DARC TUSC-MED OPS After Action Report

Direct Action Resource Center (DARC)

We recently sent a team to Direct Action Resource Center's new experience, TUSC-MED OPS. DARC (pronounced "DAR-see") is located in North Little Rock, Arkansas, and offers top-tier training to military, law enforcement, and civilians. Their core civilian class — the Tactical Urban Sustainment Course — places participants in a scenario-based, immersive experience where they must come together as a team to provide their community with security, purified water, and the means to overcome a range of adversities.

The new class, TUSC-MED OPS (medical operations), revives a legacy of teaching attendees across the spectrum — from layperson to physician — both fieldcraft and the medical practices relevant to an austere environment. DARC cadre in fact coined the term "austere medicine" and were among the first to offer training specific to this developing field.

Spoiler alert: you won't get all the answers here. You'll need to attend the class and do the work to fully appreciate the experience.

Day one

The scenario

After introductions, the class opened with an explanation of the New Madrid Seismic Zone — a 125-mile-long, 45-mile-wide region of deep-seated faults running from southern Illinois through Tennessee, Kentucky, and Missouri, terminating in northeast Arkansas. That set the stage: loss of power and clean water, severe disruption of emergency services, and an exodus of displaced persons needing medical care. Isolated from rescue and out of options, you must build a clinic in the space available — your garage — so a doctor and dentist can care for people in your neighborhood.

Water is king

How much water does an American household use? An American hospital? What is the minimum a person needs per day to survive? The class works through these questions, with the emphasis on water — how to mass-produce purified, potable water and extrapolate that to creating a sanitary environment.

He's not heavy…

How do you safely move a sick or injured person to your clinic? The class discussed a variety of methods and everyone got hands-on with commercial and improvised options under the close supervision of search-and-rescue and medical personnel. The role-players surprised participants with simulated illness and injury — and, as anyone who has trained at DARC knows, the cadre skillfully ramp up the pressure as the course progresses.

Day two

Day two focused on standing up a clinic that could serve a wide variety of patients — including "inpatients" whose injury or illness requires close supervision over multiple days.

Fire. Food. Sanitation.

Various methods of fire-starting and management led into practical discussion of feeding, bathing, and toileting patients and sterilizing bandages, bedding, and instruments. Some attention was paid to limited-power solutions for lighting — and even running hot water for the clinic.

Showtime

The last part of the class — our favorite — moved the team to one of DARC's covered structures, where participants had thirty minutes to set up a field hospital: assigning tasks, planning layout, and placing and maintaining equipment. As work continued, cadre announced that a group of displaced persons was gathering at the clinic entrance seeking care. The team treated several role-player patients that day, often performing tasks outside our comfort zone — but always under the safety and feedback of DARC's professional cadre.

Key takeaways

1. Learn from experience. Training at DARC is an opportunity to learn from field-experienced subject-matter experts.
2. The team. As our physician preaches, you cannot run a clinic alone — it takes a team of dedicated individuals.
3. Water is king. Humans need clean water to thrive. Scaling that to the needs of a clinic is a monumental task, and you need education and experience to do it properly.
4. Anyone can take this course. If you go on medical mission trips, practice in austere or wilderness environments, or simply aspire to be a professionally prepared citizen, you will find value here.

From our founder & CEO

DARC classes are always uniquely challenging, and I felt both excited and fortunate to attend the inaugural TUSC-MED OPS. I gained a deeper appreciation for facilities considerations, and the experience reinforced the importance of team-building and institutional knowledge. I hope the role-player with the shoulder dislocation is okay — I hadn't done that since residency!