VIRGINIA BEACH - At first glance, the wooden walls of a two-room shack at Camp Pendleton didn't look like much. But for just a few minutes, retired Navy SEAL medic Fred Kolberg asked his five students: Try to imagine it as something different.
Picture the building as a store in a shopping mall, he told them. Then add a gunman.
Jeremy Carey, Todd Askins and Ken Kochler approached the door. Standing nearby, Kolberg's wife, Julie, pushed a button on a remote control. A machine gun simulator began to fire in loud, rapid bursts.
Inside the shack, fake blood trickled from role-player Mike Boffo's mouth as he shivered on the ground. A buttoned-up shirt and khakis hid arm, leg and back wounds Julie Kolberg had spent hours molding and painting on him.
"You all right, man? You get hit?" one of the students asked Boffo, a former Marine.
"Yeah," he yelled back. "It hurts."
"Are we clear? Are we clear?" Kochler called, crouching outside the building.
From inside, Askins and Carey got a closer look at their mock shooting victim. "Oh my God, he's bleeding," one said.
"Make a call," instructor Fred Kolberg said. "Do what you gotta do."
He was putting his students to the test after nearly 16 hours of training in combat first aid. For two days Fred Kolberg had instructed them on stopping major bleeding, protecting airways and applying pressure dressings on wounds. The "active shooter" drill was their final test.
For the past six years, the Virginia Beach couple has traveled the country training law enforcement and military groups in tactical combat casualty care through their company, Trauma Training FX.
The goal is simple: equip students with medical skills to treat life-threatening injuries and reduce casualties. They've run military personnel through scenarios including an improvised explosive device attack on a vehicle convoy, and they've trained law enforcement officers in a mock mass casualty incident at Michigan State University.
Past students have called the training effective.
"I have returned to my department and tactical team since and am spreading this life saving information as fast as I possibly can," wrote Officer Matt Peters, a patrolman and SWAT operator with the Jackson, Mich., Police Department who participated in the training at Michigan State.
About a year ago the Kolbergs decided to offer the training to civilians, too. The company's two-day open-enrollment courses, which start at around $500, have drawn students from as far as California. Some, like Kochler, a former emergency room doctor, show up with previous medical training. Others, like Carey and Askins, know nothing about treating serious wounds before they arrive. Askins is an e-commerce director for Tactical Distributors; Carey owns Virginia Beach filmmaking company Ironclad Media Alliance. The course earlier this month even drew an FBI medic and a former Marine.
The training is more intense than a traditional first-aid workshop, students said. Tactical combat casualty care focuses on battle-honed medical skills and procedures that can be done with little to no specialized equipment - like using a belt as a tourniquet, Kochler said.
"We're saving a life here with resources we have in our pocket," said student Walt Hasser, a security contractor from Northern Virginia who served in the Marine Corps.
Now that he's a father of two, Hasser said he took the course to learn how to transfer some of his military training to his personal life.
"I kind of wanted to come in like I had no experience," he said. "How can I apply trauma treatment to nonhostile situations?"
And while the final training scenarios can seem extreme - they sometimes include pyrotechnics and Hollywood-style moulage, or realistic fake wounds - Fred Kolberg said the skills students learn can be used in any life-threatening situation, be it a car crash or a terrorist attack.
"It's applicable for not just what happened in Connecticut," he said, referring to the shooting at an elementary school in Newtown, Conn., in December that left 26 people dead, including 20 children. "It's advantageous for life in general."
In addition to teaching students about basic anatomy and physiology, Fred Kolberg talks about the importance of situational awareness. In the event of a mass casualty incident, he said, it's important to take a moment to assess the surroundings. Am I safe? Are there people around me? If there are injuries, he asks, can I help?
"For many people, our natural reaction is fight or flight," he said. "If you're not trained to fight, you run."
When casualties occur, paramedics responding to the scene sometimes can't get immediate access to the injured. Bystanders equipped with basic medical knowledge could help keep victims alive long enough to get them to an ambulance or hospital, Fred Kolberg said.
"If we have a Virginia Tech or a Columbine or a movie theater shooting here, there's two regular people who can intervene and save lives," said Kochler, talking about fellow students Carey and Askins.
And while his company hasn't marketed its training in response to the Sandy Hook shooting - much of its business, even the civilian classes, comes from networking and referrals - current events have come to play a role in the scenarios the Kolbergs create and in students' motivations for signing up.
Kochler, of Virginia Beach, said he wanted to take the class because of "the progressive deterioration of society." Others said they wanted to have the skills to help themselves and their families.
Carey compared it to insurance: "Am I ever going to need it?" he asked. "I hope not."
Outside the shack at Camp Pendleton, the civilians carried their patient out of the "hot zone," setting him on the ground.
"How bad is it?" asked Boffo, the role-player.
The men already had applied a tourniquet to Boffo's arm using a small supply kit they'd brought along. Next they cut through his clothes, finding and patching "wounds."
"We've got another wound down here on the leg," Kochler said.
"I'm going to check his back," Carey said. "He's got a big wound on his back."
They checked his pulse. So far they'd managed to keep their patient alive.
"OK," Carey said, "we're going to take you for a ride and get you to safety."