Vigilant Guard exercise helps Puerto Rico troops prepare Published March 18, 2019 By Capt. Matt Murphy 156th Airlift Wing, Puerto Rico Air National Guard SAN JUAN, Puerto Rico – Air National Guard members from the 156th Medical Group recently treated simulated mass casualties during a training exercise called Vigilant Guard. United States Northern Command in conjunction with the National Guard Bureau sponsored the exercise. The program provides state National Guard headquarters and supporting units with an opportunity to improve command/control and operational relationships with civilian and military partners at the local, state, regional and national levels. The Air Guard team members are specifically unique to the exercise for their capabilities as part of the Chemical, Biological, Radiological and Nuclear (CBRN) Enhanced Response Force Package (CERFP). The 156th’s CERFP can deploy within six hours of notification using a phased deployment. They can integrate with first responder teams, augment, or operate independently. They are integral to the U.S. military domestic response, work hand-in-hand with Civil Support Teams and Homeland Response Forces. “I am a physician in my civilian life, and we are practicing this exercise like we are dealing with a real situation of mass casualties,” said Lt. Col. Sonia Ortiz Flores, a CERFP provider. “We are divided in a tent to provide critical care and minimum care. We try to provide the immediate care patients need. We treat them as real patients so we can be organized when a real event occurs.” Search and rescue teams of Airmen and Soldiers delivered patients to the CERFP medical team for evaluation and treatment. Actors with realistic injuries were categorized, treated and moved to other stations in the area of operations based on the type of care they need. “As we receive the patients, we perform intake and assessment,” said Capt. Juan Torres Roque, another 156th provider. “We have to set priorities. Are they bleeding, is their airway blocked, and understanding if they have an allergy.” Being a medical first responder or physician is more than just treating patients. Some CERFP members are looking out for their team. For more than 10 years, Master Sgt. Khrystie Vasquez, a public health technician, has watched over her fellow Bucaneros. “As the occupational health and safety monitor of the exercise, I’m watching the staff, validating proper procedures, and implementing the work/rest cycle for the team,” said Vasquez. “If we don’t take care of our people, we can’t help the others who really need it.” Vasquez is also responsible for water intake for the staff, making sure it is potable. If a foodborne illness arrives in the mix of activity, she tracks that as well to ensure it does not affect the staff. Thousands of participants from Puerto Rico and other states' National Guard units, the Army Reserves, Army North, FEMA and other federal and state agencies were all key players in the exercise. Vigilant Guard helps military units unify their efforts to support civilian authorities during emergency response in the event a disaster happens again in Puerto Rico.