The personnel in a premier maritimesafety agency must be as professional asthe persons and organizations with whichthey deal. We can be that organization,but we must accept the notion that wemust change and adapt to fit the circum

stances. For as long as officers perceivethat their careers are in jeopardy whenthey pursue technical specialization andtrue expertise, we will never be that organization. The choice is ours to make.Let us choose wisely.

Lieulenanl Commander Hannon is a senior civilian

program manager in ihe Vessel Cotiipliance Divisionat Coast Guard Headquarters. He has held regularand reserve commission.'; in the Coast Guard and has

ser\'ed muUiple assignments as a marine inspector,senior marine investigaior. and instructor at MarineSafety School.

A Visit to the Polish Naval AcademyBy Captain William B. Garrett, U.S. Navy (Retired)

serving the Allies in uniform in Europe;every eighth Allied pilot in the Battle ofBritain was a Pole. The Royal Air Force's303 Squadron composed entirely of Polish pilots was the highest scoringsquadron in the RAP. Polish infantryfought al Narvik.Tobruk. Monte Cassino.the Falaise Gap, and Arnhem. The Polish destroyer Piomn was the first Alliedship to engage ihe German battleship Bismarck. The destroyer BIyskawica supported the Normandy invasion and now

BnOTOa COURTESY THg

Imagine visiting aSoviet-built Kilo-class submarine or a Kashin-class

guided-missile destroyer with detailedlours provided by the commanding officers. During the summer of 1995. a four-member learn from the U.S. Naval Acad

emy did just that while visiting the PolishNaval Academy at Gdynia, nearGdansk—a major home port for the Polish Navy and headquarters for AdmiralRomuald Waga, Commander of PolishNaval Forces. As pan of the visit,we loured the submarine Orzel

and the guided-missile destroyerWarszawa. flag.ship of ihe Pol- •jjkllish Fleet.

Our team consisted of Pro-

fessor Arthur A. Rachwald of the

Political Science Department;Commander Michael P. Camp-bell. U.S. Navy. Division of Pro-fessional Development; Lieu-tenant Mary K. Williams. U.S.Navy. Admissions Departmentand Women's Advocate; and theauthor, Vice Academic Dean. L^HWe focused on ihe academic,professional, and admissions pro-grams at Gdynia and comparedthem with our own. The visil Iwas sponsored by the Military-lo-Military/Joinl Contact Team The aProgram approved by both the NavalSecretaries of State and Defense, i

The Polish Naval Academyhas a proud history. Courses forPolish naval officers began in 1921 andled to the establishment of the NavalOfficers School in Torun in 1922; shortlythereafter, the school was moved to

Gdynia. On 1 September 1939, when theNazi forces attacked Gdansk. Polish

Naval Academy midshipmen respondedquickly and defended the nearby arsenalat Westerplatte. Although eventuallyoverrun, ihey continued their defenseeven after the city of Danzig hadsurrendered.

As World War II broke out. four de

stroyers and three submarines escapedfrom the Baltic and served for the dura

tion of the war in support of the Alliesas part of the Royal Navy. By the endof the war more than 600.000 Poles were

The author (center) and the team that visited the PolishNaval Academy got a firsthand look at an institutionwith a stirring history of service to its nation.

faculty of 150 officers and civilian menand women.

The curriculum has undergone a number of changes and improvements. Asteady emphasis on academic excellenceand rigor through the 1960s and "TOs ledto the establishment of a new standardcurriculum in 1974—a five-year master'sprogram heavily oriented toward seamanship and navigation.

Last year, the school shifted to a four-year bachelor's program. Prior to entry,

each midshipman chooses one ofH two majors, either navigation andR J weapons or mechanical and elec-

trical engineering. The summersare filled with two months of

practical training at sea. TheAcademy has three training cut-

-1= ters and three training vessels, in-eluding the sailing ship Iskra.which made a ten-month around-

ihe-world cruise in 1995 with 35

TUT midshipmen and 8 officers onboard. From all indications, the

newly graduating ensigns are—— extremely well prepared for their

first assignments ai sea and arewell trained professionally fortheir first watch duties on board

AUTHOB

alish The Academy location pro-ition videsother support for the Polish

Navy, including:> The two-year Naval WarrantOfficers School

>• The Naval Command and Staff Insti

tute. which provides training for officers in courses up to ten months

The Academy also serves as the scientific center for research for the Polish

Navy. At any one time there could be upto 1,500 students al the Naval Academycomplex.

We also visited ihe naval base at Hel,

located at the end of a long peninsulaacross the Bay of Gdansk. Famous as thesite of resolute resistance lo the Nazi in

vaders. it held out even after Poland had

surrendered at the beginning of WorldWar II. We also visited Westerplatte, theshipyards at Gdansk, the seaport of Sopot,the 13th century fortress and casile ofthe Teutonic Knights at Marlbork, and

Proceedings / October 1996

serves as a museum ship dockside inGdynia. She is immaculately maintainedand hosts many military ceremonies; thegraduates of the Naval Academy are commissioned on board the ship.

With the start of the war, the NavalSchool was shifted to Plymouth. England,and then to Devon for the duration of the

war, and was reestablished in Gdynia in1946. In 1955. the school was granted thestatus of a university and the name waschanged lo the Westerplalte Naval Heroes School in honor of the midshipmenwho died in battle in 1939. The name

changed again in 1987 to the PolishNaval Academy of the Westerplatte Heroes. More than 400 male midshipmenattend the Naval Academy, which has a

Being shown around a Kiio-ciasssubmarine by the commanding; officerwas an opportunity experienced byfew westerners—and even fewerformer U.S. submarine skippers.

the Naval Academy recreational centerlocated in the nearby Kaszubian Lakesregion.

