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Forward Deployed - Forward Thinking: Navy Afloat Trauma System Takes Shape

Story Number: NNS030318-03
Release Date: 3/18/2003 10:31:00 AM

By Journalist 1st Class Joseph Krypel, Camp Patriot Public Affairs

CAMP PATRIOT, Kuwait (NNS) -- The Arabian Gulf is brimming with U.S. Navy and coalition warships these days, all ready to carry out the missions they have trained for in preparation for future contingencies.

One of those contingencies could be the process of handling casualties, and the forward-deployed medical staff of Task Force 51 (TF-51) has an innovative answer - the Navy Afloat Trauma System (NATS).

NATS creates an amphibious task force trauma network patterned after the best civilian trauma networks - known more commonly as the 911 emergency system. The 911 system provides fast-response communications from your home or cellular phone to emergency dispatchers. The dispatcher then contacts the nearest ambulance for near immediate response. The network has the capability of contacting and dispatching an ambulance, fireman or policeman that is closest to you, therefore eliminating geographic or expertise restrictions.

According to Cmdr. James Gregory, TF-51 director of trauma and the conceptual engineer behind NATS, this plan is modeled after the 911 system of communications and resource allocation, into the already tested current military structure.

Current operational capabilities allow for one of four operating rooms per ship to provide services 24-hours a day as necessary, without the addition of added resources. NATS greatly enhances that capability by using six "big deck" amphibious assault ships from the Atlantic and Pacific Fleets, as well as the British Royal Navy.

Gregory explained that NATS draws together more than 1,500 medical personnel to include individual medical specialists from the various ships and coordinates them to respond to emergencies in an organized manner by using a common communication network, similar to the civilian 911 system.

"Three of the U.S. 'big decks,' along with the British Navy Hospital Ship, Royal Fleet Auxiliary (RFA) Argus, will be used as primary casualty receiving treatment ships. They'll get called into action first. The balance of the ships, all with equal capabilities, will be used in a secondary and overflow nature - basically staying in a medical stand-by mode until needed," explained Gregory.

In union with the TF-51 assets, the medical facilities of the USNS Comfort (T-AH 20), homeported in Baltimore, will be used within NATS as the primary location for an even higher level of care.

"The Comfort would serve as a primary medical treatment facility at sea for high-level care and provide an additional 1,000 bed staffing capability," added Gregory. While Comfort has a much higher bed count, Gregory explained that the amphibious assault ships are more suitable for receiving the high level of air traffic that would likely be needed in a mass casualty scenario. The Comfort allows for a single aircraft to land on one heliport pad, whereas the amphibious assault ships have multiple landing areas.

According to Gregory, the plan will eventually bring all seven U.S. ships and the U.K. vessel together into one 1,500-bed floating hospital that can provide a comprehensive trauma capability.

Gregory said once you have the sea-based facilities, you must have a means of taking a Soldier or Marine from the field, potentially hundreds of miles away, and getting him to the best care possible. "Starting with the field medic, a call would be made to a direct air support center (DASC). DASC acts as a dispatcher for medical air support to and from the battlefield," he said.

Upon receiving a call, DASC personnel dispatch air assets to the casualty location, while at the same time choose from many ground-based medical facilities near the battle front that are available, including six initial treatment facilities that travel with ground forces, called forward resuscitative surgery suites, which include a mini-operating facility. The job of these forward-deployed medical units is to provide immediate triage and stabilization of patients before sending them on to better-equipped facilities at sea. Then NATS takes over.

Gregory said NATS solves the problem of who to call by centralizing the communications from the field to one point by RAMPART. RAMPART, located aboard USS Bonhomme Richard (LHD 6), takes its name from the old "Emergency 911" television show and acts as the center point for casualty direction, ultimately determining the level of care required and to what medical facility that the patient should be sent.

Once aboard, the patient will be treated by one of many medical personnel. According to Gregory, the optimal time aboard, or "on the floor," would be no more than 48-hours before the patients are either returned to duty or sent on to a higher level of care.

"We'll make everyone as comfortable as possible," Gregory reflected, "but our primary goal is to ensure that each and every patient gets the absolute best medical care that is available -- be that within NATS or back in the United States.

"NATS dramatically improves our ability to rapidly transport casualties from the battlefield to the operating room," concluded Gregory. "We've created the first fully-functional floating trauma center."

Gregory is a 45-year-old Reservist recalled to active duty in support of Operation Enduring Freedom, and Chief of Surgery and a trauma surgeon at the University of Illinois affiliated Carle Foundation Hospital in Champaign / Urbana, Ill.