Note: MERT means Medical Emergency Response Team.
via DVIDS.
* Why travel to the UK to get ideas from how they're doing things? We have the examples of how the US Army and US Air Force handles medical emergencies.
* Why are we seeking to incorporate this capability inside the MEU. If we're expeditionary then getting the injured back to the ship is the goal. If Navy helos can't do it then a ride in a CH-53, MV-22 or UH-1Y will do...unless they're talking about a mission module for aircraft...
* We have a Special Forces example that we can follow and piggy back off if we really want to raise the level of our Corpsmen. Have them attend the Army SF Medics Course (modified).
I think the question that need to be asked are rather simple. Does the Marine Corps have the resources to have dedicated medivac helicopters or vehicles? Does it make sense to develop modules that can be used in any vehicle to develop such a capability? Are we going to be operating so far from the medical facilities aboard ships to justify this capability?
But the biggest question is this. Why are we replicating capabilities found in sister services?
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| Lieutenant Cmdr. Daniel J. Trueba, center, an emergency medicine physician with 1st Medical Battalion, 1st Marine Logistics Group, trains with members of the United Kingdom Royal Airforce, while conducting Medical Emergency Response Team training at Brize Norton Royal Air Force Base, England, July 23, 2013. As the Marine Corps transitions back to its amphibious roots, the Corps is considering creating its own emergency response teams to accommodate the independent nature of a Marine Expeditionary Unit. (Courtesy photo /Released) |
CAMP PENDLETON, Calif. – As the Marine Corps transitions out of Afghanistan and returns to its amphibious roots, it is posturing itself to bolster the expeditionary nature of the Corps. This realignment will be felt throughout the planning process, including medical operations.I'm not following the thinking here.
Sailors with 1st Medical Battalion, 1st Marine Logistics Group, are currently focused on this objective. Commander Ronald L. Schoonover, Lt. Cmdr. John D. Moore and Lt. Cmdr. Daniel J. Trueba have put it upon themselves to find an option for upcoming challenges as the Marines focus their attention on Marine Expeditionary Units.
To find answers, the three sailors embarked to England to observe the United Kingdom’s Medical Emergency Response Team in training from July 21-27, 2013.
“The MERT team was one of the primary (casualty evacuation) vehicles for the theater in Afghanistan since we’ve been deployed there,” said Moore, anesthesiologist, 1st Med. Battalion, 1st MLG. “They’ve been responsible for multiple casualty evacuations of Marines. They do primarily point of entry to up to Role-3 medical transfers with critically injured Marines, sailors, soldiers, (Afghan National Army) and multi-national personnel.”
A role-3 medical facility is the most capable medical facility in the Afghanistan theater, and is capable of providing surgery to the acutely injured. The MERT’s job is to provide stabilizing care or damage control resuscitation while casualties are in transit. The team consists of one doctor, a nurse, two paramedics and four force protection airmen.
“We had to go learn about what they do,” said Trueba, an emergency medicine physician with 1st Med. Battalion, 1st MLG. “We don’t currently have that capability within the Marine Corps and Navy, to move our personnel from one spot to another. We went to learn from people who have been doing it since 2006. We wanted to tap into that experience as observers to see how things work,” added the Bountiful, Utah, native.
Since Operation Enduring Freedom began in 2001, the Marines have largely relied on teams like a MERT or U.S. Army Air Ambulance units. With the new transition, Marines and sailors deployed with a MEU need to operate independently overseas. It is Schoonover, Moore and Trueba’s goal to implement a team similar to the MERT or train Navy corpsmen deploying aboard a MEU to have the same capability.
“The Marine Corps doesn’t have a defined medical platform with medical personnel on board,” said Moore, a native of Memphis, Tenn. “Our objective here was to explore options to implement more standardized courses of action for the Marine Corps to conduct casualty evacuation operations in an environment that is more kinetic and expeditionary in nature as opposed to a static and mature theater where you have assets like the MERT and (Dedicated Unhesitating Service To Our Fighting Forces) that are stationed with the Marines in country.”
Although the three sailors do not want to copy the MERT, they wish to create a more flexible team that has the same capabilities of a MERT but can operate in almost any vehicle, whether that’s in the back of a CH-53E Sea Stallion or armored HMMWV, added Moore.
“The Marine Corps is saying that this needs to be developed,” said Trueba. “The 13th MEU is already starting to implement these things but I’m hoping since the 13th (MEU) started the process then the 11th MEU can move it even further, incrementing steps to developing this ability.”
* Why travel to the UK to get ideas from how they're doing things? We have the examples of how the US Army and US Air Force handles medical emergencies.
