Oakland VA hospital and partners test federal response to national disaster

By Liz Zemba, VA Pittsburgh Healthcare System

VA Pittsburgh Healthcare System (VAPHS) teamed up with the 911^th Airlift Wing (AW) and local state and federal partners in November to practice the region’s ability to relocate hospitalized patients to unaffected regions during presidentially declared disasters and public health emergencies.

A test of the National Disaster Medical System (NDMS), Operation Pegasus Stride 2024 simulated the 911^th AW airlifting 35 patients from hospitals in the New Jersey area to Pittsburgh following a massive hurricane on the East Coast. With the help of partner agencies, VAPHS staff received, assessed and tracked the patients for ground transport via ambulance to regional civilian hospitals.

“Our role was to move current inpatients in an impacted disaster area to an area that is unaffected so hospitals in the disaster area could provide the necessary care and resources for people in need,” said David Kaczmarek, VAPHS’s interim area emergency manager.

For the exercise, 911th AW airmen escorted patients who were portrayed by ROTC students off a C-17 Globemaster III aircraft and into the care of VAPHS and Pennsylvania Special Medical Response Team (PA SMRT) physicians and nurses. VAPHS chaplains, social workers, mental health professionals and medical support assistants joined their civilian counterparts in moving the patients through reception, reassessment, patient tracking and onto waiting ambulances for transport to area hospitals.

Kaczmarek said unlike a mass casualty exercise, Pegasus Stride differed in that the evacuated patients were already hospitalized when the disaster struck. Providing them with medical care while moving them to civilian Pittsburgh-area hospitals opened up resources in the New Jersey area for hurricane victims.

Part of the Department of Health and Human Services, NDMS supports federal agencies in managing and coordinating the federal medical response to major emergencies and federally declared disasters. NDMS can be activated for natural disasters, major transportation accidents, technological disasters and acts of terrorism.

Under NDMS, VAPHS is one of 62 Federal Coordination Centers (FCC) located throughout the U.S. As such, it assists with coordinating the evacuation and placement of patients. Kaczmarek, who also serves as the Pittsburgh area’s interim FCC coordinator, said the exercise included over 125 volunteers from VAPHS, the 911^th AW, university and college ROTC programs, Red Cross, PA SMRT, ambulance providers, medical care facilities and Allegheny County emergency services.

Joining 38 VAPHS volunteers on site for the exercise was VAPHS’s Prachi Asher, deputy director, and Robert Kling, associate director. Asher said the exercise ensures VAPHS and its partner agencies are prepared to work together, in the event of an actual disaster or emergency.

“The key to a good disaster response is practice, practice, practice,” said Asher. “They are perfecting their response and their skills.”

Asher said many of the VAPHS staff who participated also volunteer with VHA’s Disaster Emergency Medical Personnel System (DEMPS). DEMPS is VHA’s main program for voluntary staff deployment to emergencies and disasters. It is part of VA’s Fourth Mission to improve the nation’s preparedness for war, terrorism, national emergencies and natural disasters.

VAPHS has 99 clinical and non-clinical staff who volunteer with DEMPS, said Christopher Ebert, VAPHS’s emergency management and DEMPS coordinator. Ebert, an Air Force Veteran who retired in 2020 from the 171st Air Refueling Wing in Moon Township, said VAPHS’s DEMPS volunteers have previously deployed in response to the pandemic and natural disasters such as hurricanes in Puerto Rico, Louisiana and North Carolina.

Glen Buzzelli, a VAPHS registered nurse, recently deployed with DEMPS to Asheville, North Carolina, to assist with Hurricane Helene relief. His previous deployments include with DEMPS and FEMA to assist with the COVID-19 pandemic at facilities in Louisiana, Arkansas and Oklahoma and with hurricane recovery in Puerto Rico and Florida.

Buzzelli participated in Operation Pegasus Stride, where he served as a casualty care unit leader. He said he volunteers because he believes “those that are able to assist, should do so.”

VAPHS Emergency Department (ED) physician Dr. Francesca McQueen said the exercise allowed her to refine her triage and team-building skills. VAPHS ED registered nurse Earlene “Dawn” Rafferty said it helped to prepare her for a real-world disaster response.

“Knowledge is power,” said Lafferty. “The more I know, the more prepared I am.”

Bryan Branby, 911th AW project officer, said the exercise was a year in the planning and included an earlier “tabletop,” or discussion-based review of each agency’s role and response to the exercise.

Branby, a retired Air Force lieutenant colonel with 36 years’ service with the 911^th AW, devised the exercise’s scenario. It was an opportunity, he said, for the 911th AW to demonstrate that it is prepared to assist in a national emergency.

Airmen who participated in the Pegasus exercise hailed from all over the base, including from security forces, aeromedical evacuation and maintenance. The C-17 aircraft used in the exercise is capable of rapid strategic delivery of troops and cargo worldwide, including the transport of litters and ambulatory patients during aeromedical evacuations.

Kaczmarek and Kling, VAPHS’s associate director, said VAPHS will use lessons learned during Pegasus Pride to improve its response for the next exercise or real-world event.

“VA Pittsburgh can’t do this by itself,” said Kaczmarek. “We rely on this interagency partnership and its people to step up and help us to be ready to respond, and continuously improve.”

Partner agencies included UPMC, AHN, Red Cross, Healthcare Coalition of Southwestern Pennsylvania, PA SMRT, Allegheny County Emergency Services, Allegheny County Medical Examiner’s Office, Allegheny County Airport Authority, the federal Department of Health and Human Services, 911^th AW and ambulance providers from Valley, Robinson and NorthWest EMS.

Editor’s note: to view photos of the exercise, visit the DVIDS HUB Pegasus Stride galleries by the 911^th AW’s Master Sgt. Jeffrey Grossi and Staff Sgt. James Fritz.

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