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DGMC tests casualty receiving and NDMS roles

U.S. Air Force Airmen from the 60th Medical Group work to triage and treat simulated patients at David Grant USAF Medical Center during a Casualty Receiving Hospital exercise at Travis Air Force Base, Calif., Aug. 22, 2018. The exercise simulated bringing injured troops from overseas, triaging them at Travis and then moving them to long-term and advanced-care facilities. (U.S. Air Force Photo by Heide Couch)

U.S. Air Force Airmen from the 60th Medical Group work to triage and treat simulated patients at David Grant USAF Medical Center during a Casualty Receiving Hospital exercise at Travis Air Force Base, Calif., Aug. 22, 2018. The exercise simulated bringing injured troops from overseas, triaging them at Travis and then moving them to long-term and advanced-care facilities. (U.S. Air Force Photo by Heide Couch)

U.S. Air Force Airmen from the 60th Medical Group work to triage and treat simulated patients at David Grant USAF Medical Center during a Casualty Receiving Hospital exercise at Travis Air Force Base, Calif., August 22, 2018. The exercise simulated bringing in injured troops from overseas, triaging them at Travis, and then moving them to longer-term and advanced-care facilities. (U.S. Air Force Photo by Heide Couch)

U.S. Air Force Airmen from the 60th Medical Group work to triage and treat simulated patients at David Grant USAF Medical Center during a Casualty Receiving Hospital exercise at Travis Air Force Base, Calif., August 22, 2018. The exercise simulated bringing in injured troops from overseas, triaging them at Travis, and then moving them to longer-term and advanced-care facilities. (U.S. Air Force Photo by Heide Couch)

U.S. Air Force Airmen from the 60th Medical Group work to triage and treat simulated patients at David Grant USAF Medical Center during a Casualty Receiving Hospital exercise at Travis Air Force Base, Calif., Aug. 22, 2018. The exercise simulated bringing injured troops from overseas, triaging them at Travis and then moving them to long-term and advanced-care facilities. (U.S. Air Force Photo by Heide Couch)

A U.S. Air Force Airman from the 60th Medical Group work to triage and treat simulated patients at David Grant USAF Medical Center during a Casualty Receiving Hospital exercise at Travis Air Force Base, Calif., Aug. 22, 2018. The exercise simulated bringing injured troops from overseas, triaging them at Travis and then moving them to long-term and advanced-care facilities. (U.S. Air Force Photo by Heide Couch)

U.S. Air Force medical personnel load simulated patients on board a C-130J Super Hercules aircraft during a Casualty Receiving Hospital exercise at Travis Air Force Base, Calif., Aug. 22, 2018. The exercise simulated bringing  injured troops from overseas, triaging them at Travis and then moving them to long-term and advanced-care facilities. (U.S. Air Force Photo by Heide Couch)

U.S. Air Force medical personnel load simulated patients on board a C-130J Super Hercules aircraft during a Casualty Receiving Hospital exercise at Travis Air Force Base, Calif., Aug. 22, 2018. The exercise simulated bringing injured troops from overseas, triaging them at Travis and then moving them to long-term and advanced-care facilities. (U.S. Air Force Photo by Heide Couch)

U.S. Airmen from the 60th Medical Group load simulated patients on board a C-130J Super Hercules aircraft during a Casualty Receiving Hospital exercise at Travis Air Force Base, Calif., Aug. 22, 2018. The exercise simulated bringing injured troops from overseas, triaging them at Travis and then moving them to long-term and advanced-care facilities. (U.S. Air Force Photo by Heide Couch)

U.S. Airmen from the 60th Medical Group load simulated patients on board a C-130J Super Hercules aircraft during a Casualty Receiving Hospital exercise at Travis Air Force Base, Calif., Aug. 22, 2018. The exercise simulated bringing injured troops from overseas, triaging them at Travis and then moving them to long-term and advanced-care facilities. (U.S. Air Force Photo by Heide Couch)

TRAVIS AIR FORCE BASE, Calif. – The David Grant USAF Medical Center at Travis Air Force Base, California, tested its role as a casualty receiving hospital and National Disaster Medical System Federal Coordinating Center Aug. 22 to 23.

As a CRH, the medical center staff had to receive, triage, treat, feed and simulate evacuating more than 200 critically injured service members from an overseas location in the most time-efficient manner possible.

