Surgical Suite Aboard a Small Ship

Around mid-January, there was a flutter of news that the Spanish frigate ESPS Méndez Núñez (F-104) was in Norfolk and will be integrated into the USS Abraham Lincoln (CVN-72) Carrier Strike Group until November of this year. A review of the ship’s history on Wikipedia shows that since her commissioning in 2006, she has been quite active in international anti-terrorism and anti-piratical activities.

What’s medically interesting about the ship (which, according to an article in USNI News, is being showcased by Spanish shipbuider Navantia to the U.S. Navy, presumably as a possible candidate for its FF(X) future frigate program) is that it has what looks to be a basic surgical suite instead of a simple sick bay.

Sickbay / Operating Suite Aboard ESPS Méndez Núñez (F-104). (USNI News photo)

The ship also has a separate space to accommodate four sick or injured sailors. She typically carries a physician and a nurse when deployed, according to the USNI News article.

This kind of medical space is pretty unusual in a small unit like a Frigate. I recall that the sickbay in my Adams Class guided missile destroyer – I was the staff medical officer for Destroyer Squadron 15 – was no larger than a large closet. Sure, one could evaluate sick sailors there (physical diagnosis only; no Xray or lab) and perhaps do minor surgical procedures such as suturing wounds or draining abscesses, but there was no room to do something as basic as an appendectomy (the crew’s mess deck, a much larger space,  could be fitted out for surgery, but this was intended for combat casualty care, and doing even simple appendectomies was officially discouraged). Most U.S. small units don’t rate medical officers unless they are squadron flagships (and I’m not sure even these ships rate a physician these days). Independent duty corpsmen, specially trained to be the sole “Medical Department Representative” serve on these smaller ships, and have proven to be most capable for tending to the minor surgical and medical needs of the crew. Sailors with more serious problems are typically medically evacuated to an amphibious ship, aircraft carrier, hospital ship (all of which carry qualified surgeons, or would in a potential combat situation) or a facility ashore.

So I’m not sure the operating room in Méndez Núñez would be all that useful. Surely, for instance, there is no way laparoscopic work (the clear trend in abdominal and chest surgery not related to trauma) could be performed in that space. It would be interesting to learn what the Spanish experience has been.

©2019 Thomas L Snyder

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  • Paul Sayles.  On 29 Jan 2019 at 04:34

    I imagine that the skill level of the doc is one determining factor. If he is fresh from medical school/newly commissioned, it might not be that useful. If the doc is more seasoned it might be useful for minor surgeries, I&Ds, circs, various lacerations and maybe a bit of plastic surgery. I`d be worried if the doc were to attempt something more ambitious such as a lap or appendectomy. Likewise the nurse assigned – hopefully they would be ER or OR inclined.

    The old Hamilton Class WHECs had a doc (USPHS) aboard at first and the ship was equipped with an x-ray unit. Both were later removed in favour of IDCs and no x-ray capability. When I was doing training assessments in BOUTWELL and other WEHCs of that class, the remnants of the x-ray unit were still in visible.

  • southpoledoc  On 04 Feb 2019 at 03:46

    Hello Tom,

    Interesting article! When I was U.S. 5th Fleet Surgeon (2008 – 2010) we had an 8-person surgical team with transportable equipment called the Expeditionary Resuscitative Surgical System (ERSS) designed to provide damage control surgery in case we had some casualties during our counter-piracy operations. They could basically go aboard a small ship and covert any room with running water and electricity into a surgical suite. We had two teams; one in the Red Sea and one in the Arabian Sea.

    I suspect the Spaniards realize the need for a bigger team (Surgeon, OR tech, Anesthesia, Emergency Medicine doc, etc.) for anything more than relatively minor procedures. A decent blood supply for trauma and medevac assets with long enough “legs” were always a concern when operating in areas a long distance from “friendlies.”

    Best regards,
    Dale Mole’ (from Kathmandu)

    • thomaslsnyder  On 04 Feb 2019 at 07:15

      Thanks for this informative comment. One hopes the Spaniards’ planning is enlightened. As for blood supply, my friend Helmer (Scott) Huseby, then CO of our Navy’s first field hospital in Vietnam, relates as to how no blood banking program existed at the time so he had to institute a “walking blood bank” program – that is, a database of all personnel blood types so people with needed types could be called in for what would essentially be “warm transfusions” – until the Navy put a banking system in place. Did you have that capability as a back up?
      Best to you in Kathmandu!

  • Boris  On 16 Jul 2019 at 09:42

    Doc thank you for your post. I served both as a Surface IDC 8425 and 8404 Recon IDC, currently I am a Master on top of being a MEDPIC aboard a commercial vessel. I am always in awe of how much we did, and do without any “fancy” equipment what a great sense of relief when I can pass my casualties up stream. (I am always humbled by the trust our chain of command gave us to provide care for our shipmates). Most my practice is still out of a box and in the galley, though my iPad is my go to instead of my many reference books, so much for the 21st century lol, again thanks for your writing and posts.

    • thomaslsnyder  On 16 Jul 2019 at 09:51

      Boris, I can tell you that I and all of my colleagues hold Independent Duty Corpsmen in absolute highest esteem, right up there with your shipmates who go out with the Marines. You are the quiet and mostly unsung heroes of the Navy Medical establishment. Bravo Zulu for what sounds like an interesting retirement activity!

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