DRAWSKO POMORSKIE TRAINING AREA, Poland — Several explosions kicked up dirt and sand as spectators looked on from an old bunker on a hill above a military range.

In the distance, figures immediately started moving, running or carrying injured soldiers to a green mound on the open, dusty range.

This mass-casualty exercise was hosted by the 30th Medical Brigade, U.S. Army Europe, based in Sembach, Germany, and supported by soldiers from 1st Armored Brigade Combat Team, 3rd Infantry Division, as well as from Albania, Sweden and Poland.

Soldiers from 1st ABCT are participating in Anakonda 16, a Polish-led exercise that has brought militaries from more than 20 nations to train together in multiple exercises across the country.

The mass-casualty exercise Saturday was meant to use every person and vehicle that the participating medical teams possessed and coordinate care between the soldiers from different nations.

On the range where the exercise took place, soldiers and medics dealt with a simulated mortar attack that injured more than 50 soldiers. Earlier that day, the volunteers were given prosthetic wounds and injuries, called moulage.

Joanna Parvin with Trauma FX of North Yorkshire, England, helped apply the graphic-looking injuries, including burns, impalements and deep cuts.

“It just adds to the realism and gets the medic to think that it’s actually real so they believe it more,” she said about the moulage’s importance to the exercise.

The exercise also had volunteers who were actual amputees, making their simulated injuries more realistic for the medics who would work on them.

After the simulated attack, soldiers ran to aid casualties, yelling for more litters (stretchers) and medics assessed the wounded to determine the most urgent. Several wheeled and tracked vehicles and helicopters were called in to assist with the recovery, including a Polish Mi-17, which is a designated medical-evacuation helicopter that can take up to six litters and one ambulatory patient.

Back at the Charlie Company, 3rd Brigade Support Battalion, 1st ABCT aid station, casualties were coming in on litters one by one, averaging 15 minutes each from when they entered the tent, were seen and treated by a provider in the tent, and then out the door to be taken to another medevac vehicle, according to Capt. Lee Anne Cosper, Charlie Company commander.

It took between three and four hours from the first patient to the last to arrive at the aid station, she said.

Cosper said the treatment was what she expected and that everyone from the medical providers to the medics are experienced and well-trained, including the Swedish medical platoon who assisted them.

“Having this kind of exercise, this is almost like game day for us,” she said. “So we’ll practice and rehearse internally, but when you’re practicing, you don’t have the adrenaline, nor do you have the moulage that makes it more realistic. You’re not able to really use the class 8, the medical supplies, that we use in order to treat the injuries.

“So it gives them a level of practice that they don’t normally get,” she added. “And with the adrenaline, it just gives them an opportunity that they don’t get on a daily basis.”

First Lt. Matthew Smith, the evacuation platoon leader for Charlie Company, was on the ground with the foreign treatment team, communicating casualty information between the brigade surgeon’s section and the Polish command post at the scene of the exercise.

The medics “did a fantastic job,” he said Sunday. “Our team in particular, we didn’t get a lot of time to rehearse; however, they’re extremely competent,” making the triage process go smoothly.

Smith said he discussed with his team afterward how to work with medics from other countries during triage.

“Really learning — like going past language barriers — how to properly classify patients with a mixed group of medics,” he said.

The mass-casualty exercise also emphasized the stress that a real-world situation puts on all soldiers.

“I believe the exercise was important for the brigade because it gave the medics of 3rd ID an opportunity to not only work with other nations, but also to work in an environment that was stressful and kind of urgent,” said Maj. Christopher Stewart, the 1st ABCT surgeon. “And it kind of forces them to put their skills and their training into practice in a kind of semi-real world situation.”