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Air Force medics partner with University of Nebraska to sharpen biocontainment care skills

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Lt. Gen. Robert I Miller, center, U.S. Air Force Surgeon General, gets an overview on the Isolation System for Treatment and Agile Response for high-risk Infections, or ISTARI, from Dr. James Lawler, right, executive director of international programs and innovation at the Global Center for Health Security at the University of Nebraska Medical Center in Omaha, Nebraska, August 18, 2021. The ISTARI is located in the Training, Simulation and Quarantine Center in the Davis Global Center at UNMC. (Photo by Kent Sievers, University of Nebraska Medical Center)

FALLS CHURCH, Va. -- Lt. Gen. Robert I. Miller, U.S. Air Force Surgeon General, visited the Center for Sustainment of Trauma and Readiness Skills Omaha program on August 18, receiving updates on the program’s Principles of Biocontainment Care course and the Air Force’s partnership with Nebraska Medicine and the University of Nebraska.

“This is my second visit to UNMC, but to see how far this facility has come is quite impressive,” said Miller. “The biocontainment training and the partnership between UNMC and the Air Force is critical to our mission, so we appreciate this relationship and look forward to continuing to develop it. It’s not only important to the Air Force, it’s important to our country.”

This year, Air Force infectious disease physicians and infection preventionists have begun rotating through the Center for Sustainment of Trauma and Readiness Skills Omaha program, building critical skills for highly hazardous, communicable disease response.

The C-STARS Omaha program, a partnership developed by the U.S. Air Force School of Aerospace Medicine with Nebraska Medicine and the University of Nebraska Medical Center, began officially rotating Air Force infectious disease physicians and infection preventionists in its Principles of Biocontainment Care course in March, after delays related to COVID-19. Since then, 10 Airmen have gone through the program, with the next group set to start in September.

The course focuses on building critical skills for highly hazardous communicable disease response. It also fills a gap in addressing the challenges initially highlighted during the Ebola outbreak in 2014. Last year, many of the skills taught in the course proved to be invaluable when quickly training aeromedical evacuation teams to transport COVID-19 patients on the back of aircraft while mitigating the spread to aircrew.

“During the 2014 to 2016 Ebola outbreak, military medics across the Department of Defense had limited experience dealing with high consequence pathogens,” said Lt. Col. Elizabeth Schnaubelt, director, C-STARS Omaha. “With access to this course, our infectious disease specialists can build the foundational skills to know how to effectively and safely respond during an outbreak. Having this training is key to the operational readiness of our medics.”

Through a mix of lectures and hands-on training, the course provides an overview of special pathogens, clinical care in a biocontainment unit, donning and doffing personal protective equipment, and safely operating and effectively communicating as a team.

“We need our medics to be able to continue operating in a high-stress environment while implementing all the safety measures geared to mitigating transmission of these highly hazardous diseases,” said Schnaubelt. “Our course stresses the importance of strict adherence to infection prevention and control principles. Delivering patient care in a biocontainment setting poses significant challenges as multiple layers of personal protective equipment can cause sensory deprivation, obscure field of vision, alter tactile sensations, and impair communication. We work to prepare medics to be effective in this environment.”

Col. Jason Okulicz, the infectious disease consultant to the U.S. Air Force Surgeon General, attended the program in March and found the course critical in bolstering the capabilities of infectious disease specialist who would be the first ones called upon to respond to highly hazardous diseases.

“This course has given me a framework on how to approach scenarios effectively,” said Okulicz. “With a course like this, we are significantly better prepared, directly filling in gaps we have had as a military. The probability of encountering such hazardous, communicable pathogens, is high and it is essential for us to know how to respond. The course is an excellent opportunity to expand knowledge and develop these critical skills.”

In addition to the cadre of C-STARS instructors who are embedded at the University of Nebraska Medical Center, students also have an opportunity to learn from and connect with civilian colleagues who specialize in working in biocontainment units.

“As C-STARS instructors, we participate in iterative training alongside our Nebraska partners who have experience caring for patients with Ebola in the Nebraska Biocontainment Unit and in the field. We invite them to share their experience and expertise during our course,” said Schnaubelt.

Through the program, the Air Force has strengthened its partnership with the University of Nebraska Medical Center and Nebraska Medicine, which has been valuable during the COVID-19 pandemic.

“The hospital received some of the first patients in the country before COVID was declared a pandemic and our C-STARS team worked alongside our Nebraska partners during the initial response to a novel infectious disease,” said Schnaubelt. “We subsequently deployed to support Air Mobility Command to develop an air transport capability to move patients who were infected. We brought not only the biocontainment knowledge we have built through this partnership, but also our direct patient care experience to apply to safely treating infected patients on the back of aircraft. As we continue to develop this capability, we rely on this incredible partnership to help build our subject matter knowledge in both depth and breadth.”

Currently, the Principles of Biocontainment Care course is only offered to infectious disease physicians and infection preventionists, but may expand to other military medical specialties. The faculty are also working with the Air Mobility Command to explore the possibility of developing of a future course on infectious disease care during aeromedical evacuation.

C-STARS Omaha is one of four programs managed through the U.S. Air Force School of Aerospace Medicine, part of the Air Force Research Laboratory’s 711th Human Performance Wing at Wright-Patterson Air Force Base in Dayton, Ohio. Like the program in Nebraska, each has its own specialty where military medical professionals train alongside civilian counterparts. The other three C-STARS programs include Baltimore, Cincinnati and St. Louis.

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