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Pacific Ocean. (November 2, 2023): Looking like men from Mars, Aviation Boatswain's Mate (Handling) Airman Jalon English, right, and Aviation Boatswain's Mate (Handling) 3rd Class Roman Grepo race across the flight deck in hazmat suits to rescue a simulated casualty. This photo by MC2 Madison Cassidy captures the chaos Sailors can expect in a mass casualty event during recent drills on the Nimitz-class aircraft carrier USS Abraham Lincoln while underway in the Pacific.

Either through combat or by the dangers inherent to fleet operations, mass casualty incidents are an unfortunate reality for Navy planners. Like their civilian counterparts, the Navy has instituted a triage system to offer the “greatest good to the greatest amount of people” as the ship’s resources will be limited. But unlike civilians, every Sailor on board has a role to play in saving lives during a catastrophic event.

With a crew of 5,600 Sailors and carrying up to 90 aircraft, the USS Abraham Lincoln is like a floating American city at sea. In an emergency, the ship’s doctors, nurses, and corpsmen will be busy setting up triage stations while every Sailor will play a role from donating blood to assisting transporting patients. The term “triage” refers to the preliminary assessment of casualties to determine the urgency of their need for treatment and the nature of the help they need.

Medical crews identify and track patients using medical triage cards that come in four colors. Grean means the patient has relatively minor injuries and receives the lowest priority. A Yellow card indicates the patient can be stabilized and transport can be delayed while a Red card means the casualty needs immediate intervention and transport. Expectant Black means there is little chance of recovery.

The challenge for medical teams is to maintain focus and discipline in the most chaotic situation imaginable. To do this takes practice and repetition through mass casualty training events like these and a resolute crew ready to respond when needed.