As the number of COVID-19 positive cases surged in Texas last month, the South Veterans Health Care System in San Antonio prepared to meet an increasing demand.
The SVHCS’ Audie L. Murphy Veterans Affairs Medical Center sought to expand the facility’s COVID-19 capacity in its Spinal Cord Injury Unit, but in doing so, eight patients required relocation to the VA North Texas Health Care System’s SCI Center, Dallas, Texas.
Moving the veterans approximately 275 miles northeast by vehicular transport was not felt to be a safe option, so the VA requested assistance from the Department of Defense. On Sunday, July 12, 2020, with DOD’s concurrence, U.S. Transportation Command acted on the VA’s request to rapidly move the eight SCI patients via a C-130 aircraft. Less than 48 hours later, they were safely secure in their new location at VANTHCS.
Serving as the DOD’s single manager for global patient movement, USTRANSCOM executes this critical mission through the U.S. Air Force’s aeromedical evacuation system. Each month, the combatant command conducts between 500 to 600 aeromedical evacuations, transporting ill and injured active-duty service members, as well as other patients – like those from the SVHCS – to locales with appropriate medical treatment facilities.
For the VA patients’ transport within the Lone Star State, four members of USTRANSCOM’s Command Surgeon Directorate – a sailor, airman, federal civil servant, and soldier – teamed together to ensure this AE mission’s accomplishment. The ensuing text focuses on their efforts in coordinating, organizing, and implementing the command’s expeditious response, while working in the USTRANSCOM Patient Movement Requirements Center – Americas here.
After notifying his chain of command on July 12 of the DOD-approved, VA patients’ movement, U.S. Navy Petty Officer 2nd Class and Hospital Corpsman Jacob Proctor initiated his shift the next day by drafting the patient movement requests, which included an overview of the veterans’ clinical histories and administrative details for validation by the flight surgeon. He then assisted U.S. Air Force Lt. Col. Daniele Loyd, senior flight nurse and patient movement clinical coordinator, in inputting the patients’ medications, also for the flight surgeon’s confirmation, in the USTRANSCOM Regulating and Command and Control Evacuation System, the DOD’s automated, electronic patient movement information system.
In addition, during this timeframe, the Air Force assigned a C-130 aircraft to transport the eight veterans from Joint Base-San Antonio-Kelly Airfield to Dallas Love Field Airport.
Following flight surgeon validation and orders submission to the attending VA physician at approximately 12 a.m., Monday, July 14, Proctor, who serves in two positions, patient movement controller and patient movement clinical operations specialist, returned to the TPMRC-A a few hours later to coordinate and confirm ground logistics at the point of aircraft departure and arrival.
“There is a great amount of team work and communication for every move, and any error risks the safety of our patients,” said Proctor. “I am incredibly proud of the mission that we have here at USTRANSCOM’s Command Surgeon Directorate, as it is truly an incredible team to be a part of.”
Working in unison with Proctor, Loyd, an 18-year Air Force Reservist, also addressed the clinical challenges of transporting SCI patients, particularly regulating their body temperature, with the in-flight critical care air transport team physician and AE charge nurse. She spoke from experience in providing medical support to veterans. In her civilian employment, Loyd serves at the Marion VA Medical Center, Marion, Illinois.
“Because of my connection with the VA, I had a personal investment in the move of the eight SCI patients,” Loyd stated. “It was a true team effort – USTRANSCOM, Command Surgeon Directorate, the Air Force, and VA – working behind the scenes to make this unique patient movement happen.”
Patient Movement Operations Officer Gerald Moralde also worked in tandem with Proctor and Loyd in coordinating and confirming the clinical and logistical aspects of the VA patients’ movement. His engaged interactions with, and updates for, the ground transport coordinators at JBSA-Kelly Airfield and Dallas Love Field Airport, as well as the Kelly En-Route Patient Staging Facility staff, synchronized patient movement operations in the air and below.
“In the patient movement process, our – and my – focus is on the main players, particularly logistics. It’s important to maintain contact with them around the clock,” said Moralde. “We have to deal with ground traffic, weather, and aircraft delays. In our business, a delay of any kind can impact the patient.”
Similarly, while helping Proctor, Loyd, and Moralde navigate through the various processes and procedures involved in moving multiple patients on an airframe, U.S. Army Lt. Col. David Weir, also a patient movement operations officer, primarily concentrated on ensuring every facet of the arrival at Dallas Love Field Airport and subsequent transfer to the VANTHCS went as planned. He coordinated with the airport’s fixed-base operator on the large number of participating ambulances and on required special equipment, such as an air conditioning cart to regulate the temperature in the C-130 while on the ground.
The patient movement experience and expertise of the four Command Surgeon Directorate colleagues significantly contributed to the overall team effort in safely, securely, and soundly transporting the eight veterans to their new treatment facility.
“This was definitely a unique and complex move, safely and successfully executed in a short timeframe because of a strong team effort,” stated Weir. “The motto for USTRANSCOM states "Together, We Deliver"... and together we did, just like we do every day.”
USTRANSCOM exists as a warfighting combatant command to project and sustain military power at a time and place of the nation’s choosing. Powered by dedicated men and women, we underwrite the lethality of the Joint Force, we advance American interests around the globe, and we provide our nation's leaders with strategic flexibility to select from multiple options, while creating multiple dilemmas for our adversaries.