The gunshot wounds to the leg and arm were simulated, but the pressure was real as Staff Sgt. Vance Maxey carried the "wounded" soldier about 50 feet Thursday, administered intravenous fluid (using a rubber prosthetic arm) and applied a pressure wrap to the injuries sustained by the role-playing soldier.

"You’ve got your pressure dressing. You are going to check it. Is it still holding?" asked Sgt. Jerry Muniz, an evaluator.

The past few days have been practice at a remote area of Schofield Barracks. But starting Saturday, Maxey and 169 other soldiers will be tested for real during timed and closely watched evaluations — occasionally with simulated artillery and machine gun blasts ringing in their ears — as they seek to earn the prestigious Expert Field Medical Badge.

Created in 1965, the EFMB is one of the most difficult Army badges to earn, with just a 17 percent pass rate in recent years, officials said.

"Honestly, it makes you think about what a lot of line medics are doing — the stuff they have to engage in," said Maxey, 24, who works in the dental clinic at Tripler Army Medical Center.

The Oceanside, Calif., man said he’s seeking the medical badge "definitely to set myself apart from my peers, but at the same time it’s to test myself."

Lt. Col. Jacob Dlu­­gosz, who is with the 18th Medical Command at Fort Shafter Flats, the unit overseeing the testing, said all of the candidates have ties to the Army Medical Department.

Army officials said those seeking the badge must take a written test and successfully complete 28 tasks in three combat testing "lanes," as well as night and day land navigation and a 12-mile foot march in less than three hours.

The soldiers have to treat simulated lung punctures and other chest wounds. Among the mock battlefield horrors at the trainers’ disposal are rubber "wounds" that can be affixed to a role player’s body and through which fake blood can be pumped.

Soldiers also have to react to a chemical weapons artillery or mortar attack by putting on a protective mask in less than nine seconds and donning a protective suit in eight to nine minutes, officials said.

Sgt. 1st Class Erin Trudden, who normally works at Tripler as a lab technician but is the noncommissioned officer in charge of one of the testing lanes, said approximately 1 percent of the Army medical field is eligible to wear the EFMB.

"It won’t change your (military speciality) to being a combat field medic, but it trains you to be proficient at expediting field medical care under fire and stabilizing a casualty well enough for transport and evacuation," Trudden said.

The soldiers seeking the badge are based in Hawaii, Alaska, South Korea and other locations, officials said.

Over the next week, the testing will take place at Schofield, Wheeler Army Airfield and the Army’s East Range.

Some of that simulated medical care will be administered amid smoke and mock machine gun and artillery fire.

"We try to make it as realistic as possible," Dlu­gosz said. "We kind of elevate the stress level a little bit for the candidates as well."