Surgeries on Small Ships

The US Naval Institute News service reports a Navy lab is looking into whether surgeries could be performed on “small ships,” specifically the Littoral Combat Ships and the former “Joint High Speed Vessel.”

The select surgical procedures included in the study are stabilizing a fractured pelvis, treating a displaced femur fracture, treating an open wound of the abdominal wall, and a traumatic amputation of the leg. A medical team – consisting of a surgeon, a nurse, a surgical technician and an anesthesiologist – would conduct simulated surgeries in a realistic environment in up to sea state five conditions.

I am not sure why the Navy is doing this, and why specifically sea state five, there are going to be a lot of circumstances when the sea state is lower. Obviously surgeries have been done on small ships in the past. An appendectomy was famously performed on a submarine by a corpsman using a sharpened spoon (although subs have the advantage of being able to submerge out of severe sea conditions).

Perhaps they are talking about putting a surgical module on these ships, and maybe it might fit on Cutters. I’m still hoping the OPC will have some provision for using at least some of the LCS modules.

When we did Ocean Station, cutters deployed with Public Health Service doctors on board, and Midgett did have a SAR case involving a traumatic amputation of a leg in the Bering Sea while I was aboard, but I doubt we could justify regularly deploying with a surgical team. Still, there are circumstances like the 2010 Haiti earthquake when a surgical team and operating room on our cutters could be useful. Big hospital ships are great for some things, but in that case there were several smaller communities that also needed help. Some times you need the ability to spread the capability around.

9 thoughts on “Surgeries on Small Ships

  1. The listed injuries strike me as a reasonable representative sample of the kinds of more serious traumatic injuries that might be expected aboard a smaller vessel in a high sea state. They are also representative of the surgical cases that, in my experience, are expected after a natural or other disaster.

    Unstabilized pelvic and femur fractures present a continuing risk of rapidly fatal internal hemorrhage and death due to lacerations of large vessels by adjacent fractured bone, that cannot be stopped externally. Some patients with open abdominal trauma or traumatic extremity amputations may also require prompt initial surgical intervention for any of numerous reasons, either to survive or to enable a better eventual recovery.

    But I seriously doubt that anyone in their right mind would choose to perform these or similar procedures on a smaller vessel in rough seas, unless there was no better option. But that’s been the case before, and doubtless will be again. So it makes good sense to conduct research into the unique challenges those circumstances present, and to identify any modifications or adaptations that may be required to overcome them.

    BTW, I spent part of my Haiti deployment working at the onshore Casualty Collection Point for the USNS Comfort and another part at the Embassy and airport, with frequent contact with USCG personnel. It was an interesting experience.

      • Just guessing here. Naval medical research is in my wife’s department, not mine. But perhaps they anticipate a need for such surgical capability during operations that won’t allow for returning inshore or seeking calmer conditions?

  2. Well, in the case of the JSHV, I know the ship was specifically intended to lift and/or support an Expeditionary Medical Facility. Six container spots have utilities to them. USNS Spearhead has one on it now. So maybe NRL is trying to see what else is needed? SS5 rqmt I have NO idea, since the HSV as pretty bouncy at speed.

    EMFs have been around for years. Mostly containerized subsets of a Fleet Hospital. MPS ships carry a version for sometime now – as cargo.

    • Excellent point, R. Improving technology is making advanced medical care under austere conditions increasingly feasible, accessible and successful. It also enables non-physician medical personnel to provide increasing levels of diagnostic and interventional care that were once out of their reach.

  3. Partly joking, but at the same time serious. Maybe Obama care can save the Polar Sea, or help fund another Polar Icebreaker. By voiding out the 2006 law and switching funding from NSF to the DHS, and turning it into a mobile Medical Clinic/Station for the Alaska patrols. It could service remote Alaskan coastal villages, or be stationed close by fishing areas. All the while performing its ice breaking role when needed. I know this comment probably also belongs in the ice breaker section.

    • I think we’re gonna need more icebreakers, and sooner than some think, so whatever it takes to convince Congress and the Administration to fund them . . .

  4. Train for the worst, hope for the best… I’m guessing that’s what they’re doing here. If you can perform abdominal surgery or an amputation in sea state 5 on a small ship, then you can do it in much better conditions.

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