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Maritime Medical Support Defense Support of Civil Authorities. CAPT Peter F Roberts , MC, USN US Third Fleet Surgeon UNCLASSIFIED. Disclosure. The views expressed are those of the presenter and do not necessarily reflect those of the Navy, the Department of Defense nor the US Government.
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Maritime Medical Support Defense Support of Civil Authorities CAPT Peter F Roberts, MC, USN US Third Fleet Surgeon UNCLASSIFIED
Disclosure • The views expressed are those of the presenter and do not necessarily reflect those of the Navy, the Department of Defense nor the US Government.
Who is THIRD Fleet? • One of 7x numbered Fleets in the Navy (2nd, 3rd, 4th, 5th, 6th, 7th and 10th). • One of 2x numbered fleets in the • Pacific, Under PacFleet (3rd and 7th), • Under PACOM. • Operational commander for 125 ships • and submarines, multiple subordinate • units, and over 60,000 sailors. • A Maritime Operations Center (MOC) • providing planning and execution at the • operational level of war. • A force provider for 4th, 5th, 6th and 7th • Fleets.
Pacific Partnership, borne from disaster 2004 Indonesia Tsunami -Magnitude 9.0 Quake off of Sumatra -230,000 people dead -1.6 million displaced -$14 billion in damages Eased Suffering, Strengthened Relationships + USNS MERCY LINCOLN CSG + MULTI-NATIONAL WORLDWIDE ASSISTANCE
It’s Challenging to Build Relationships in the Midst of a Crisis Despite This… -Regional Partnerships -NGO Engagement -Training and Readiness -Cooperation -Disaster Response -Interagency Cooperation Needed to Focus on: Pacific Partnership Disaster response identified major weaknesses: -Lack of pre-planning -Lack of international cooperation
Albay, Philippines The question is not if, but when. Mt Mayon Eruption January 2018 >60,000 Displaced Persons USNS MERCY Pacific Partnership 27 Jun-11 Jul 2016 HADR Exercise Simulating Mt Mayon Eruption
Talcahuano Naval Hospital Inaugurated October 15th 1980 240 Beds February, 2010 Water and Heating System
The 2016 Kaikoura Earthquake, NZ Expect the Unexpected
Medical Capabilities • Amphibious Readiness Group (ARG) • Navy and Marine Corps Team • Hospital Ships (T-AH) • Carrier Strike Group (CSG) • Environmental and Preventive Medicine Unit (EPMU) • 22 ships on average UNCLASSIFIED
AMPHIBIOUS READINESS GROUP (ARG) -LHA, LHD -LPD -LSD Navy and Marine Corps Team
LHD/LHA Amphibious Assault Ship Mission Primary: Amphibious operations Secondary: Mass casualty care UNCLASSIFIED
AMPHIBIOUS ASSAULT SHIP • 1,800+ troops with helicopters, boats, vehicles, amphib vehicles • Capable of receiving both helicopter and waterborne casualties Level 2-Forward Resuscitation
Landing Helicopter Dock (LHD) Medical Assets with Fleet Surgical Team • 4 x Physicians • 1 x General Surgeon • 3 x Nurses (CRNA, OR, ICU) • 33 x Hospital Corpsmen • 2 x Healthcare Administrators • * Possible to augment 84 additional personnel (Phys, Surg, Nurse, Corpsmen) Medical Capability • 4-6 Operating Rooms • 15 ICU Beds • 40-45 Ward Beds • 3 Dental Operatories • Ancillary Capabilities • Lab • X-ray • Blood Banks • Pharmacy • Biomed Repair • Preventative Medicine UNCLASSIFIED
LPD-17 Amphibious Assault Ship • Mission • Primary: Amphibious operations • Secondary: Mass casualty Care UNCLASSIFIED
LPD–17 Amphibious Assault Ship • Ancillary Capabilities • Lab and X-ray • Blood Bank • Pharmacy • Biomed Repair • Preventative Medicine Medical Capability • 2 Operating Rooms • 6 ICU Beds • 18 Ward Beds • 2 Dental Operatories Level 2 - Forward Resuscitation (capable) ***Must have FST Fly-Away Team or ERSS
1 operating room Gen Surgeon, Oral Surgeon, Anesthesia Provider Clinical Psychologist, Physical Therapist 3 ICU beds 8 Isolation beds 42 Ward beds AIRCRAFT CARRIER
USNS Mercy – Hospital Ship Mission Provide a mobile and flexible, rapidly responsive, acute care medical capability in support of amphibious and naval forces, disaster, and humanitarian relief operations. UNCLASSIFIED
T-AH Characteristics/Capabilities • Crew: (Reduced & Full Operating Status) • Civilian Mariners: ROS: 20 FOS: 71 • MTF Personnel: ROS 59 FOS: 1,215 T-AH 19 USNS MERCY T-AH 20 USNS COMFORT • Length: 894 feet • Beam: 106 feet • Draft: 33 feet • Displacement (full): 69,360 long tons • Speed: 17.5 knots • Endurance: 13,420 nm • Ship’s Fuel: DFM/F76 42,000 Barrels • Helo Fuel: JP-5/F44 90,000 Gallons • Shafts: 1 • Main Engines: 2 GE turbines, 2 GE boilers • Patient Transfer: Helo, Small Boat, and Pier side • Potable Water: 300,000 gal/day • Chapel • Elevators: 9 • Galley – aft CIVMAR galley & forward Hospital galley. • Laundry – hospital laundry, & self-serve laundries. • Incineration – 2 Ship waste & medical waste. • VERTREP (Helo replenishment) & Landing • CONREP (Connected Replenishment & Fueling) • RAS- replenishment at sea • FAS- fueling at sea. • INREP(In port Replenishment) • Patient Transfer Boats: 2 Tenders/Lifeboats • Mission gear transport boats: 2 10M Navy Utility • Total Hospital Beds: 1,000 • Intensive Care Beds (ICU): 88 • Isolation Ward Beds: 11 • Intermediate Care Beds: 400 • Minimal Care Beds: 500 • Casualty Receiving Stations: 50 • Operating Rooms: 12 • Blood Bank (Largest in DoD): 3,500u • CAT Scan: 01 • Angiography Suite: 01 • Services: • Surgical (Ortho/GYN/Laparoscopy, etc.) • Full Laboratory (Micro, BW, PT Care) • Radiological (4)Rad Rooms/Portables • Optical (including Exp Ashore) • Dental (Including Exp Ashore) • Pharmacy • Telemedicine/Electronic Health Record • 02N2 Plants (2) w/TRIM System • Morgue (22) units • Burn Center/Physical Therapy • Hospital Logistics (78,485 cubic feet) • Berthing to SPT MTF, Hull and DESRON
