Page 15 - JSOM Summer 2022

– At a cruising speed of approximately 130 mph, the flight – Mass Casualty Boxes are located in the forward, amid-
time from the LHA to the casualty ship in an MH-60S ships, and after spaces of the ship. Designated Damage
would be approximately 45 minutes (personal communica- Control Teams and Stretcher Bearers will bring the Mass
tion – CDR Nicholas Koetter 19 November 2021). Casualty Boxes, to include oxygen cylinders, to the Hangar
Bay, once it has been designated as the casualty staging,
Assuming that it would take no more than 45 minutes for
damage to the casualty ship to be assessed, flight clearance evaluation, and treatment area.
to be obtained from the CATF, and preflight checks to be per- – The capability to transport medical supplies from the LHA
formed on the helicopter, and that this would be followed by to the casualty ship via Unmanned Aerial Vehicle does not
the 45 minutes of flight time, the IDC and other TCCC-trained currently exist, but needed TCCC supplies and personnel
first responders on board the casualty ship will be required to could be transported to the casualty ship via the evacuation
care for the casualties with no additional personnel or equip- helicopters when they arrive to transport the casualties to
ment for approximately 90 minutes. the LHA.
– A search of the DDG’s Authorized Medical Allowance List
– Further assuming a 15-minute time to load the casualties, (AMAL) finds one “H” cylinder of oxygen and four “D”
combined with the 45-minute return flight, the casualties cylinders.
would not begin to reach the surgical capability present on – Destroyers and other small surface combatants do not have
the LHA until approximately two hours and 30 minutes a walking blood bank capability and they carry no cold-
after the missile impact. Flight times would be shortened if stored Low Titer Group O Whole Blood (LTOWB), frozen
the LHA changes course to close the distance to the casu- red blood cells (RBCs) or frozen plasma (FFP.)
alty ship after the first missile strike. – CRTSs such as the LHA in this scenario do carry frozen
– Since the FST has only one surgeon and one anesthetist, only RBCs and frozen plasma; they also have a walking blood
one casualty at a time will be able to receive surgical care. bank (WBB) capability.
– Rescue of casualties in the water would be carried out by – Despite the missile strike, communications between the ca-
the destroyer crew launching the ship’s RHIBs from the sualty ship and the LHA are intact. On a DDG, there is
boat davits on the ship. The launch would typically occur a ship-to-ship communications capability using the Mako
within minutes of personnel going overboard, especially if system that operates in 4 locations. There is also ship-to-
the crew is at General Quarters (the highest state of combat ship secure phone in the Combat Information Center (CIC.)
readiness on board a ship, in which routine ship’s work is The most expedient means of medical communication be-
discontinued and the crew reports to their battle stations) tween the LHA and the casualty ship at present is through
and there are no hostile craft in the area. The rescue evo- the CIC watchstanders on the two ships. The IDC or a des-
lution would normally take approximately 45 minutes. For ignee will have to leave the hangar bay and move to the CIC
the purposes of this scenario, we will assume that the res- with the information that needs to be relayed to the LHA.
cue is accomplished and the casualties moved to the hangar The LHA’s Senior Medical Officer and the CATF Surgeon
bay in 45 minutes. should report or send runners to the Combat Information
– This scenario assumes that one of the two junior corpsmen Center onboard the LHA to receive this information.
on board the casualty ship was killed in the first missile – The airfield typically used for direct aircraft-to-aircraft
strike. The IDC and the other corpsman are unhurt and are transfers in this area is Al Udeid Air Force Base in Qatar
co-located in the hangar bay. The remaining corpsman is (approximately 500 miles distant) if the casualties need to
assisting the IDC with casualty management. be flown to a distant Role 3 or Role 4 military medical
– Sailors on board ships at sea do not wear Individual First treatment facility or to a civilian hospital.
Aid Kits on their person, as ground combatants do, nor do – Medical treatment facility options include the Role 3 Hos-
they wear body armor. Medical supplies on the casualty pital in Kuwait (approximately 750 miles away) and the
ship are located in the main medical space, located on the Navy Expeditionary Medical Facility at Camp Lemonnier,
main deck and connected to the ship’s Main Galley. The Djibouti.
forward Battle Dressing Station is located in the forward – There is also a civilian Level 1 trauma center in Qatar and
pallet staging area on the main deck. The Aft Battle Dress- host nation hospitals in Oman, the United Arab Emirates,
ing Station is located one deck below the flight deck and Saudi Arabia, and Bahrain that could assist with providing
nearly all the way aft. Medications and medical equipment care to the casualties as needed.
are stored in all three spaces.
– Tourniquets and Combat Gauze are located in Main Med- Initial Evaluation of the Casualties
ical, both Battle Dressing Stations, and in First Aid Boxes Note that the wounded sailors in this shipboard casualty sce-
throughout the ship. Additional tourniquets and Combat nario would likely not all arrive at the casualty staging area si-
Gauze are also present in the Mass Casualty Boxes. multaneously, but rather would arrive in sequence, as stretcher
– When General Quarters sounds, the IDC would have tour- bearers and shipmates transport wounded crew members from
niquets in the provider response bag, which would rou- the damaged areas of the ship to the hangar bay. Thus, the
tinely be brought to the casualty staging area and which IDC might have the opportunity to triage casualties and un-
would contain additional equipment with which to per- dertake immediate, quickly performed actions for each injured
form TCCC interventions. crew member when they are first evaluated, prior to the arrival
– First Aid Boxes are strategically located throughout the of subsequent casualties.
ship in all work and watch stations and approximately The IDC’s initial evaluation of the casualties reveals the
every twenty feet apart in the passageways. These boxes following:
contain three full kits of supplies that match TCCC rec- o Casualty 1 has a left trouser leg that is saturated with
ommendations (e.g., tourniquets, hemostatic dressings, and blood. He is alert, but noted to have a rapid, weak
chest seals.)

TCCC Maritime Scenario: Shipboard Missile Strike | 13