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NEWS | Oct. 31, 2014

ARNORTH helps train local medical response team for possible Ebola cases

By Army Sgt. 1st Class Tyrone C. Marshall Jr. DOD News, Defense Media Activity

Department of Defense leaders are ensuring the 30 members of a medical support team at Joint Base San Antonio-Fort Sam Houston that may be called upon to respond to new cases of Ebola in the U.S., are receiving world-class, state-of-the-art training, a senior military doctor said. Air Force Col. John J. DeGoes, command surgeon for U.S. Northern Command and North American Aerospace Defense Command, discussed the training and its potential impact should the team be called upon to respond to Ebola cases.

U.S. Northern Command tasked U.S. Army North (Fifth Army) to work with medical experts to devise and lead the team's training.  In less than three days, ARNORTH's Task Force 51 devised a program that provided the world-class training the team of medical experts received and ultimately met with certification for all 30 members.

The team began training at the San Antonio Military Medical Center Oct. 23. It is comprised of 10 critical care nurses; 10 noncritical care in-patient nurses; five physicians with experience in infectious disease, internal medicine and critical care; and five individuals trained in specialties related to infection control.

"Because there's this need," DeGoes said, "we're going to make sure that we can respond effectively to it, but only after people are trained fully are proficient.
"It's absolutely critical that we train to standard and not to a pre-conceived time," he said. "There's risk, but we're doing everything to mitigate it and we think that this is an important mission for the United States of America."

DeGoes noted that NORTHCOM commander Army Gen. Charles H. Jacoby Jr. emphasized the importance of training the team properly, even if that means expanding the training schedule.

Jacoby also spent a substantial amount of time observing the training and interacting with the team members, hospital staff and course instructors at SAMMC.

DeGoes said he thinks the team - composed of "some of the best the military health system has to offer" - is receiving "some world-class training" to ensure they can succeed if they are called upon.

"We're using really good training items," he said. "This isn't your grandfather's training where you're just sitting in a bland classroom hearing lectures and seeing PowerPoint presentations."

Training is taking place in an actual intensive care unit converted into a simulation center with state-of-the-art personal protective equipment, DeGoes said.

Team members practice putting on personal protective equipment in a relevant setting, he said, simulating conditions they would encounter while caring for patients. The training is designed to help the team apply their new skills in the event they are necessary in an actual care environment.

"They're in something that's nearly identical to where they'd be called to go," DeGoes said. "We're able to use the great training aids of the San Antonio Military Medical Center's Education, Training and Simulation Department."

"They've got state-of-the-art mannequins here that they can simulate drawing blood," he said. "They can simulate all the things that you would do in an Ebola patient that was mildly sick to completely sick."

DeGoes also noted a particular training aid - glow germ - that lights up under a black light, indicating simulated contamination. This drives home the importance of not just putting the equipment on correctly, but taking it off correctly as well, the colonel said.

"This is one of the diseases where PPE is not just helpful - It could really save your life," he said. "And proper use of it will also protect other people in the hospital, so that health care workers don't unknowingly drag contamination to a previously clean area that could potentially get to another patient."

The training includes measures to protect not just the health care workers, DeGoes said, but also the medical facility, other patients and families of health care workers.

"So not only will they have this training, but they will be supported by appropriate protocols that don't assume that they were perfect in the PPE," he said.

As precautions, DeGoes said the team will take their own temperatures twice a day, "even if they feel great enough to run a marathon."

"That will happen every day while they're working and then after they're done working, to protect them in the unlikely event they get sick," he said. "They would get diagnosed earlier and protect their families and the community in which they work and live."

DeGoes said the team's risk of exposure to Ebola is certainly a concern, "... but it is a need for the nation right now."

He said the team members, doctors, nurses and trainers, understand that they have been asked to join with counterparts from civilian agencies such as the Department of Health and Human Services and the Centers for Disease Control, to take part in the national effort to stop this threat.

"But it is a risk," DeGoes acknowledged, "and as command surgeon, and a physician myself, I want to make sure that we do everything, every day in patient care to be as safe as possible for our health care workers and for patients to ensure the best outcome."

The colonel noted there's no template for a team like this, because "we've never had this before in the United States."

"So it was with an abundance of caution that the Department of Defense and Health and Human Services got together to come up with this particular team that had some broad capabilities that could go to any facility," DeGoes said.

Putting this team together, he said, shows the American people and the international community "that we are willing to work together to do whatever it takes to prevent the spread of this deadly disease."

"Working together is key," DeGoes said, "because none of us have all of the resources, and clearly it is an interagency effort."

The Department of Homeland Security, Health and Human Services and DOD, he said, working together with the National Guard, are key to this response and part of Jacoby's strategic plan to improve the nation's bio-response preparedness - not just for Ebola, but for other future requirements as well.