Other initiatives are ongoing betweenour navies. These include the visit of U.S.

ships to Polish ports, exercises such asBALTOPS 95 in which U.S. combatantshosted Polish officers and midshipmen atsea then made port visits, and a programthat invites Polish nationals to attendthe U.S. Naval Academy. The first Polish midshipman graduated with the classof 1996 and has been commissioned inthe Polish Navy. Two others are midshipmen. In addition, two Polish NavalAcademy inidshipmen attended the 1996Naval Academy Foreign Affairs Confer

ence in Annapolis. We hope to see thesailing ship Lskm in Annapolisduring oneof her long training voyages.

Our visit to Gdynia was memorableand we are indebted to the officers, staff,and midshipmen of the Polish NavalAcademy and the Polish Navy fortheir hospitality. They are dedicatedprofessionals.

Captain Garretl is Vice Academic Dean al the U.S.Naval Academy. A submariner whileon activeduty,he commanded the USS Grenadier {^S-525). servedas executive of'llcerol' the USS Himley (AS-31). andw:i.s a plannerin the olTiee of the Chiefof Naval Operations. He holds a PiiD from ihe Johns HopkinsSchool of Advanced Inlcrnaiioniil Studies.

Biting On a Bullet Is Not EnoughBy Lieutenant Colonels Jerry L. Brown, Medical Corps, and Eugene J. Murdock, Jr.,

CRNA, MSN, Nurse Corps, U.S. Army Reserve; Major Dewey Galeas, CRNA, MSN, NurseCorps, U.S. Army (Retired); and Captain Arthur M. Smith, Medical Corps, U.S. Naval Reserve

As we prepare to conduct militaryoperations in two simultaneous

major regional conflicts, supported by adownsized military medical cadre, medical operational readiness assumes agreater priority. The administration offield anesthesia to combat casualties and

disaster victims is an important component of today's medical readinessmission. Military anesthesia providersmay be called on to provide emergencycare under suboptimal conditions, without the security of the sophisticatedequipment, drugs, and compressed gasesthat are now considered essential. Un

fortunately, there are substantial obstacles to adequate peacetime training ofanesthesia providers in operational (field)anesthesia.

Operational Anesthesia:FundamentalRequirements

Familiarity with the implements andtechniques of operational anesthesia is acritical component of military medicalreadiness. The techniques of total intravenous and regional anesthesia, as wellas local nerve blocks, may be very useful under certain conditions. To completetheir formal training in anesthesia caredelivery within the austere environment,military anesthesia providers also needtraining in the use of the field equipmentpresently available.

One of the prime targets of the debateover operational readiness is the decades-old field anesthesia machine or FAM

885(A),' which has been used with greatproficiency by U.S. military anesthesia

personnel since the Vietnam War. TheFAM 885(A) is a standardcomponent offield medical equipment and one of theprincipal forms of anesthesia equipmenton board the larger Navy amphibious assault ships. Because it lacks many ofthe technical specifications now commonly included in modern state-of-the-art equipment, however, it is consideredto be below the minimum standards foruse in fixed surgical facilities within theUnited States. Nevertheless, even duringthe Vietnam War. its unimproved predecessor proved 10 be a very reliableand durable instrument, with an exceptional safety record.

Most standard anesthesia machines, including the FAM 885(A). depend onmedical gases for vaporization of thevolatile anesthesia agent. An adequatesupply of cylinders of compressed gases,most notably oxygen, may be a major logistical problem in the combat setting.For rapid deployment and field anesthesia. therefore, the alternative drawover

anesthetic system is the most versatile solution; it has no absolute requirement fora compressed gas supply, because air canbe used as the carrier gas. This minimizesor eliminates the need to transport heavyoxygen cylinders.

The drawover system is a portableanesthetic apparatus that is small, light,portable, and simple to use, but sufficiently versatile to meet the more sophisticated anesthetic requirements of afield or base hospital. It also can operate under reduced barometric pressure(i.e., in aircraft or mountainous regions),and its performance has been well doc

umented between sea level and a heightof 4,000 meters.

Medical units of the Israeli armedforces used drawover units during theYom Kippur War in October 1973.British medical units involved in the

high-temperature environment of Omanand in the ongoing conflict in NorthernIreland have used them extensively.

During May 19S2. British naval forcesin the Falkland Islands provided the firstexample of prolonged use of the draw-over apparatus under field conditions.Two anesthetists from the Royal ArmyMedical Corps, who were part of theinitial Parachute Field Surgical Team, reported that 133 inhalation anesthetic procedures were performed with this apparatus. The distribution of injuries isimportant to note, however. In keepingwith the historical record from most previous military conllicts, 65% of all injuries were to the extremities, and 75%of all general anesthetics were for cleaning and removal of debris and dead tissue from these wounds. Only 4% ofcases required abdominal exploration, andsurgical procedures within the chest composed only 1% of the total.

Variations of drawover anesthesia

equipment are still in regular use in manyThird World countries. Similarly, it is stillused by some armies as a field apparatus, where it is employed for simple aswell as complex surgery, including majortrauma cases. During the 1991 PersianGulf War, drawover devices were usedin U.S. field hospitals when supplies ofcompressed oxygen were in short supply.The spartan but easily transportable Uni-

Proceedings / Octobcr 1996