* Why are we seeking to incorporate this capability inside the MEU. If we're expeditionary then getting the injured back to the ship is the goal. If Navy helos can't do it then a ride in a CH-53, MV-22 or UH-1Y will do...unless they're talking about a mission module for aircraft...
* We have a Special Forces example that we can follow and piggy back off if we really want to raise the level of our Corpsmen. Have them attend the Army SF Medics Course (modified).
I think the question that need to be asked are rather simple. Does the Marine Corps have the resources to have dedicated medivac helicopters or vehicles? Does it make sense to develop modules that can be used in any vehicle to develop such a capability? Are we going to be operating so far from the medical facilities aboard ships to justify this capability?
But the biggest question is this. Why are we replicating capabilities found in sister services?
We have examples here in America, they should make use of Fleet surgical teams, USPHS DMAT teams and even USAR teams as well. Even the US Military can make use of state defense forces as Medical response companies, engineering, comms or field hospital units.
ReplyDeleteyeah...for every person in the military that doesn't believe in anything that isn't invented here there are 10 more that believe we should be copying the Brits, Italians, Russians...whoever as long as it has a foreign flavor.
DeleteI would think its not a case of them wanting to copy either the British way of doing things, or the US army of air force. Rather they are most likely sending observers to each of those groups, so that they can try to pick the best methods from each and see how they could best fit in with their own forces.
DeleteDoes anyone know if the Army still has the medical kit for H-47's still? They used to have them. It was a palatalized system slid into an H-47, had a mini-ER setup on it. O2, EKG, supplies, saline etc all preloaded. I saw some in Germany many years ago, but they may have been a victim of "Peace Dividends"
ReplyDeleteyeah i remember the concept from the Vietnam era that sounds sorta like what you're talking about. a full fledged mobile ER that was contained in a pod that could be flown in by a SkyCrane. i'll try and find a pic...
DeleteOkay, you did solicit my comment... ;-)
ReplyDeleteI don't see why the USMC shouldn't consider medical team models from outside the US box. In other countries, military and civilian field medicine operate on some quite different models. In the US, for instance, it is rare to have a physician participate in initial transport and treatment. I think in the military it almost never happens; and in civilian air EMS it is limited to only a few services in the entire country.
The European models make wide use of physicians in the field in civilian EMS response. Many air medical crews include a physician regularly; and some MICU ground units do, too. In Israel we used a system influenced by both American (thanks to Dr. Nancy Caroline) and European inputs. In the civilian realm, some trucks were designated MICU and ran with a physician and paramedic in back (my truck in Kiryat Shmonah was like that); and some ran just paramedics and EMTs. In the IDF in my time ('80-/89; I'm not so up to date now) we also used physicians in places the US did not typically do so. If a mission looked to be especially high risk for casualties or isolated from help (say, a raid up the Lebanese coast), then extra medics and a physician went along as part of the raiding force. The wounded wouldn't wait to see a physician until they could be moved back to a more secure location kilometers and many minutes away - he was right there. I still recall one infamous and sad raid (up the coast, in fact) by Navy commandos that was ambushed on the beach upon landing and one of the medics and the team physician were among the KIAs.
Our CSAR and air medevac was two tier. The boots on the ground were all young, regular service combat medics (like the American PJs); but in the helicopter a physician and older reserve medic (usually) were waiting to receive the casualties.
So the model is philosophically and functionally different. The British NHS site that briefly talks about MERT mentions that their goal is to have the wounded in a physician's care within ten minutes, rather than the 'golden hour' concept.
Personally, I applaud the Marines for looking at alternate models to see what will work best for their mission. I presume that they are familiar with and studying the various American models as well; but it may be that the European and/or Israeli experiences have something to offer as they consider providing their own care in a stand-alone model that may involve serious distances and time factors. In the end, they've got to figure out what works best for them. It is best to study it well now. We all know that once a system is set up, even provisionally/experimentally, inertia takes over and it is hard to change later. That's how military machines are. Best to try and get it right from the beginning.
Sol, I thought you would have been all for learning from operational experience.
ReplyDeleteThe MERT system is cutting edge
I don't think it is a case of not invented here or wanting to do the opposite, it's just professional knowledge sharing to improve things.
I imagine there are many UK and US personnel that are alive today because of the MERT system and the Role 3 medical facility at Bastion
Read more...
http://www.dailymail.co.uk/home/moslive/article-1248526/The-flight-angels-saving-lives-Afghanistans-airborne-A-E.html
http://aerosociety.com/Assets/Docs/Events/680/Sqn%20Ldr%20C%20Thompson.pdf