NEWS | April 11, 2019

Field emergency room drill at Vigorous Warrior 19 affirms interoperability, relationships between Swedish and U.S. Navy counterparts

By 1st Lt. Andrew Layton, USAFE-AFAFRICA Public Affairs

Medical specialists from U.S. Navy Forces Europe-Naval Forces Africa (NAVEUR-NAVAF) staged a unique field emergency room drill with counterparts from the Swedish armed forces Wednesday during exercise Vigorous Warrior 19, Cincu Military Base, Romania.

The scenario, which integrated U.S. Navy personnel into operations of a Swedish field hospital (termed a “Role 2” facility under NATO doctrine), exemplified the unique opportunity Vigorous Warrior provides to test multinational cooperation in a dynamic environment.

Vigorous Warrior is a biannual readiness event organized by the NATO Military Medicine Centre of Excellence, headquartered in Budapest, Romania. With over 2,500 participants, Vigorous Warrior 19 is NATO’s largest-ever medical exercise.

“This morning we had a simulated blast injury that was a critical patient with significant trauma,” said Cdr. Corey Gustafson, emergency room physician, U.S. Navy Hospital, Naples. “Based on what we were seeing in the trauma bay, I consulted with my Swedish colleague who agreed to bring the patient into the operating room. After that, our U.S. anesthesiologist and surgical technician went with the Swedish surgeon into the operating room and operated on the case.”

According to Gustafson, the drill was a teachable moment for counterparts from very different backgrounds.

“For me as a provider, there were several things this morning that will ultimately help increase my scope of care,” Gustafson said. “I learned new things about centralized points of access for intravenous therapy (IVs); also seeing how the Swedes are interoperable within their own trauma team, to the point that even their doctors know how to run the x-ray machine -- this concept was something that was very new to us.”

After the drills were complete, the rapport forged between Gustafson and his counterpart, Capt. Martin Stenerös, trauma surgeon, Swedish armed forces, was evident.

“Working together, communicating with each other hasn’t been any problem whatsoever,” Steneros said. “I worked with both Corey and the American intensive care nurse very well, although there were different nuances in our techniques which I think were very good to learn from.”

What made the scenario even more unique was that it was planned with almost no notice. Only the day before had Gustafson first reached out to the Swedish team on a whim.

“On my father’s side, I’m Swedish, so I naturally I had a curiosity and I wanted to come visit the Swedish Role 2 tent here at Vigorous Warrior,” Gustafson said. “I asked my Swedish colleagues if they were amenable to us augmenting them since this is a concept that we’re looking at developing in the NAVEUR Theater, and they were very open to working with us.”

Before Wednesday’s drills began, Gustafson and his team of 11 Sailors had time only for brief introductions and a tour of their Nordic partners’ Role 2 facility. For Gustafson, the fact that the cooperation was agreed upon at the spur of the moment added its own value to the experience.

“To me, this is a demonstration of dynamic force employment in what I think was a very realistic scenario,” Gustafson said. “It proves that at NAVEUR-NAVAF, if we were to have a Role 2 light maneuver-like capability, we could augment NATO forces or partner country forces with agility and be very effective with very short notice.”

The experience was so positive for the combined team that when the first blast injury scenario was complete, the U.S. personnel continued working with the Swedes for six more casualty drills and planned to work together again the following day.

“After the first scenario, we realized that we operated very similarly, so we decided to integrate teams,” said Gustafson. “We had two teams led by a Swedish surgeon with two Americans; meanwhile, I followed Martin around and tried to maintain an overall cognizance of patient flow.”

Together, the multinational team also practiced the aerial evacuation of a critically-wounded patient to a Role 3 facility for secondary surgeries.

Beyond its value from as a professional exchange, Wednesday’s scenario illustrates the strategic value of multinational exercises in rehearsing the overall coordination between allies and partner militaries in times of crisis.

“What we did today with our partners from the U.S. shows what we can do together, with a few extra hands,” said Stenerös. “It’s nice to know we can help each other in a situation where we may need to work together in the real world.”