Field Report on a Submarine Disaster Mass Casualty Exercise

Summary: The loss of the Indonesian submarine KRI Nanggala in 2021 and the commercial Titan Submersible in 2023 highlight the importance of preparedness for Submarine disasters. As a Submarine operating navy with Submarine Rescue (SR) capabilities, the Republic of Singapore Navy (RSN) regularly exercises its SR capabilities to maintain this edge. The Medical Flotilla (MedFlot) is tasked with the medical response component of RSN’s SR capability. Quarterly component training is conducted for all medical personnel. However, there was no opportunity for the entire 37-member medical team to exercise a Submarine Disaster Mass Casualty Scenario (SMASHEX) between 2020 and 2023 due to COVID-19 restrictions. This paper focuses on the lessons learned from conducting MedFlot’s first SMASHEX since 2019. Conduct of Exercise: SMASHEX was conducted over a single day in April 2024. Two serials of 10 casualties each were simulated; The first serial simulated casualties rescued directly from the Submarine via a submersible rescue vehicle, while the second serial simulated casualties who had escaped from the distressed submarine in Submarine Escape Immersion Equipment (SEIE) suits. After-Action Reviews (AARs) were initially conducted in small groups before being held in a larger group setting that involved the conducting team, simulated casualties, and participants. Feedback was initially wholly qualitative in nature. Feedback highlighted that existing processes were robust. However, a proactive approach surfaced several areas for improvement: i) Triage processes; ii) casualty tracking; iii) medical team communications; iv) familiarity with equipment and processes for casualty movement. As with other areas of disaster preparedness, the onus falls on organisations with SR capabilities to regularly exercise, evaluate, and improve their Submarine disaster response processes. Future efforts to improve training and evaluation in this realm should involve the use of quantitative markers for benchmarking and tracking.