Medical

The medical problems associated with rescuing the crew in a distressed submarine are critical and complex. People may get injured by physical impact, by fi re or by breathing toxic gases. Cold water may cause hypothermia and rapid changes in pressure during rescue may cause decompression sickness. If the submarine’s support systems are out of service, the build up of carbon dioxide will cause a toxic atmosphere, and impaired hygiene may cause gastroenteritis. In a deteriorating situation large numbers of people could very quickly become severely incapacitated.

   The worst scenario in a submarine accident is if the submariners are trapped in a submarine unable to surface with toxic atmosphere and rising pressure. This is an extremely challenging situation that calls for a high degree of professional expertise and close co-operation between operators and specialist medical personnel.

   During Exercise Sorbet Royal considerable emphasis will be placed on the medical aspects of submarine escape and rescue and over 40 doctors from as many different nations will be taking part.

   The interest in this highly specialized fi eld of medical care has grown far beyond NATO, and the opportunity to train in a unique and realistic full scale rescue exercise as part of a large multi national team, will provide invaluable experience and skills which will benefi t submarine operating nations worldwide.

   There are two ways of rescuing people from a bottomed distressed submarine. If the situation is dangerous or uncontrollable, the fi rst is escape. If the distressed submarine is not too deep escapees will leave the submarine by the escape locks and be rescued on the surface.

   The second means is by rescue. If possible the crew will wait for a submarine rescue vehicle or submarine rescue chamber to come to their assistance. Reaching the distressed submarine and then transferring injured personnel if necessary under pressure into the rescue vehicles and bringing them to the surface is a most complex procedure with many specifi c medical challenges including the risk of decompression.

   Some of the injuries may be such that the medical teams have to operate either before transfer into a rescue vehicle, in the vehicle itself, or on the surface inside a decompression chamber. Preparing, prioritizing and treating the wounded takes a considerable number of medical personnel experienced in mass casualty handling, triage, diagnosis and emergency care well before casualties can be fl own or taken to hospitals ashore.

   There is no doubt that in the event of an accident, the submariners’ families, the Navy operating the submarine and the international public would all expect there to be a reasonable means for the personnel in the submarine to survive.

   Sorbet Royal 2005 will be a unique exercise bringing together some of the most experienced medical specialists in this developing fi eld. The differences in procedures, language and culture of the different nations taking part will call for the closest co-operation and teamwork in an extremely stressful environment, but the experience gained will almost certainly save lives in the future.