From August through to October 2016, the amphibious assault ship USS WASP LHD 1 and embarked elements of the 22nd Marine Expeditionary Unit (MEU) were forward deployed in support of amphibious combat operations. The embarked medical assets included a fleet surgical team (FST) which included a general surgeon and an anaesthesia provider with expertise in regional anaesthesia (RA), including peripheral nerve blocks (PNBs). Here we report a case series demonstrating the safe and effective use of PNBs aboard USS WASP during the above-noted deployment. RA, and PNBs in particular, can play an important role in maritime expeditionary surgery and likely across the entire spectrum of high threat and austere environments.

Blast injuries are not commonly seen by civilian healthcare workers. Injury patterns may be unfamiliar. In the high threat environment, which is likely to be present after an event, the types of care provided need to balance the probable clinical needs of the victim and the safety and security needs of responders.