PACIFIC OCEAN – U.S. Navy ships are known for their operational capabilities at sea. Guided-missile destroyers have shot down falling satellites at sea with standard missile systems, aircraft carriers launch strike fighters off their flight decks and amphibious assault ships deploying Marine expeditionary units. With these cutting-edge abilities, it can be easy to overlook the importance of forward-deployed medical facilities capable of performing complex medical procedures for combat casualties and humanitarian assistance/disaster relief mission sets.
The Navy’s newest and most technologically advanced amphibious assault ship USS America (LHA 6) executes a wide variety of essential missions, and during Rim of the Pacific 2016, a multinational, biennial training exercise, America has added HA/DR medical response to the list of the ship’s proven capabilities.
Off the coast of Hawaii on the afternoon of July 13, America received an urgent training message kicking off a mass casualty drill. The message stated military forces ashore suffered injuries during an explosion, and all shore medical facilities were either at full capacity or lacked the resources to adequately treat those in need.
Immediately, the information was disseminated throughout the ship and passed over the ship’s 1MC announcement system, “Mass casualty, mass casualty.”
On the ground in Hawaii, U.S. Army soldiers loaded 15 patients in a CH-47D Chinook helicopter. The simulated patients’ best hope for immediate treatment was on board the navy vessels of participating RIMPAC nations steaming nearby. On board America, a team of highly trained medical professionals prepared medical spaces for a mass casualty embark.
Many of the incoming wounded had minor injuries such as dislocated joints and burns, while others suffered life-threatening injuries requiring complex surgery such as major trauma to the chest and abdomen.
As medical personnel and the ship’s stretcher bearers prepared for the incoming wounded, the walking blood bank, a group of volunteer Sailors on standby to donate blood when a need arises, mustered in the hangar bay.
Just 30 minutes after receiving the message, an Army helicopter landed on the ship’s flight deck. One-by-one, stretcher bearers rushed the patients to the ship’s medical ward.
The mock casualty scene was a sight to behold. Bones protruded from limbs, blood soaked bandages laid about the deck, and screams of agony echoed throughout the ship’s passageways as patients were carried through the ship on stretchers.
To bring a more realistic feel to the drill, this scenario included several patients wearing make-up and red liquefied silicon, called “moulage.” Some of the patients wore full-body “cut suits” that took added a dimension of reality to the drill.
“They came in actually gushing blood,” said Hospital Corpsman 3rd Class Tasha Kuglar, assigned to America. “There were veins to draw blood from and real compound fractures to treat. The suits they used were very life-like.”
The realism tested the medical team’s training and their ability to work together under extreme pressure.
“No matter how much we know as individuals, it still takes practice and repetition to put all of the components together into a highly-functioning, optimized team,” said Lt. Cmdr. Katherin Wrenn, assigned to Fleet Surgical Team 1, currently embarked on America. “We want those glitches to be in a training environment, so that when we are faced with a real-life trauma scenario, the team has already gone through those growing pains and is coordinated and ready. Using the cut suits helps us make that training as realistic as possible, which accelerates that process of team integration. It’s easy to forget that it is a simulation when the ‘patient’ is bleeding out in front of you, and you have to come together and act quickly. “
This HA/DR drill tested the ability of multiple RIMPAC participants to work as a unified team in the wake of a disaster. The drill was led by Japan Maritime Self-Defense Force Vice Commander Rear Adm. Koji Manabe and included several ships and the Japan Maritime Self-Defense Force helicopter destroyer JS Hyuga’s (DDH 181).
“It was definitely very exciting to work with the different countries. To see exactly what [capabilities] they have on their ships and compare it to what we have. We learn from them and they learn from us. This is exactly what I joined for,” said Kugler.
America’s medical team overcame several challenges during the drill and say they feel better prepared to work with partner nations if ever faced with a real-world HA/DR.
“The idea of this whole HA/DR [drill] is to learn,” said Cmdr. William Nguyen, America’s senior medial officer. “If there truly was [a disaster], we would be a casualty-receiving ship. This is an opportunity to not only better learn our capabilities but to also learn how to work with other nations – learn to play with each other. The end game is to learn how to work in a multicomplex situation with multiple nations.”
America is currently underway participating in RIMPAC. Twenty-six nations, more than 40 ships and submarines, more than 200 aircraft and 25,000 personnel are participating in RIMPAC from June 30 to Aug. 4, in and around the Hawaiian Islands and Southern California. The world's largest international maritime exercise, RIMPAC provides a unique training opportunity that helps participants foster and sustain the cooperative relationships that are critical to ensuring the safety of sea lanes and security on the world's oceans. RIMPAC 2016 is the 25th exercise in the series that began in 1971.