T-AH Medical Treatment Facility (MTF) Surgical Capabilities General Orthopedic Cardiothoracic Dental Ear/Nose/Throat Plastic Neurosurgery Maxillofacial Ophthalmic Urology Obstetric and Gynecology Non-Surgical Medical Capabilities Internal Medicine Dermatology Dialysis Psychiatry Respiratory Therapy Angiography Ancillary and Support Services Capabilities Dental Prosthetics Radiology Lens Fabrication Blood Bank Laboratory Pharmacy Medical Equipment Repair Dietary Burn Treatment Physical Therapy Medical Supply
USNS MERCY Initiatives SIMULATION Hyper-realistic trauma training scenarios using state-of-the art trauma simulation manikins and surgical cut-suits. Will increase operational readiness of the medical force in support of the warfighter. VIRTUAL HEALTH Virtual health capabilities will be tested during PP18 using the CISCO DX80 unit to virtually project imagery from the novice to the expert. Global health and ship to ship/shore assistance concepts will be tested. ROBOTIC SURGERY First time ever in an operational military setting, the da Vinci Xi Robotic Surgical System will test over-the-horizon ship-to-shore clinical interaction technology. -Operation Komodo, USUHS student participation, advanced water testing
Amateur Radio on USNS MERCY • MERCY has three (3) full time Amateur Radio Operators that hold General and Technician Class FCC Licenses • The Amateur Radio Shack on MERCY operates in “all modes” meaning HF/VHF/UHF of civilian frequency range, and also participates in MARS (Military Auxiliary Radio Service) • Capabilities are not limited to voice communication. Most of the traffic MERCY transmits is Data over HF radio. This means email, position reports, images, etc. • MERCY operates as a information relay using these technologies, relaying radio calls and data from the beach to other adjacent units to coordinate support from afar Capability Execution • HAM radio operators from MERCY participated in RIMPAC14 and were included in all elements of the HADR event • On Pacific Partnership 2015 MERCY HAM radio operators gave SME exchanges and training to local radio users in multiple countries on Emergency Radio Operations and Coordination during Disaster situations • During Pacific Partnership 2018 MERCY conducted additional exercises involving Data over HF and WSPR (Weak Signal Propagation Reporting), reaching every continent (photo) • MERCY was asked to operate as a coordination platform for the final HADR event at RIMPAC18 Discussion Future Radio • “Radio MERCY” has been onboarded into the Department of Homeland Security SHARES (Shared Resources) Disaster Response network that interoperates with FEMA and other response organizations. • Continue local SoCal and regional drill/exercise participation to keep up the bonds with Civilian organizations. All full time operators will work toward and receive FEMA licenses. • Update existing equipment and enhance capability • Continue to mentor our MERCY Sailors, help them to gain their FCC License, and learn the craft of Amateur Radio! • Amateur radio operators can provide a vital communications platform during HADR events, as demonstrated during the Philippine Earthquakes, major Floods in India, and even recently in Puerto Rico where locals were communicating with each other to find evacuation centers • This capability is not limited to Mission use. MERCY participates in local Southern California Healthcare Network drills, simulating how our Hospital Ship could be used as a coordination platform for MIL/CIV communication partnership. UNCLASSIFIED
Fleet Medical Capabilities 920 JMSDF Helo on MERCY 80
USNS MERCY Tender boats x 2 Various Configurations for patients Most common: 50 ambulatory, 6 liter, 4 wheelchair 60 pax as tender 150 pax as life boat
LANDING CRAFT AIR CUSHION (LCAC) Personnel Transport Module • One per Amphibious Landing Group • 54 litter patients • Normal Configuration • 3 litter patients • Range: 200nm • Speed 45K
SH-60B SEAHAWK • 4 Litter and 1 Ambulatory or • 7 Ambulatory • Depends on model and mission equipment aboard • Range: 450 nm • Speed 146 kn
CH-53D/E SEA STALLION • 24 Litter or • 37 Ambulatory • (55 w/center line seating) • Range: 540 nm • Speed 150 kn
12 Litter or 24 Ambulatory Range: 879 nm Speed 241 kn V-22 OSPREY
USNS Mercy – Hospital Ship Response Time to Alaska Disaster • 5 (3) day preparation to get underway • 7 day travel time • 12 (10) days until response after tasking • Develop plan, ask for a capability UNCLASSIFIED
Environmental and Preventive Medicine Units Mission Provide specialized preventive medicine support to forward deployed US Forces. Capability • 13 Member team with 5 functional detection/analysis components • Preventive Medicine • Disease Vector Control • Microbiology • Chemical (HazMat, Toxicology) • Radiation UNCLASSIFIED