British and American medics based in the Middle East tested their ability to provide life-saving medical care aboard the vessel.

In 2017 the exercise Azraq Serpent made use of the now sold HMS Ocean. For 2018, the Americans used Cardigan Bay, which acts as a mother ship for British and US minehunters operating in the Gulf say the Royal Navy.

“The medics of Expeditionary Resuscitative Surgical System 19 normally provide care for the US Marine Corps’ 5th Expeditionary Brigade. They joined US Coast Guard and Air Force comrades, British military medics and Royal Marines of 42 Commando – some of whom ‘volunteered’ to be casualties – aboard the 16,000-tonne support ship for the week-long workout.

RFA Cardigan Bay leads minehunters in the Gulf.

Although she doesn’t possess the comprehensive ‘hospital suite’ fitted aboard RFA Argus, Cardigan Bay still has a sizeable medical facility – including an operating table and several critical care beds. In emergencies and conflict, a fully-operational sickbay could provide ‘Role 2’ treatment – performing emergency surgery sufficient to stabilise a casualty so they can be transported to a permanent hospital ashore.”

“From a medical and clinical basis we’ve had quite a lot of experience in the past working with US medical teams in Afghanistan, but we haven’t really had that much experience in a maritime environment,” said Jon Matthews, clinical director of Cardigan Bay’s Role 2 Afloat facility.

“I think we all work very similarly from a medical point of view, but it’s establishing processes and the infrastructure of how we integrate.

Among the chief differences is power. The Americans’ medical equipment runs on just 110 volts… whereas the UK system runs on 240 volts… so electrical transformers are required.”

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