“We’re testing our ability to come together and deliver a capability, which we are required to deliver,” said Col. Kristen Beals, 60th Medical Group commander. “We’re not testing the clinical ability of the staff, but their ability to get patients in and get them out.”

Although medical staff did not actually treat role-playing patients, they did go through the treatment steps to ensure they have the supplies and equipment needed in a real-world crisis.

Since DGMC used bed-expansion rooms reserved for casualty receiving, staff members needed to “figure out what we don’t have,” said Col. (Dr.) Rachel Hight, 60th MDG trauma surgeon and wing inspection team member.

“I want to see you actually put on the blood pressure cuffs, check the respiratory rate, take the temperature and (patient’s) weight,” said Hight. “Don’t tell me that you requested labs, I want to see you fill out that lab request paperwork.”

While DGMC participated in one exercise, U.S. Transportation Command conducted a separate week-long exercise, testing its patient movement and aeromedical evacuation roles using Travis C-5M Super Galaxy and C-17 Globemaster III aircraft.

The En-Route Patient Staging System at Travis was staked in the medical center’s southeast parking area in support of the USTRANSCOM exercise, demonstrating its ability to expand bed space by 58 percent.

With staff supporting both exercises and carrying out real-world responsibilities, DGMC closed some clinics, but not the emergency department, pharmacy or Family Medicine.

DGMC serves as one of more than 70 FCCs in the country and one of three in the Air Force, along with Keesler AFB, Mississippi, and Wright-Patterson AFB, Ohio, said Mondel Anderson, 60th MDG FCC coordinator.

“NDMS is a partnership between four federal agencies: the Departments of Health and Human Services, Homeland Security, Defense and Veterans Affairs,” said Anderson. “HHS has overall responsibility for NDMS.”

Under NDMS, the DOD provides a coordinated medical response, patient movement and patient care during a military health emergency, national emergency, domestic disaster or when directed by the President.

“If a major earthquake occurred in the Bay Area and 10 hospitals were damaged, the patients would need to be evacuated to an area not in the disaster area,” said Anderson. “You can imagine what kind of chaos that would create because there aren’t enough hospitals in the area to absorb all of those patients.”

At that point, NDMS-designated hospitals around the country fill the gap.

When the system is activated, participating hospitals communicate their number and type of available bed spaces to a central command and control point. Patients can then be distributed to several hospitals without overwhelming any one facility.

“NDMS is about moving patients from a disaster area to a hospital outside the disaster area that can accommodate them,” said Anderson.

NDMS’s goal is two-fold: assist state and local authorities with medical and health effects during peacetime disasters – such as Hurricane Katrina and the terrorist attacks on 9-11 – and provide support to military and VA medical systems in caring for military casualties returning to U.S. hospitals.

For this exercise DGMC received notice Aug. 20 that it would be receiving casualties from an overseas location. The notice could have come from any combatant commander in any area of responsibility, said Beals.

“This is what we do – mass casualty and patient movement,” she said.

To determine its ability to accurately track patients from the time they land on a medical evacuation flight at Travis to the minute they are admitted to DGMC or transferred to an NDMS hospital, DGMC bussed role-players from the base theater (simulated flightline) to the hospital’s south entrance.

Once the patients’ medical conditions were assessed, DGMC admitted 24 role-playing volunteers and transported 10 others by ambulance to NorthBay Medical Center in Fairfield, California; VacaValley Hospital, in Vacaville, California; and Sutter Health in Vallejo, California.

On the fourth day of the exercise, DGMC bussed its 24 role-players to the former Mather AFB in Sacramento, California, where they were met by a patient reception team composed of DGMC staff.

Meanwhile, a C-130 Hercules from Dyess AFB, Texas, took off from Travis headed to Mather carrying 20 mannequins, simulating actual patients. The reception team off loaded the mannequins and sent the role-players to four NDMS hospitals in Sacramento.

NDMS civilian hospitals serve as backup to military treatment facilities when both DOD and VA hospitals are at capacity during a military health emergency. More than 1,800 civilian hospitals across the nation are voluntary members of NDMS, providing approximately 100,000 hospital beds in support of NDMS operations.

“Getting NDMS hospitals to participate in the exercise was huge,” said Beals. “We could not do this without their support.”




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