Photo By Cpl. Ryan Schmid | U.S. Navy Lt. Cmdr. Marissa Mayor, a general surgeon with 2nd Medical Battalion, 2nd...... read more read more
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RIO DE JANEIRO – Tucked away in the coastal jungles of southeastern Brazil, the corpsmen and medical officers with 2nd Medical Battalion, 2nd Marine Logistics Group were hard at work testing and developing an innovative medical concept for a Role 2 light maneuver element organic to the Marine Corps.
In accordance with Joint Publication 4.02, Joint Health Services, and the requirement for Role 2 care, a Role 2 light maneuver (R2LM) element is capable of bridging the gap between traditional Role 1 and Role 2 facilities, providing surgical and resuscitative capabilities to company sized units in austere environments.
Role 1, first responder care, capabilities are organic to the unit and provide care at the point of injury. Role 2, forward resuscitative care, capabilities exist to stabilize the patient by providing damage control resuscitation and surgical intervention until the patient can be moved to a higher echelon of care. The current Role 2 capability in the Marine Corps requires a large logistical footprint and is not classified as “a light, highly mobile medical unit” and therefore not structured to support future operations.
“What the Marine Corps currently uses, the Shock Trauma Platoon/ Forward Resuscitative Surgical System, consists of 45 personnel, fills over 20 Quadcons, and uses multiple large tents to house the facility once it’s set up,” said Lt. Cmdr. Marissa Mayor, a general surgeon with 2nd Medical Battalion.
The system was developed and perfected during the Global War on Terrorism, with the idea of operating under the “golden hour” standard of transporting a trauma patient from the point of injury to the operating table within one hour.
“Obviously, [the STP/FRSS has] a lot of people and gear for our smallest surgically capable asset,” said Mayor. “If Marines and Sailors are to be operating in small, mobile, low signature elements, the STP/FRSS simply has too large of a footprint to be feasible with [Force Design 2030] concepts,” she added.
Role 2 lifesaving and patient sustainment capability is particularly important to the Marine Corps for support in austere locations in and throughout the littorals. The current gap for a R2LM capability presents a problem to force employment concepts in the future operating environment.
Mayor is no stranger to big problems given her occupation as a surgeon. Correspondingly, she is also no stranger to fixing them. That is why she and her colleagues are working diligently to experiment, test and field new R2LM systems in partnership with the Marine Corps Warfighting Laboratory.
“[2nd Medical Battalion is] working on a surgical capability for Force Design 2030, one answer, the smallest answer for the Marine Corps,” said Mayor.
The answer she is referring to is the experimental Tactical Scalable Surgical System (TS3).
“TS3, as we have it now, is entirely man portable within 9 packs, and is capable of bridging the gap between traditional Role 1 and Role 2 facilities,” said Mayor. “[Compared to the STP/FRSS,] TS3 has similar capability, but it does have reduced capacity.”
The experiment will identify the smallest possible surgical capable team and scale up from there, according to Mayor. If trucks are available for use, they enable the TS3 team to carry more equipment and improve overall capacity.
TS3 is designed to operate in a contested environment, which is perfect for Force Design 2030’s refinement and implementation of distributed operations that directly places Marines into those situations.
Within a contested environment, medical evacuation via air may not be possible. The minutes spent transporting a trauma patient are vital; in a study of a civilian trauma system, patients with penetrative and hypotension injuries that most closely resemble combat injuries need to be in the operating room within 19 minutes in order to save 95 percent of patients, according to the “Journal of Trauma and Acute Care Surgery” cited by Mayor.
TS3 aims to reduce the distance between the point of injury and the operating room. Being highly maneuverable, TS3 can be brought closer to troops in combat, providing casualties with life-saving surgery with a smaller logistical footprint.
“The goal of TS3 is to get smaller,” said Mayor. “We are aiming to be able to provide commanders with more options; scalable, maneuverable, adaptable options.”
