Between the devil and the deep blue sea: A review of 25 modern naval mass casualty incidents with implications for future Distributed Maritime Operations
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Updated: Oct 26, 2025

Integrated Compensatory Responses in a Human Model of Hemorrhage
Published on: November 20, 2016
Matthew D Tadlock1, Jennifer Gurney, Michael S Tripp
1From the Navy Medicine Readiness & Training Command (M.D.T., J.B., M.C., M.V.), San Diego, California; US Army Institute of Surgical Research (J.G.), Fort Sam Houston; Joint Trauma System, Defense Health Agency (J.G.), San Antonio, Texas; Bureau of Medicine and Surgery (M.S.T.), Falls Church, Virginia; Division of Trauma (M.J.S.), Scripps Mercy Hospital, San Diego, California; Uniformed Services University of the Health Sciences (J.L.), Bethesda, Maryland; and Veterans Administration Loma Linda Healthcare System (J.A.A.), Loma Linda, California.
Abstract:
In the future, United States Navy Role 1 and Role 2 shipboard medical departments will be caring for patients during Distributed Maritime Operations in both contested and noncontested austere environments; likely for prolonged periods of time. This literature review examines 25 modern naval mass casualty incidents over a 40-year period representative of naval warfare, routine naval operations, and ship-based health service support of air and land operations. Challenges, lessons learned, and injury patterns are identified to prepare afloat medical departments for the future fight.
Level Of Evidence:
Literature Review, level V.
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