Vigorous Warrior ’19, the largest dedicated medical exercise in the history of the Alliance, co-organized by the NATO Centre of Excellence for Military Medicine, the Romanian Armed Forces General Staff and the Romanian Ministry of National Defence Medical Directorate, was conducted 1-15 April 2019. It was a NATO Joint Multi-level and Multinational Medical Exercise, as it encompassed the simulation of actions with 38 participating NATO and Partner Nations, included various air, land and naval components and multiple echelons of the deployed units’ command structure. Furthermore, a considerable civilian component also participated in the exercise, with 10 different organizations.
After the first week of build-up and preparation, the Live Exercise part begun on the 7th of April and ended on the morning of 12 April, with a Distinguished Visitors Day scheduled also for the 12th of April. The exercise concluded with the Medical Evaluation and First Impression Report submission on the 15th, with the units redeploying from the 13th of April.
The land component (civilian and military) was situated in the Joint National Training Center in Cincu, the air components at the Romanian Air Force 71st Airbase in Campia Turzii, the naval component in the Constanta Naval Base and on the Black Sea, with multiple civilian and uniformed units in various locations in Bucharest. Strategic evacuation locations included Germany (to the Landshtul US Role-4 Military Hospital), the United Kingdom and Hungary; also, multiple Romanian hospitals took part in the in-country medical evacuation drills.
Train and evaluate the interoperability/modular approach of a joint multinational medical support system including Medical C4I (Command, Control, Communications, Computers, and Intelligence). Increasing upon the scale of Vigorous Warrior ’17, continue to train the interaction between military, civilian, national (uniformed services included), and multinational entities and Non-governmental organizations. Test the guidance to national authorities for planning for incidents involving catastrophic mass casualties. Train the Medical C4I system at all involved levels. Train the dynamic maneuverability of the medical support system. Train the continuum of care, including Strategic Evacuation. Train the preparedness and responsiveness to a possible chemical, biological, radiological, nuclear and enhanced (improvised) explosives (CBRN-E) incident. Concept Development and Experimentation (CD&E) and Transformational Activities: Conduct follow up experimentation on TRJE 18 medical Transformational Activities Train national and multinational Medical Logistic procedures. Train Combat Search and Rescue (C)SAR.
In this context, more than 300 rescue firefighters, doctors, paramedics, assistants, and volunteers supported the efforts of the Ministry of National Defense and the other states involved.
A large number of simulated events took place in several locations in Bucharest. Based on different scenarios where people were trapped under collapsed structures and unable to self-evacuate, specialized forces from the General Inspectorate for Emergency Situations and Emergency Services conducted a joint intervention for searching and rescuing victims, and providing emergency medical assistance.
A large-scale subway exercise was organized on the night 11-12 April, designed to test the specific capabilities of victim search and localization missions, assess vital functions, immobilize them and evacuate outside the risk area, transport and delivered for emergency medical assistance. In this section were involved over 200 victims, two search-rescue teams, personal transport and multiple casualties, a mobile hospital, as well as an impressive number of first-aid and mobile intensive care crews.
This sequence, which aimed at the coherent and combined action of national and multinational military and civilian medical entities, was based on a scenario on a NATO / NATO type intervention, involving the Central Military Emergency University Hospital CAROL DAVILLA, Bucharest, with 70 military doctors and auxiliary personnel, 10 ambulances, 1 truck with a generator group.
The National Center for Joint Training in Cincu
In the military base at Cincu, the firefighters supported measures to protect the civilian population by evacuating and temporarily accommodating them in mobile camps for evicted persons. This type of mobile camp is composed of an automotive kitchen, tents for accommodation and feeding, with the necessary equipment (folding beds, sleeping bags, heating, and cooling accessories for dining and lighting). At the same time, mobile campus hospitals were being deployed to complement the available resources of the militarized structures, as well as a “Get Ready” Caravan where military actions and emergency response can be simulated through the virtual reality system.
City of Constanta
In that scenario of Vigorous Warrior, IGSU crews provided emergency medical assistance to victims, with SMURD ambulances, personal transports for one and multiple victims, mobile intensive care crews, a mobile hospital, as well as oxygen therapy and hyperbaric treatments.
“Roman Square” Subway Station
70 military doctors and auxiliary personnel, 10 ambulances, a truck with a generator group from the Central Military Emergency University Hospital “Dr Carol Davila”, and the advanced ROL 1 mobile hospital was the contribution of the Ministry of National Defense to the sequence of the Vigorous Warrior 2019 exercise that took place on the night of 11th to 12th of April at the Roman Square Subway Station.
According to the scenario, at around 1.00 hours, the specialized personnel of the Ministry of Defense and the Ministry of National Affairs, respectively two search-rescue teams, transport for single and multiple victims, a mobile hospital ROL 1 for the stabilization of victims before being moved to medical units in Bucharest, as well as an impressive number of first-aid crews intervened to save about 200 victims who were caught by an explosion that took place on the subway.
The mobile hospital of SUUMC has specialized personnel and medical infrastructure of the latest generation (medical equipment and surgical instruments and intensive care, medical devices, medicines, and intravenous solutions).
Thus, the capabilities of searching, locating and evacuating the victims outside the risk area, triage of the wounded and transporting them to medical units in the Capital were tested, including the Central Military Emergency University Hospital “Dr. Carol Davila “. Also were assessed the modalities of action, in a coherent and combined manner, of military and civilian medical entities, both national and multinational, based on a NATO V / III intervention scenario.
Multinational Exercise Sea Shield 19
On its last day, Vigorous Warrior 19 was linked with Romanian-led multinational exercise Sea Shield 19, through some incidents on board the Romanian Navy frigate Regele Ferdinand. The main event was characterized by a multi-victim incident with air evacuation into Constanta Harbour, followed by the hyperbaric medical treatment provided by the SMURD (Romanian emergency rescue service) team in cooperation with the Romanian Navy medical team.
“We have a number of 18 victims, resulting from the explosion, they will gradually be discharged from the sea, will arrive in these medical facilities where they will receive primary care and are to be transferred to Constanta Military Hospital and the County Hospital,” said Major Dr. Alexandru, Surgeon General of Romanian Naval Forces. “We have a diving accident with two divers who suffered a decompression sickness. And they will be evacuated from the sea and receive treatment in the civilian mobile hyperbaric chamber at the pier in Constanta Harbour“.
Photos: IGSU, Romanian Ministry of Defense (Sergiu Iosub)