Obviously, any commander would choose the largest, most capable medical facility for their troops, but with the Marine Corps' commitment to distributed operations within the enemy’s weapon engagement zones, insertion, resupply, and medical evacuation cannot be guaranteed. Transportation to a dedicated Role 2 facility immediately after sustaining a casualty may not be possible. TS3 is intended to be a smaller option for commanders when larger systems are unavailable, according to Mayor.
“With the capability to hold patients and perform damage control surgeries close to the point of injury, and quickly after sustaining injuries, we have a higher chance of saving that patient’s life,” said Lt. Cmdr. Nathan Butler, an emergency physician with 2nd Medical Battalion.
Butler said TS3 also has the capability of holding patients after injury who would be waiting transfer to higher echelons of care. Patients requiring additional or specialized care must be medically evacuated due to the limited scope of a R2LM element. TS3 aims to hold patients until that medical evacuation opportunity presents itself.
“In a contested environment, similar to what we’re seeing with the conflict in Ukraine, resupply and medical evacuation isn’t always possible, but there are times it is,” said Butler. “The goal is that TS3 should be able to hold and stabilize critical patients until they can be moved to a higher level of care.”
Butler stressed TS3 is not to replace a dedicated Role 2 capability like the STP/FRSS, but to compliment it and act as a bridge between Role 1 and Role 2 facilities.
Sailors with 2nd Medical Battalion used exercise UNITAS LXIII in Rio de Janeiro and other locations in Brazil to test and improve their experimental concepts for the R2LM capability. The TS3 rehearsed during UNITAS informs and refines Role 2 requirements in support of Marine Corps operations, which will result in a task-organized asset with the ability to be scaled or adapted for real-world missions.
UNITAS is the world’s longest-running annual multinational maritime exercise that, this year, brought together forces from 19 countries to include Brazil, Cameroon, Chile, Colombia, Dominican Republic, Ecuador, France, Guyana, Jamaica, Mexico, Namibia, Panama, Paraguay, Peru, South Korea, Spain, the United Kingdom, the United States, and Uruguay. The exercise focuses on enhancing interoperability among multiple nations and joint forces during littoral and amphibious operations in order to build on existing regional partnerships and create new enduring relationships that promote peace, stability, and prosperity in the U.S. Southern Command’s area of responsibility.
In addition to strengthening partnerships in region, U.S. Marine Corps Forces, South utilizes these training and readiness opportunities to advance innovation and experimentation concepts for the service and joint military communities.
“Here at UNITAS, we were able to demonstrate the feasibility of what we’ve come up with for TS3,” said Butler. “We’ve shown it’s entirely feasible for us to do a lot with the small nine-person team.”
Butler explained the team was inserted via a MH-60S Sea Hawk helicopter and a landing craft, utility, and was able to successfully complete patient scenarios in improvised surgical suites. This included one scenario where the team fabricated an operating room and demonstrated a surgical capability inside a Brazilian M113 armored personnel carrier in four minutes and 27 seconds.
Butler also stressed the importance of integrating the TS3 concept with the medical department aboard the amphibious transport dock ship USS Mesa Verde (LPD 19), the flag ship of Special Purpose Marine Air-Ground Task Force UNITAS LXIII during the exercise.
Mayor believes the TS3 concept is a step in the right direction for the Navy and Marine Corps team and hopes to see it come to total fruition and ultimately save lives.
For the future of TS3, Mayor explained, “[Our next step with TS3] is to begin providing Role 2 capability to Marine Corps exercises within the next one to three months, and over the next six months to a year to further develop mission capabilities in parallel and specific to Force Design 2030.”
| Date Taken: | 09.20.2022 |
| Date Posted: | 09.29.2022 15:18 |
| Story ID: | 429590 |
| Location: | RIO DE JANEIRO, RIO DE JANEIRO, BR |
| Web Views: | 1,025 |
| Downloads: | 2 |
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