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1 Ground manoeuvre surgical group (GMSG) development – lessons from theatre entry
  1. Lt Col Jonathan A Round
  1. Consultant Anaesthetist, Clinical Director Roto 1A; Joint Hospital Group (North), South Tees Hospitals NHS Foundation Trust, James Cook University Hospital, Marton Road, MIDDLESBROUGH TS4 3BW, UK


In 2017, conceptual work began to develop a Role 2 Forward Surgical Capability (FSC) that could be rapidly deployable and manoeuvrable, modular and scalable, delivering Damage Control Resuscitation, Surgery and critical care patient hold. This developmental work was underpinned by lessons from other United Kingdom (UK) Role 2 light manoeuvre capabilities and exercising with a similar French capability. To standardise UK military medical descriptive nomenclature, direction was given to replace FSC with the term Ground Manoeuvre Surgical Group (GMSG).

In Autumn 2019, 34 Field Hospital were tasked with delivering a GMSG the following year, supporting a 250-strong Long Range Reconnaissance Group (LRRG) provided by the UK, contributing to the United Nations Multidimensional Integrated Stabilisation Mission in Mali (MINUSMA).

Initial planning guidance was to expect long range patrols in a desert environment for four to six weeks duration with no or minimal resupply. Mali has ambient day time temperatures more than 40°C enduring for most of the year. This was judged likely to have significant impact on the safe storage of blood products and components, as well as temperature sensitive drugs while mobile on long range patrols. Existing in-service cold storage equipment was not designed to be operated while mobile nor to operate in a high ambient temperature, risking failure.

An innovative integrated temperature control solution was ultimately fielded, consisting of air-conditioned tentage, extended life cold boxes and a power solution to ensure cold box plates could remain frozen in a freezer while mobile on patrol. The integration of these capabilities led to successful delivery of medical support to the LRRG.

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