They’ve fought side-by-side in every major conflict spanning the past quarter of a century. But can American medics using American equipment save British lives aboard a British ship?
The answer is 'yes' obviously - but it's not as cut and dried as you might think - as a week-long exercise aboard RFA Cardigan Bay in the Gulf demonstrated.
Each year medics based in the Middle East test their ability to provide life-saving medical care in alien surroundings.
In 2017 Azraq Serpent made use of Britain's flagship HMS Ocean. For the 2018 run-out of the exercise, the Americans used Cardigan Bay, which acts as a mother ship for British and US minehunters operating in the Gulf.
The medics of Expeditionary Resuscitative Surgical System 19 normally provide care for the US Marine Corps' 5th Expeditionary Brigade.
They joined US Coast Guard and Air Force comrades, British military medics and Royal Marines of 42 Commando - some of whom 'volunteered' to be casualties - aboard the 16,000-tonne support ship for the week-long workout.
Although she doesn't possess the comprehensive 'hospital suite' fitted aboard RFA Argus, Cardigan Bay still has a sizeable medical facility - including an operating table and several critical care beds.
In emergencies and conflict, a fully-operational sickbay could provide 'Role 2' treatment - performing emergency surgery sufficient to stabilise a casualty so they can be transported to a permanent hospital ashore.
The two nations' medical teams practised casualty handling, treating combat casualty care and airway management, including intubation training - putting a pipe down the throat to aid a patient's breathing.
"From a medical and clinical basis we've had quite a lot of experience in the past working with US medical teams in Afghanistan, but we haven't really had that much experience in a maritime environment," said Jon Matthews, clinical director of Cardigan Bay's Role 2 Afloat facility.
"I think we all work very similarly from a medical point of view, but it's establishing processes and the infrastructure of how we integrate."
Among the chief differences is power. The Americans' medical equipment runs on just 110 volts… whereas the UK system runs on 240 volts… so electrical transformers are required.
"The American team comes as a package with their own equipment, and if they were to deploy on board here, they would bring their own equipment," Jon explained.
"It allows the Americans an opportunity to see that we've got an in-built operating table, for instance, in-operating lights and critical care beds, so they know what's actually on this ship and what they can expect to be able to use when they come on board."
Lieutenant Commander David Morley, medical staff officer with the Royal Navy’s permanent staff in Bahrain, UKMCC, said the team aboard Cardigan Bay were "really, really happy" with the results of Azraq Serpent 18. "Both our surgical teams - US and UK - have really seen a benefit."
