[This article was first published in Army Sustainment Professional Bulletin, which was then called Army Logistician, volume 2, number 1 (January–February 1970), pages 12–15.]
PROMPT RESPONSE to emergency medical materiel requirements, coupled with rapid helicopter and airplane evacuation of the wounded, ranks among the major contributions to the greatly improved survival rate of the seriously wounded in the Republic of Vietnam. It is this kind of immediate response by the Army's medical logistics system that is giving the American soldier the best chance of survival of any war to date and making it possible for the more seriously wounded to receive the full benefits of modern American medicine. Even unusual requirements, such as freeze-dried human skin needed for temporary grafting, are only a phone call away.
When physicians at a hospital in the Republic of Vietnam urgently needed 2,500 centimeters of human skin for a patient whose stomach and chest wounds had become grossly infected, a rush call to the Defense Personnel Support Center (DPSC) at Philadelphia, Pennsylvania, made the life-saving materiel available within five days. For the Center, buyer of food, clothing, and medical materiel for the Armed Forces, the requirement for such an unusual item produces a flurry of activity. In this case, quick detective work traced the item to the Bethesda Naval Hospital in Maryland, where its use in the treatment of burn patients is being pioneered by the Navy.
The Navy agreed to supply the skin and shipped it by commercial airlines to Okinawa. From there, military aircraft flew it to Vietnam, arriving one day ahead of schedule. This incident demonstrates the effectiveness of a streamlined supply management system augmented by efficient air evacuation and modern medical care.
Unlike anything available in previous wars, this management system includes a modern communications network, automation of requisitions, financial and accounting records, and personnel records, modern procedures and methods for procurement, quality assurance, storage, distribution, and information feedback from customers and users.
"Medical Lifeline"
The U.S. Army's "medical lifeline” to Southeast Asia (SEA) may be said to start at the DPSC in Philadelphia, which was established as a field activity of the Defense Supply Agency on July 1965. DPSC procures needed items, at the wholesale level, from the many medical industries which produce the materiel required by the Armed Forces. Medical supplies destined for SEA are usually shipped to the Defense depot at Tracy, California, for eventual shipment to Okinawa. Upon their arrival, the Army assumes custody for storage and distribution. Within Vietnam, the 32d Medical Depot is the prime storer and distributor servicing numerous military medical activities in the field.
Requisitions for medical supplies for all Army forces in Vietnam are relayed through the 32d Medical Depot, the U.S. Army Medical Depot in Okinawa, to the U.S. Army Medical Materiel Agency at Phoenixville, Pennsylvania, and finally to DPSC. At the Center, supply specialists validate the requisitions and determine whether the supplies requisitioned are stocked or whether they have to be specially purchased.
Requisitions for medical supplies for Navy and Air Force organizations in SEA are handled in a manner similar to that of the Army. The Navy's Field Branch, Bureau of Medicine and Surgery, provides liaison with DPSC. The Air Force Medical Materiel Field Office, located at the Valley Forge General Hospital, Phoenixville, Pennsylvania, provides liaison for the Department of the Air Force.
The Center procures medical supplies for delivery by contractors either to its storage depots throughout the country or directly to military customers. Its office of data systems has three large-scale and three medium-sized computers, as well as associated electronic accounting machines and automated source data input equipment. Vendor technical representatives are available at all times to guarantee the functioning of all the computerized data processing equipment.
The Center strives to insure that medical materiel procured for the U.S. Army and other military services is pure, safe, and clinically effective from the moment it enters the supply system until it is used. ln depots which store medical materiel for DPSC, the personnel pursue a policy of "first in, first out" with regard to medical supplies. In addition, they maintain strict depot stock surveillance and inspection.
Because quality and quality control aspects of drugs and medical materiel are highly complex, DPSC employs pharmacists, chemists, and engineers to develop specifications and tests necessary to insure that only items of high quality are competitively procured. DPSC bases the preparation of specifications for medical material on essential characteristics provided by the Defense Medical Materiel Board.
Specifications, in addition to detailing the requirements for particular medical items, include quality assurance provisions. They indicate tests the item must pass, sampling procedures to be applied, and, in many cases, the applicable classification of defects and acceptable quality levels for each category of defects. Because medical materiel procured by the Center is distributed worldwide and is subject to extremes in climatic conditions, the specifications often exceed National Compendia standards. Furthermore, the Center buys for long-term storage, for mobilization purposes, and for pre-positioned stocks.
