“We started Global Medic as ‘an Army thing,’ but we realized that we don’t just operate as Army Medicine anymore,” echoed Fasano. “It is joint medical capabilities that we bring out. So if we are going to train as we fight, then we need to train with our sister services. And this is really our opportunity to do that.”
Although the facility itself falls under Fasano, he was quick to credit the success of the operation within the hospital to Col. Roxanne Arndt, chief nurse for the 228th.
“The training and work starts before we even hit the ground,” Arndt said. Noting how she works closely with her chief wardmaster, Master Sgt. Annette Coleman, Arndt explained, “First the ‘staking team’ comes up with a plan. They show us the plan. We examine it and see where things are located, with an eye toward our main concern, which is patient flow. We want the patients to come in at one point and then flow smoothly through the facility without any backtracking. Then we look at where they have proposed to set up the ancillary services – pharmacy, lab, X-ray – and we want those to be close to the EMT [emergency medical treatment section], because that’s where patients come in. We need someone there to draw blood, do X-rays, and we need them situated to do that quickly. We also want a straight shot back to the OR [operating room] for any patients who need surgery when they come to the EMT.”
U.S. Army and Navy medical personnel engage opposing forces in a simulated firefight to defend the tactical entry point during Global Medic at Fort Hunter Liggett, Calif., June 16, 2012. U.S. Air Force photo by Staff Sgt. Ashley Moreno
Reiterating, “We want to make sure that … whatever flow the staking team has laid out is right,” she added, “They show it to us. We look at it. And we might say, ‘Well, you may need to move this hospital element over here’ or ‘you forgot that this element needs an office.’ And we also need to look at the flow of traffic around the outside of the hospital as well. We need to make sure that there is room for the ambulances to come in one way and go out the other.”
Exterior flow considerations also include specific placement of the ISO containers that normally hold the CSH elements, which are positioned to enhance facility force protection planning.
“And as we’re setting this up, we also start ‘tailgate medicine’ so that we are able to take care of any of our soldiers who may be injured,” Coleman offered. “We may not have the EMT totally set up, but we are able to see some patients if we have injuries during the set-up period.”
“The beauty of the ‘Cash’ [CSH] is, though the setup is an engineering project to start with, it is fully modular. So we can design it based on the capabilities that we need and also the terrain,” Fasano said. “So if the terrain doesn’t fit one particular set-up design, we can also change the design to fit the terrain situation.”
The modular capabilities of the CSH were highlighted by the addition of a Modular Care Detachment (MCD) from Joplin, Mo., to the 228th during Global Medic 2012.
“The MCD augments us with an additional capability,” Fasano said. “In this case, it’s minimal care. For example, if you have folks who don’t require surgery but are injured on the battlefield and need a place to recover, minimal care is the place for that.”
“This is our first time at Global Medic,” offered Maj. Heidi Schuster, head nurse at the MCD. “This is very interesting. There are some great learning opportunities and chances to learn things and get better at what we do normally.”