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NATO Staff Maritime Medical CourseLO-3 Manage the Recognised Maritme Medical Picture

RECOGNIZE HEALTH THREATS

CAPT Jeffery Paulson and CAPT Frank ChapmanUS Fleet Forces Command and US NAV EUR

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Recognize Health Threats

IntroductionObjectives

Anticipate ThreatsPrepare to preventPrepare to respond

Summary

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Initial Data to Recognize Health Threats

Planned operational environmentCombatNon-Combat

Know the POEOperations at SeaOperations on ShoreEngagements ashoreLiberty

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Medical Intelligence and the Threat Assessment

ALLIED JOINT MEDICAL DOCTRINE FOR MEDICAL INTELLIGENCE, AJMedP-3

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Planned Operational Environment

Questions to ask: Who is going?What are they doing?When are they going?Where are they going?How are they doing it?

Open-ended

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Threats Afloat

War Damage from Combat ActionsMines, Missiles, Explosives

Sea EnvironmentStorms and Sea StateCollisions at SeaGroundingsMan Overboard

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Combat

Opposing forces Conventional Warfare

Small ArmsExplosives

Asymmetrical WarfareIEDs

Ashore vs Afloat

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Environmental

Heat and ColdSmoke and Inhalation injuriesChemical ContaminationAnimal Bites – Rabies, InfectionSnake Bites – VenomMarine Animal Bites and Venom

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Alcohol and Illicit DrugsPrescribed Drugs Operational Stress

Behavioral Threats

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Non Combat Trauma

MVA’sMotorcycle – ScootersBoatingOther Recreational Activities

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Health Risks – Biological

Infectious diseaseFood Borne illnessesSafe Food and Water are critical

Disease can degrade a fighting force quickly and for a prolonged time

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Infectious Disease

Pandemic Illness Influenza as exampleSARS and others

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Food Borne

Food SourcesFood Acquisition Policy

Food HandlingFood Storage (frozen, chilled, dry)Food Preparation (hepatitis and other

human vector disease)

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Vector Borne

Port callsTravel or Deployment Ashore

Malaria, Rabies, Dengue, JEV

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Operating Environment at Sea

INDUSTRIAL HIGH RISK ENVIRONMENT

High Risk Evolutions:Underway ReplenishmentVertical ReplenishmentRe-fueling at SeaCargo and personnel transfer

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Occupational Safety

Electrical WorkSmall Boat OperationsHelicopter OperationsFuels, Including Otto Fuel IIFiresWelding, Cutting, BrazingMachinery maintenance and operationsHeavy Weather Operations

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Ship Distress at Sea

Abandon ship – Immersion Injuries

Oil on SeaBurning Oil Fire

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Survival in the Water

Windchill Non freezing cold injury Freezing cold injury Heat illness and sunburn Seasickness in the life raft Osmotic Diarrhea Oil Contamination Skin Ulcers Toxic Chemicals Triage of Survivors Psychological considerations

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Urgency

Balance: Risk to SailorThreats

Urgency vs Operational Tasking

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Biological Chemical and Radiological

Ship capabilities?Detection of exposureConfirmation of agentAir boundariesCountermeasures - washdown?Treatment

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Stress Management

Management of critical stress and traumatic stress

Stress reactions, PTS, Suicide Resources?

Medical, Chaplain, Chain of Command, Friends

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Threat Assessment Summary

Threat Analysis can provide the commander information critical to mission accomplishment.

Mitigation of potential threats increases chance of mission success.

Medical threats are a critical piece of a proper threat analysis and must not be overlooked in mission planning.

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Helge Barstrand, Cdr SG, NOR Navy, MSc, KCLJ,(N43) Branch Head Medical, Medical Plans & Concepts, MC Northwood UK

+44 (0) 1923 956 675 Email: h.barstrand@manw.nato.int

Questions?