, so we can share the best practices and continue to evolve,” said Pasley. “We also had team from Hawaii come out and see how we were activated during the 2019 California fire activation. They could see exactly what we were doing on ground and how we were incorporated with the civilian response.”

Over the past year, Hawaii’s CERFP supported civilian agencies in a number of real-word hazards. The unit mobilized and reacted to mudslides, floods and hurricanes. During the Big Island’s volcanic outbreak, 75 percent were directly tasked to support operations with more than half of its members deployed in rotations that lasted four months. Faumuina said every response involved extensive amounts teamwork and coordination between the joint services and civilian responders. In contrast to most military units, CERFP relies on its close ties in with civilian community in order to serve the local populace.

“Det. 1 Hawaii is poised in the middle of the pacific, where we train to respond quickly with a team made up of professional responders. “Some of our Airmen are already in the local fire department, police and EMS departments,” said Faumuina. “It makes it easy to just sync right in. So there’s a credibility that we worry less about catching up to the civilian standards, because we come trained, equipped and interoperable with our civilian response partners. We have a small, close knit community in Hawaii, but at the same time, it’s also like we’re one big, extended family always find ways to provide kokua.”