Medical logistics managers keep finger on equipment pulse
ANDERSEN AIR FORCE BASE, Guam -- To patients of the 36th Medical Group, trained medical experts in and out of uniform are the face of medical care.
While trained eyes and ears go a long way in ensuring patients' health, every medical technician also relies on a variety of sophisticated tools allowing them to track vitals and the physical status of their patient's well-being.
The small staff of the 36th Medical Support Squadron's Logistics Flight here work out of the sight of patients to provide all necessary appliances and devices at the heart of medical exams.
"Our mission is to make sure the medical clinic has all the medical supplies and equipment to get the job done," said Staff Sgt. Carlos Rance, 36th Medical Support Squadron NCO in charge of medical equipment and contracting. "We provide and track anything needed in the clinic environment."
Together, a handful of Airmen manage and are responsible for more than $4.4 million of specialized Air Force medical equipment in daily operations on Guam. Additionally, the team handles all contracts for civilian medical employees on the clinic staff.
Working side by side, logisticians and biomedical equipment maintainers also ensure every item is checked, calibrated and delivers accurate diagnostics of patients' data.
"We're a constant part of the equipment lifecycle," said Tech. Sgt. Virgilio Biascan, 36th MDSS NCO in charge of biomedical equipment maintenance. "From cradle to the grave, that is from the initial purchase to taking it out of the system, we manage it and keep it operating."
Responsible for a wide range of software updates and physical repairs, Biascan has extensive knowledge of many different platforms and machines covering the entire range of patient care. As the lone technician on staff, he said he often finds himself researching repair techniques and on the phone with U.S.-based manufacturers even off-duty to compensate for time differences.
"You have to be a jack-of-all-trades knowing all of the equipment," Biascan said. "If you didn't know how to do it at first, you have to learn on the job and that takes time."
From defibrillators and infusion pumps to dental chairs and lab equipment, only a few items are too complicated to fix. Working hand-in-hand with experts and representatives of major medical supply manufacturers, they ensure they meet both military and industry maintenance requirements.
"Our (medical equipment) maintainers are probably some of the most important Airmen in the Air Force," Rance said. "If any of our vital medical equipment quits working, they're the only ones who can fix it. It doesn't matter whether it's a doctor's chair breaking or a blood pressure machine malfunctioning -- it could be any piece of equipment, any manufacturer or model. They are the first ones to be called and are certified to work on this equipment."
Most life-saving and critical equipment is maintained on a six-month rhythm, which ensures their readiness when minutes count, Biascan said.
"An (automated external defibrillator) giving out the wrong jolt of energy or an infusion pump operating at the wrong rate could risk a person's life and excessive radiation can be very damaging during x-rays," he said. "On critical items like this, we regularly check how much radiation the machine gives and check it against its tolerances. So what we do ensures patient safety on a daily basis."
One of the most essential machines in daily use is the dental clinic's panoramic x-ray machine, which allows dentists an up-close look at problems hidden below the gumline or inside a tooth. With only one machine of its kind in the facility, a pending repair and resulting downtime could delay treatments and even affect missions downrange.
For Capt. (Dr.) Barrington Dykes, 36th Medical Operations Squadron general dentist, precision and reliability is crucial in providing accurate assessments to patients. While maintainers ensured that patients received the correct and minimal dosage of radiation necessary, Rance and his team recently secured a timely replacement for this critical tool, which is already on its way to Guam.
"We ensure the deployability of our Airmen," Dykes said. "One of their stops is through dental, for updated radiographs. If we don't have the necessary machinery and our equipment is not working, we can't actually clear deployers and somebody else has to go in their place. So keeping the equipment running is beyond essential and the (maintainers and logisticians) are our lifeline."
To ensure accountability and expedite such essential equipment swaps, the team conducts a annual inventory that lists each and every piece of equipment in use at the clinic.
"During the inventory we ensure everything is running and functioning at 100 percent," Rance said. "We can project which pieces come up for maintenance and to the end of their life expectancy and make sure we put in new orders in time."
On Guam, the team regularly surveys more than 776 pieces of operational medical equipment and manages stocking levels of supplies, some of which have to be stored in climate controlled storage.
"If we see fluctuations in usage, we can adjust levels according to expectations," Rance said. "The providers may not even notice we adjust inventories, but we want to make sure nobody runs out of essential items when needs increase."
To keep exam rooms and the pharmacy well stocked year-round, the logistics team keeps essential medical materiel packed floor-to-ceiling on more than 10,000 square feet of warehouse space.
"Here on Guam, our biggest challenge is getting supplies ordered and sent to us," Rance said. "It's all about timing. We're very fast and proficient when it comes to fixing items and finding and ordering new equipment, but getting certain shipments sent to Guam is not as quick and timely. We have no control over that, unfortunately, so we work with an advanced timeline in mind to get things shipped to the island punctually or keep it in warehouse stock."
Hidden in the bowels of the warehouse, packed tightly in boxes and crates on ready-to-ship aircraft pallets, the team also curates the Expeditionary Medical Support Health Response Team package. The pallets are organized by priority. The first to roll out contains the emergency and operating rooms to enable emergency care. Together, the set contains a fully stocked basic expeditionary clinic that can be deployed in support of contingencies around the Indo-Asia Pacific region with only a few hours' notice.
"We are the holders of the Pacific Air Forces' EMDS-HRT, which means we are the first line of medical support," Rance said. "It is a deployable clinic that is ready to be dropped anywhere in the world. We're on stand by and ready to roll out should we need to activate that package."
Until then, the logistics team focuses on ongoing readiness and providing the right tools for Andersen AFB's medical professionals.
"We're part of the foundation of the medical clinic," Rance said. "We're not directly working with patients, but if you pulled us out of the clinic, supplies wouldn't get restocked and equipment would eventually fail. Anything in the exam rooms is there and working because of us."