U.S. Transportation Command’s Patient Movement Requirements Center-East administered hundreds of compassionate care COVID-19 aeromedical evacuations across three continents

Release #: 20201207-1

Monday, December 07, 2020

Photo Caption: Airmen assigned to the 313th Expeditionary Operations Support Squadron transfer a COVID-19 patient following the first-ever operational use of the Negatively Pressurized Conex (NPC) to transport 12 patients aboard a C-17 Globemaster III aircraft at Ramstein Air Base (AB), Germany, July 1, to receive higher level of care at the Landstuhl Regional Medical Center, Germany. (U.S. Air Force photo by Airman 1st Class John R. Wright)




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SCOTT AIR FORCE BASE, Ill. (December 8, 2020) – Since March 22, 2020, at the onset of the global coronavirus outbreak, the U.S. Transportation’s Command (USTRANSCOM) Patient Movement Requirements Center-East (TPMRC-E), Ramstein Air Base, Germany, has directed the execution of approximately 305 COVID-related aeromedical evacuations (AE) from Europe, Africa, the Middle East, and southwest Asia.


As the AE center for U.S. Africa Command, U.S. Central Command, and U.S. European Command, the TPMRC-E administers more than 97 percent of all COVID-19 patient movements for the Department of Defense (DOD). 


“This represents the largest, in essentially every measureable metric, sustained airlift resulting from a pandemic; largest number of patients, most missions, most miles flown, etc.  In every aspect, this has been the greatest-ever AE response to a single infectious disease event,” stated U.S. Air Force Col. Billy Pruett, TPMRC-E director.  


Annually, the TPMRC-E staff, comprised of 20 U.S. Air Force, Army, and Navy personnel, organize and orchestrate 6,000 AE missions.


Serving as the DOD’s single manager for global patient movement, one of its five Unified Command Plan responsibilities, USTRANSCOM executes this critical mission primarily through the U.S. Air Force’s AE system, which provides safe, secure, and sound in-flight health care to the ill and injured transiting the skies.


The initial phase of the global patient movement process begins with a decision by the treating medical team that a patient needs to move to a higher level of care. Next, the involved senior medical authority requests patient movement through the USTRANSCOM Regulating and Command and Control Evacuation System (TRAC2ES), the DOD’s automated, electronic information tool utilized by the three USTRANSCOM PMRCs.  In addition to TPMRC-E, the other two are TPMRC-Americas, Scott Air Force Base, Illinois, and TPMRC-West, Joint Base Pearl Harbor-Hickam, Hawaii.


Then, the appropriate TPMRC receives and validates the requested requirement. During the validation process, a flight surgeon determines the individual’s capability to fly and if allowed to do so, ensures the availability of an attending physician and a bed at the destination. They also address flight specifics including altitude restrictions, patient positioning, and special equipment. The servicing TPMRC also coordinates other support such as enroute care and ground transportation to the accepting medical treatment facility.


A standard AE flight crew consists of two flight nurses and three technicians, and for specialized in-transit support, a critical care air transport team (CCATT), comprised of one physician, one intensive care unit nurse, and one specially-trained respiratory technician.  The CCATT team can assist up to four patients.  For COVID missions, an augmented AE crew, CCATT, Public Health and Infectious Disease physician all fly as part of the 16-person COVID force package with a medical crew director. 


“Our mission has not slowed down during the pandemic and we've processed over 5,500 COVID-screening questionnaires to ensure mitigation of any risk prior to our AE patients getting manifested on any mission,” said U.S. Air Force Lt. Col. Sylvia Kim, Mission Support chief, TPMRC-E. “In addition to our employing military aircraft such as the C-17 Globemaster III and the C-130 Hercules to conduct AE sorties, we've also worked closely with International-SOS to secure civilian air ambulance missions, providing urgent and priority coronavirus patient movements from Kosovo, Georgia, Poland, Djibouti, Afghanistan, Saudi Arabia, Kuwait, Jordan, Iraq, and Morocco.”  


Last spring, at the height of the pandemic’s international eruption, the TPMRC-E coordinated the movement of a COVID-positive contractor from Afghanistan to Germany and during the AF flight, the individual coded (almost died) twice.  But the onboard medical professionals AE staff and a Critical Care Air Transport Tea, (CCATT)) saved his life, and the follow-on treatment and compassionate care provided by the Landstuhl Regional Medical (LMRC), Landstuhl, Germany, enabled him to safely return home.


In addition, in October, the TPMRC-E organized an AE mission assisting a five-member family infected with the coronavirus from Saudi Arabia to Ramstein.  The active duty father originally contacted COVID and was aeromedically evacuated two days prior, and eventually, the mother and three children. 


“Originally, the mom, dad, and youngest daughter tested positive, but there were no test results for the oldest daughter or 20-month old infant son when the AE flight was requested. But we did get the results within 24 hours of the original request,” U.S. Air Force Tech. Sgt. Robert Gonzales, patient movement controller, TPMRC-East. “We did not want to break up the family in this situation.  With the entire family COVID-19 positive, there was a silver lining in the gray cloud.”


And the TPMRC-E balances other critical, life-saving AE missions, while leading the execution of more than 97 percent of all coronavirus patient movements for the DOD.


“Everybody serving in TPMRC-E has stepped up.  It’s been a tremendous effort,” Gonzales said.  “We’ve done so many COVID patients movements, transporting over 300 DoD patients.  Each one is special.”


USTRANSCOM exists as a warfighting combatant command to project and sustain military power at a time and place of the nation’s choosing. Powered by dedicated men and women, TRANSCOM underwrites the lethality of the Joint Force, advances American interests around the globe, and provides our nation's leaders with strategic flexibility to select from multiple options, while creating multiple dilemmas for our adversaries.

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