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NEWS | June 18, 2024

Mass Casualty Exercise Increases Medical Readiness, BALTOPS 24

By Lt. Mckensey Cobb, USS Wasp Public Affairs

American, Dutch, and Spanish Sailors and Marines conducted simultaneous medical drills between time zones and geographic boundaries aboard their vessels across the Baltic Region, during exercise Baltic Operations 2024 (BALTOPS 24), June 14, 2024.

The amphibious assault ship USS Wasp (LHD 1), the San Antonio-class amphibious transport dock ship USS New York (LPD 21), the Royal Netherlands Navy Rotterdam class landing platform dock ship HNLMS Johan de Witt (L 801), the Spanish Navy aircraft carrier Juan Carlos I (L 61), and the 24th Marine Expeditionary Unit (MEU) Special Operations Capable (SOC) conducted a simulated mass casualty event to exercise medical readiness, response and interoperability demonstrating coordination and cohesiveness across the joint and Allied force.

The drill allowed the ships’ medical teams to practice the type of medical readiness critical for sustaining operations in theater, and showcased their ability to provide a higher echelon of care to Sailors and Marines, regardless of nationality.

It began with several role players simulating injuries aboard the Johan de Witt and the New York. Once the medical teams on board determined a need for a higher echelon of care, the ships walked through the process of conducting medical evacuation (MEDEVAC) flights to Wasp and Juan Carlos I, respectively, although no aircraft were used to physically transfer patients from one ship to another.

On board Wasp in the Kattegat Straits, “This is drill, this is a drill. Medical emergency, medical emergency inbound to the flight deck,” the call sounded over the ships announcing system, warning the crew of an inbound casualty. “Personnel in the vicinity, draw first aid supplies and render aid. Away the medical response team; stretcher-bearers lay to the scene!”

Role players with realistic makeup and prosthetics lay on stretchers on the flight deck, pretending to be the patients sent from Johan de Witt. Within minutes, stretcher-bearers and initial responders arrived and began initial medical interventions, such as checking patients for injuries that may prevent them from being moved and ensuring no further injuries occurred during the simulated transfer. Once the team determined all patients could be moved without harm, the stretcher-bearers carefully lifted their charges and descended the ramp from the flight deck down to ship’s medical triage for the second portion of the drill.

With practiced ease, the medical team in triage received patients in an orderly fashion, assessed injuries, and transported patients to operating rooms for intensive care as the drill progressed.

The drill overall represented the transition between “Role 1” and “Role 2” echelons of care in a maritime environment.

“As a Role 2 care ship, Wasp’s ability to provide medical services to patients is second only to the Military Sealift Command hospital ships, USNS Mercy and USNS Comfort,” said Cmdr. John Roman, Wasp’s senior medical officer,

The term "Role" or "Echelon" is used to describe the classification of the four tiers in which medical support is organized. Care begins at Role 1 with first responder (self-aid/buddy aid and combat lifesaver), rapidly progresses through Tactical Combat Casualty Care (TCCC) and advanced trauma management, to stabilizing surgery. The final echelon, or Role 4, involves transporting the patient to a higher form of critical care, usually received at a land-based hospital facility.

“The Wasp’s primary [medical] mission is to connect patients from lower echelons of care to higher,” said Roman. “Our incredible medical team is highly trained and highly capable of sustaining the continuum of care for any patient we treat.”

BALTOPS 24 has two Role 2 care ships participating in this year’s exercise: Wasp and Juan Carlos I. Role 2 care provides advanced trauma management and emergency medical treatment including continuation of resuscitation started in Role 1. Ships with this ability can receive patients and provide basic secondary healthcare, which includes primary surgery, an intensive care unit, and availability of ward beds.

Wasp’s medical team, supplemented by the embarked Fleet Surgical Team 4, is able to stabilize post-surgical cases for evacuation to Role 3 or Role 4 facilities without having to route them through an intermediate facility. Role 4 care takes place when a patient either needs care from specialized staff, or care for more extended periods of time than are sustainable at sea.

“There’s a saying in operational medicine,” said Roman. “‘You have to work with what you’ve got.’ When what you’ve got is the Wasp, you’ve got a lot to work with.”

Wasp is underway in the Baltic Sea in support of BALTOPS 24 as the flagship of the Wasp Amphibious Ready Group and embarked 24th MEU (SOC). BALTOPS is an annual, multinational exercise designed to enhance interoperability and demonstrate NATO- and partner-force resolve to defend the Baltic region. The exercise will test the flexibility of joint forces in order to strengthen the combined capabilities necessary for immediate maritime crisis response and regional stability.

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To learn more about WASP ARG and 24th MEU “Team of Teams,” visit their DVIDS feature page at