The Center maintains a modern, well-equipped medical laboratory where tests are performed to validate the quality of medical materiel procured for the military medical lifeline.
New Items
Although most requisitions are for routine medical supplies and equipment, such as drugs, bandages, surgical instruments, and hospital beds, requisitions also include requests for many special medical types of equipment and systems. Among the best known of these is the hospital system called MUST (Medical Unit, Self-Contained, Transportable). This system is made up of inflatable rooms joined to form a complex containing operating rooms, sterile preparation rooms, and modern ward facilities. Several MUST units are being used in Southeast Asia, not only by the Army but also by Naval medical activities supporting Marine organizations. While constant revisions are being made to the system, it has provided as close to a CONUS medical institutional environment under complete field conditions as it has been possible to achieve.
Other new items procured by DPSC include a field gas anesthesia apparatus. This unit, although designed primarily for field use, can be readily used in base hospitals in the United States. It is lightweight—about one third less than older models—and it is easier to maintain than the several models in use the past 30 years.
Portable dental equipment is also being procured by DPSC for the troops in Vietnam. A portable ultrasonic prophylaxis unit with a water supply tank takes the cleansing of teeth by ultrasonics out to the field. The unit produces 25,000 microscopic mechanical strikes per second which, with the application of water, gently dislodges calculus and stain. DPSC also procures a portable, self-contained, field dental operating and treatment unit, with a reciprocating, power-driven compressor, which provides dentists with equipment sufficient for their needs.
The constantly changing state-of-the-art of the medical profession and its technological developments have a continuing and strong influence on the activities of DPSC. Scarcely a standard medical item exists which does not alter some of its physical or performance characteristics within a year or two. New materials, especially in the pharmaceutical field, appear on the market almost daily and the Center must take action to supply the best and most effective of these to military service physicians in the field. After the decision has been made either to alter an existing item or to add a new one to the inventory—a decision made by a tri-service board at the Department of Defense level—DPSC must take many actions. These range from the promulgation or updating of specifications and performance criteria, to conferences with industry whose technical know-bow and ability are the prime prerequisite for the supply of any medical item for the Armed Forces.
12,500 Articles
Some of the most active medical supply items handled by the Directorate of Medical Materiel at DPSC are: serum albumin—used as a blood expander; chloramphenicol—used as a broad spectrum antibiotic; field litter—used for transporting patients; immune serum globulin—used for the treatment of hepatitis; X-Ray film—used for taking radiographs; chlordiazepoxide hydrochloride—used as a mild tranquilizer; and tetracycline—used as a broad spectrum antibiotic.
These are only a few of the approximately 12,500 medical, dental, veterinary, and chemical and laboratory articles procured, stored, and managed by DPSC.
The Directorate of Medical Materiel processes more than 4,000 requisitions every 24 hours and purchases $1 million worth of medical equipment and supplies every working day. The cooperative effort of the medical industry and the military now makes it possible to fill a high priority medical order and have it delivered in Vietnam within four days of the time the requisition is put into the transceiver by the requisitioner.
Delivery of medical supplies and equipment to the military services does not end the Center's vigilance and interest in the effectiveness of its procurements. It continues to maintain an open information pipeline which enables its supply specialists to keep abreast of medical needs of the fighting men. In addition to the feedback of customer complaints, the Center has a program of customer liaison visits. These visits involve quality checks at field activities, where Center representatives, recognizing the reluctance of some people to place complaints in writing, solicit comments on medical materiel. Center personnel also travel to Southeast Asia periodically on such visits.
The medical lifeline is manned by teams of experts from its source at DPSC in Philadelphia to the supply delivery points of the military services. Along this line flow the medical supplies and equipment essential to the health and care of the U.S. Army, U.S. Navy, U.S. Air Force, and U.S. Marine Corps personnel in Southeast Asia and the requisitions that make their medical needs known to DPSC. These needs are provided through the enterprise and cooperation of the military services and American industry. Scientific developments of the past five years have resulted in the use of many modern types of equipment and supplies which, together with the fast evacuation by helicopter and airplane, have saved more lives in the Vietnam War than in any other previous conflict.
Brigadier General William M. Mantz commands the Defense Personnel Support Center (DPSC), Philadelphia, Pennsylvania. Before assuming command of the DPSC in November 1967, he was commanding general of the U.S. Army Natick Laboratories, Natick, Massachusetts. General Mantz was certified as a fully qualified Army logistician in 1961.
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