'Amphibious MASH' - HMAS Kanimbla's Primary Casualty Reception Facilities
24 August 2009
The 1970's hit television program M*A*S*H, (Mobile Army Surgical Hospital) was about the escapades of a group of US Army medical personnel during the Korean War. Even though it was a comedy, the show also presented a serious side, including the unwavering dedication of its doctors and nurses in difficult circumstances.
In many respects Navy’s Primary Casualty Reception Facility (PCRF) operates like MASH. It is mobile, receives patients via helicopter, has surgical capabilities, hospital facilities and many of its members have civilian careers but work for Navy as Reservists.
The major difference is that while MASH was land based, the PCRF operates 'on water' from HMAS Kanimbla, (Commanding Officer, CMDR Tim Byles). The ship has the best medical facilities of any vessel in the Royal Australian Navy. In fact, Kanimbla has Level 3 PCRF capabilities (the highest), and is therefore qualified to provide surgery and intensive care support.
According to PCRF Senior Medical Officer, CMDR Ian Young, an Orthopedic Surgeon, whether Kanimbla is involved in a conventional conflict, peacekeeping operations or humanitarian aid, the quality of medical care his team provides is consistently of a high standard.
"It doesn't matter to us in what circumstances a person becomes sick or injured. What matters is that we are able to provide the best possible medical care, so that their condition can be stabilized as soon as possible," said CMDR Young.
To ensure that the PCRF is up to scratch, their facilities and patient care is benchmarked against NATO standards. By doing this, Navy can be confident that its medical care matches 'worlds best practice', a comforting thought for the men and women of the Australian Defence Force who one day may need to rely upon the PCRF.
Providing this specialist care requires a large number of medical personnel with a broad range of skills to be assembled and rigorously trained. With around fourteen different types of medical professionals, from Basic Medical Assistant through to Specialist Doctors, ensuring genuine 'interoperability' within the team requires regular practice.
The recently completed exercise Talisman Saber 09, presented a great opportunity for the PCRF to be 'put through the hoops'. Over a three week period in July, twenty six members of the team undertook daily practice on land, in the air and at sea, to make sure they would be ready, willing and able to meet any future demands.
The PCRF is broadly divided into three areas and members of the team are allocated to each section according to their particular skills. During a medical emergency, the PCRF will be activated after being directed by an overarching medical coordinator, the Casualty Regulating Cell, to receive wounded or injured personnel. From this point on, the PCRF swings into action, beginning with the Aero-Medical Evacuation (AME) team.
Consisting of an Emergency Doctor, Critical Care Nurse and Clinical Manager, the AME will fly to the required area in a helicopter, assess each of the injured, and ensure that the most serious cases were evacuated first.
On arrival on board Kanimbla, the helicopter will be met by a Triage Manager, usually a Surgeon, who will be responsible for allocating each case to one of the Resuscitation Stations. Each station consists of a Doctor, Nurse, Clinical Manager and Advanced Medical Assistant and their role is to prepare the most serious cases for surgery, placement in the High Dependency Unit, or provide general medical care to less serious cases.
According to CMDR Young, "For those cases requiring surgery, we have one dedicated operating theatre with a potential to upgrade to two. We also have an intensive care recovery unit, so our ability to assist those seriously ill or injured is very advanced."
After the patient's condition has been stabilised, transfer to other on shore medical facilities for further treatment and recuperation occurs, thereby allowing the PCRF to receive new cases.
"The PCRF is a great example of the sophisticated way Navy is able to deal with a mass casualty situation, and this is why our expertise was so important to the recent peacekeeping and humanitarian aid missions in East Timor, the Solomon Islands and Indonesia," said CMDR Young.
Even with a contribution of permanent Royal Australian Air Force personnel, who generally provide pathology and radiology services, the PCRF still relies heavily on Reservists from all services, making up to half of the medical complement.
The Officer in Charge of PCRF, LCDR Don Jamieson says, "Their value is much more than in making up the numbers. Naval Reservists bring with them irreplaceable experience, having worked for many of Australia's largest tertiary hospitals. Our aim is to provide first class care so having personnel from first class civilian hospitals in the PCRF is vital to our continuing success."
