Advancing Expeditionary Medical Care, One Team at a Time

Story by Seaman Troy Davis

Amphibious Squadron Four

Amphibious Ready Groups (ARG) and embarked Marine Expeditionary Units (MEU) have long been ready to care for those in need, whether helping Sailors and Marines who are wounded, ill, or injured; or supporting humanitarian assistance and disaster relief operations. The Wasp (WSP) ARG-24th MEU are underway completing the final training and certification event prior to a scheduled deployment – Composite Training Unit Exercise (COMPTUEX). They are the first ARG to train with two new medical capabilities: the En-Route Care System (ERCS) and the Expeditionary Resuscitative Surgical System (ERSS). Both are designed to improve the survivability of personnel across the full spectrum of care, regardless of ship or environment, and may be activated during the 2024 ARG/MEU deployment.

Within the WSP ARG, both ERCS and ERSS are led by Fleet Surgical Team (FST) 4, an embarked medical command-and-control element that delivers care on demand in combat and non-combat situations.

FST 4 is a team of 18 officers and enlisted personnel who provide medical care across the WSP ARG-24th MEU. Specifically, they provide damage control surgery, meaning they can take a patient who is critically injured and stabilize them onboard the USS WASP until they are moved to a facility with more specialized care, such as a shore-based hospital.

“The biggest reason we brought these programs into play is to make [expeditionary medical care] more effective,” said Cmdr. John Saenz, the Officer In Charge of FST 4. “The ERSS is capable of going ashore anywhere, or afloat on any platform; while the ERCS is capable of stabilizing patients with special training and equipment from the point of injury to the ship via helicopter – something that FST 4 didn’t previously have the capability to do without limiting our own capabilities on our medical teams.”

ERCS provides a ready, rapidly deployable and combat effective medical force, consisting of a two-person team with mobile equipment that supports medical care for up to two critically injured or ill patients. They can provide medical care for up to eight hours and can transport patients via a variety of means, such as: rotary wing air craft, tiltrotor aircraft, landing cushion air craft (LCAC), rigid hull inflatable boat (RHIB), and ground transport.

Hospital Corpsman 3rd Class Elisha Rodgers is a trained Search and Rescue Medical Technician on the ERCS team training with FST 4 aboard the amphibious assault ship USS Wasp (LHD 1), the flagship of the WSP ARG-24th MEU. “The En-Route Care System is still in its infancy,” said Rodgers. “Our goal is trying to network with our Sailors and Marines, in order for them to know [members of the ERCS team] are trained and highly capable people who are ready to respond if something happens.”

The first ERCS deployed with the Nimitz-class aircraft carrier USS Dwight D. Eisenhower (CVN 69) in support of the currently deployed Dwight D. Eisenhower Carrier Strike Group (CSG). Despite the protocols existing for more than a decade, ERCS was only recently implemented as a program of record. Working within the ARG-MEU construct will provide new challenges for the team, but it is a natural and needed step in making Navy expeditionary and afloat medicine more capable.

“The reason behind the development of these programs is to better equip the WSP ARG-24th MEU with the capability to move causalities without degrading other teams that are in place, such as the Fleet Surgical Team that is on board,” said Lt. Rebecca Smith, the ERCS critical care nurse assigned to FST 4.

“The goal is for ERCS to be ready for any mission, whether that is pushing forward to provide a more advanced level care closer to point of injury, or providing transport to the next level of care after the casualty has been stabilized on the ship,” said Smith.

Another unique piece of the WSP ARG-24th MEU’s medical readiness is the Expeditionary Resuscitative Surgical System. The ERSS team, embarked aboard the San Antonio-class amphibious transport dock USS New York (LPD 21), consists of a seven-person team designed to be scalable and highly mobile. They provide support to missions anywhere and aboard any platform with mobile equipment that supports damage control surgery. In contrast, the ERSS provides damage-control resuscitation and surgery for up to four critically injured or ill patients and six non-critical patients until safe transfer can occur.

Aboard New York, Navy Capt. Sean Conley, the officer in charge of ERSS Alpha, highlights his team’s ability to be flexible no matter what setting they are in.

“We bring subject matter expertise in critical care and prolonged casualty care, “said Conley. “The ability to manage sick or injured patients in remote locations, with limited resources for longer than traditionally intended, is our job.”

The ERSS team aboard New York is a diverse team, including members from various medical commands. Prior to coming aboard New York, they came together for four weeks of training and preparation for anything deployment may throw their way.

“This team is comprised of members from Walter Reed Naval Military Medical Center, Naval Medical Center (NMC) Portsmouth and NMC Camp Lejeune,” explained Conley. “We first came together in January where we spent three weeks out at the [Navy] Trauma Training Center in Los Angeles, followed by a week at the Naval Expeditionary Training Institute at Camp Pendleton. While in LA, we got ‘reps and sets’ on real life trauma patients, and discussed some of the practical aspects and limitations of the equipment and locations we may operate within.”
While Conley admitted he does not know what future tasking may bring, he expressed that his team and their goals will not deviate.

“My three major goals for the team are: One – [to have] a familiarization with the LPD’s mission and medical department, and the ARG-MEU’s mission and capabilities. Two – to determine how and where the ERSS can provide support to those missions; and three – to educate everyone we can on who we are and what the ERSS brings to the table, helping smooth future teams’ integrations and incorporation into mission-planning.”

ERCS and ERSS are both highly capable teams determined to educate the wider Navy and Marine Corps on their capabilities and how they plan to tackle challenges presented to them. These teams are masters in their field, rising to a new standard as they prepare to support the WSP ARG-24th MEU on their upcoming deployment.
As the old phrase says, “train as you fight.” As WSP ARG-24th MEU’s COMPTUEX nears completion, the ERCS and ERSS teams are in their corner, ready to step into the ring.

Wasp and New York are underway in the Atlantic Ocean as part of the WSP ARG-24th MEU completing integrated naval training. For more information on the WSP ARG-24th MEU visit: https://www.dvidshub.net/feature/wasparg24thmeu

The WASP ARG consists of the Wasp-class amphibious assault ship USS Wasp (LHD 1), San Antonio-class amphibious transport dock ship USS New York (LPD 21), Harpers Ferry class dock landing ship USS Oak Hill (LSD 51), and embarked 24th Marine Expeditionary Unit (MEU).

The 24th MEU is a Marine Air-Ground Task Force (MAGTF) with a command element, Aviation Combat Element (Medium Marine Tiltrotor Squadron 365 (reinforced)), Ground Combat Element (Battalion Landing Team 1/8), and Logistics Combat Element (Combat Logistics Battalion 24).