Aeromedical nurse directs complex missions to provide priority care

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  • Air Mobility Command Public Affairs
Multiple patient movements occurred as three hurricanes made way through Texas, the Caribbean and Florida, Aug. 24 to Sept. 19, 2017.

Maj. Terri Felder from the 43rd Aeromedical Evacuation Squadron at Pope Army Airfield, North Carolina, served as a medical crew director for these flights.

AE crews were prepositioned at Scott Air Force Base, Illinois, Sept. 8, 2017, after returning from different missions supporting Hurricane Harvey and Irma relief. As Hurricane Maria was approaching, Felder and her crew were directed to MacDill AFB, Florida, to be closer to support. 

It was from there she helped build crews using AE members from different squadrons to meet mission needs. They weren’t sure what to expect when landing in St. Croix.

“Traditionally when we get patients they are what we call a regulated patient,” said Felder, a native of Anderson, South Carolina. “We know what their diagnoses are, what medications they are taking and their medical history. These were unregulated. It’s like trying to take care of someone without knowing what is going on.”

Aeromedical evacuation has three patient classes, urgent, priority and routine, which affect the timelines of care. Most of the patients were priority, requiring the AE crews to get them to a definitive area of care within 48 hours.

The crew faced communication issues upon arrival about aircraft space availability and what to expect, in terms of patients and their needs. Felder anticipated this problem in St. Croix because communication lines were down, but this was unexpected with missions within the States. 

On the second mission from Miami to Dobbins Air Reserve Base, Georgia, they needed to transport 102 people on a C-130J. Because of the aircraft size, they were required to take two trips in order to complete this task.

The team was expecting 11 to 19 patients on litters, but when they arrived, many of the patients were in wheelchairs. As the aircraft was configured for one type of patient movement versus what the team was presented, this created delays. The crew only had seven litter on the plane so they had to adapt and prioritize.

“The number we were going to transport kept changing,” she said. “I had two extra nurses and one extra tech on the aircraft when we landed. So they went on the ground to prioritize who we would transport first.”

With the hurricanes forcing people to leave their homes, many patients had grabbed everything they could carry of their belongings and stowed them in trash bags. Felder’s crew is trained in anti-hijack measures and needed to examine more than 80 bags to be palletized.

These unexpected challenges ended up extending the crew’s time to two hours and 45 minutes, putting the crew in a position where they would not be able to make a second trip due to crew rest.

However, they were able to get public health members to Dobbins on that first trip. Those individuals would later go on to San Juan, Puerto Rico, to provide medical care to residents affected by the storms.

A secondary crew based at Dobbins was able to get the remaining patients in Miami and Felder’s crew was able to communicate with them what was needed for a smoother transition.

Felder said since coming into the career field in August of 2011, she had always wanted to be on a crew supporting a humanitarian mission. This was her first humanitarian mission and what she describe as one of her most rewarding missions.

”You choose AE to serve individuals who may never be able to say thank you but that doesn’t matter, because you are serving for a higher purpose,” she said. “The thought of doing a humanitarian mission, to me, feels like I am serving mankind and putting something good into this world.”