Partial exercise: Role2Sea

Mine strike resulting in a mass casualty incident on the high seas. This kind of scenario requires close cooperation between the Navy, the Bundeswehr Medical Service and civilian hospitals. Exercise Role2Sea brought them all together to train the provision of medical support in the Baltic Sea and onshore after a large-scale emergency. This part of the Quadriga 2025 exercise series focused on robust medical evacuation chains and civil-military cooperation. 

Western Baltic Sea. Alert on Mine Countermeasures (MCM) Drone Controller “Pegnitz”. A voice calls over the loudspeakers: “Exercise, exercise, exercise: Mine strike! Casualties and fire on board!” This is the signal for the start of the Role2Sea exercise in the western Baltic Sea. Casualty care and firefighting and damage control require the entire crew of the “Pegnitz” to take immediate action in unison. Tender Werra rushes to provide assistance - and is also hit by a mine, resulting in a mass casualty. Combat Support Ship (CSS) “Frankfurt am Main”, which also forms part of the naval task force, initiates the medical evacuation chain. The ship is equipped with an integrated mobile naval surgical hospital (German: Integriertes Marineeinsatzrettungszentrum, or i-MERZintegriertes Marine Einsatzrettungszentrum). This is where casualties can receive the best possible initial medical care.

Medical evacuation gets going

As soon as reports start coming into the combat information centre of the combat support ship, the crew turn to organising the evacuation of casualties. Heavy swells prevent a fast transfer of the seriously injured casualties by boat to the nearest port. The Commanding Officer of CSS “Frankfurt am Main”, Commander Sebastian Fliege, issues orders to request available means of transport from the Air Rescue Coordination Centre in Glücksburg. Their staff alert the Central Command for Maritime Emergencies in Cuxhaven.

Naval Air Wing 5, 10 Transport Helicopter Regiment of the German Army and the Federal Police provide helicopters to evacuate the casualties to the “Frankfurt am Main”. Some of them are directly taken to civilian hospitals in Kiel and Rostock. Commander Fliege positions his ship to smooth the waves for the arriving boats and ensure the safe embarkment of casualties in the shelter of the lee side of the CSS.

The mobile naval surgical hospital is a permanently installed component of CSS “Frankfurt am Main”, and includes trauma rooms, two operating theatres and a 40-bed ward. The Role 2 treatment facility covers various medical specialties ranging from preclinical treatment, laboratory services, x-ray diagnosis, pharmaceutical services, anaesthesia, surgery and intensive care to dental treatment. The medical officers of the Bundeswehr Joint Medical Service and their nursing and paramedical personnel on board provide medical treatment and care to the victims. A pharmacist is also part of the team. Twenty Medical Service officer candidates and ten members of the Petty Officer School wearing moulage makeup play the part of the casualties, following individual scripts to simulate severe brain, burn and other injuries.

While medical personnel are busy administering initial treatment to the casualties on board, the “Frankfurt am Main” sets course for Rostock. Teams have been assembled for a mass casualty incident at two civilian hospitals in the city. Ambulance vehicles provided by the Rostock Fire Department are already waiting at the Warnemünde Naval Arsenal. As soon as the ship arrives at the port, two intubated patients with traumatic brain injuries and massive burns are carefully carried down the gangway. They are transferred to ambulance vehicles taking them to the Rostock University Hospital and the “Klinikum Südstadt” hospital. As the medical director of the integrated emergency centre at the “Klinikum Südstadt” hospital, Jan-Arne Lauffs, points out: “Exercises such as these are extremely important to build a sustainable network and promote cooperation based on mutual trust. The exercise scenarios help us to identify weak spots, and thus, to avoid mistakes in an emergency.”

The mobile naval surgical hospital is a permanently installed component of CSS “Frankfurt am Main”, and includes trauma rooms, two operating theatres and a 40-bed ward. The Role 2 treatment facility covers various medical specialties ranging from preclinical treatment, laboratory services, x-ray diagnosis, pharmaceutical services, anaesthesia, surgery and intensive care to dental treatment. The medical officers of the Bundeswehr Joint Medical Service and their nursing and paramedical personnel on board provide medical treatment and care to the victims. A pharmacist is also part of the team. Twenty Medical Service officer candidates and ten members of the Petty Officer School wearing moulage makeup play the part of the casualties, following individual scripts to simulate severe brain, burn and other injuries.

While medical personnel are busy administering initial treatment to the casualties on board, the “Frankfurt am Main” sets course for Rostock. Teams have been assembled for a mass casualty incident at two civilian hospitals in the city. Ambulance vehicles provided by the Rostock Fire Department are already waiting at the Warnemünde Naval Arsenal. As soon as the ship arrives at the port, two intubated patients with traumatic brain injuries and massive burns are carefully carried down the gangway. They are transferred to ambulance vehicles taking them to the Rostock University Hospital and the “Klinikum Südstadt” hospital. As the medical director of the integrated emergency centre at the “Klinikum Südstadt” hospital, Jan-Arne Lauffs, points out: “Exercises such as these are extremely important to build a sustainable network and promote cooperation based on mutual trust. The exercise scenarios help us to identify weak spots, and thus, to avoid mistakes in an emergency.”

Civil-military cooperation must be trained

Role2Sea is the German Navy’s key medical exercise. It serves to practice the provision of operational medical support at sea. To this end, naval personnel administer “first aid”, followed by medical personnel of the Bundeswehr Joint Support Command, who are responsible for providing Role 2 medical treatment within the medical evacuation chain in theatre. After receiving medical care at sea, including emergency surgery, if required, the victims are transferred to civilian health facilities ashore.

Nadine A., Commander, Medical Corps, and Section Chief at the German Navy Headquarters, where she is responsible for planning maritime medical operations and exercises, is satisfied with the results of Exercise Role2Sea: "One and a half years of planning and the great commitment of all those involved in the exercise have paid off. Now, it is important to further intensify cooperation and continue to practice the procedures and the transfer of casualties within the medical evacuation chain from seagoing units to land-based civilian health facilities on a regular basis.