Back to Top Skip to main content Skip to sub-navigation

Army dietitian uses nutritional care to fight COVID-19

Image of Military personnel wearing a face mask standing in front of a Nutrition Clinic. Army Dietitian Capt. Melissa Shaffer is a registered dietitian and certified nutrition support clinician at Blanchfield Army Community Hospital, Fort Campbell, Kentucky. Recently Shaffer had to create a specialized diet plan for a hospitalized patient who was sedated and on a ventilator for a month battling COVID-19. Since ventilated patients cannot swallow Shaffer used enteral tube feeding to provide the patient a continuous feed of a no fiber, high protein formula, with supplements to meet his nutrition needs (Photo by: Maria Christina Yager, Blanchfield Army Community Hospital, Fort Campbell, KY).

Recommended Content:

Nutritional Fitness | Total Force Fitness | Coronavirus

Army Capt. Melissa Shaffer, a registered dietitian-nutritionist at Blanchfield Army Community Hospital at Fort Campbell in Kentucky, doesn't swab nasal cavities to test for COVID-19 or administer COVID-19 vaccines.

In the fight against COVID-19, her mission is to oversee the nutritional needs and special diets of all military healthcare beneficiaries admitted to the hospital - including those with COVID-19. As a certified nutrition support clinician, she was specifically trained to work with critically ill patients, and is part of the hospital treatment team for a critically ill COVID-19 patient.

Air Force retiree Gino Garcia can testify to the importance of her role at the hospital, as spent about two months in Blanchfield’s intensive care unit where a team of healthcare professionals worked together to help him recover from the deadly disease.

When he first arrived, his doctors noticed he wasn't able to oxygenate his blood so they decided he would benefit from being intubated and placed on a ventilator. A ventilator is a life-support machine that uses a tube inserted into the trachea through the mouth or nose that forces air into the lungs, artificially breathing for a patient who cannot adequately breathe on their own.

"The last thing I remember was that I had COVID and that I went through [the hospital] doors to be taken care of like any other patient. After that I don't have any other memories," said Garcia.

Now in recovery, Garcia referred to his time on the ventilator as "lights out" because he had no recollection of the month prior when the ventilator, his care team, his family's love and many prayers were at work to help him beat COVID-19.

Shaffer was responsible for the nutrition care needs of Garcia, which she coordinated with other medical specialists involved with his care.

"Nutrition plays an important role with the recovery of critically ill patients. Since Mister Garcia was ventilated and sedated he couldn't eat on his own," said Shaffer. "You have to feed critically ill patients who are ventilated with enteral tube-feeding and you have to consider the formula, the rate, and the type of feeding you are going to give them."

Shaffer used predictive equations to calculate his energy needs and started Garcia out on a continuous feed of a no fiber, high protein formula to meet all of his nutrition needs. She gave him additional protein supplements so he wouldn't lose a lot of lean body mass while he was hospitalized and also evaluated his medications.

"We screen all the patient's medication for nutrient/drug interactions. There are certain things you have to watch for if somebody is on tube feedings because certain drugs can deteriorate the tube," she said.

Garcia's case was extremely critical but after nearly a month on the ventilator he began to improve and became aware of his surroundings.

He was very weak from the toll the virus took on his body but ready to begin the recovery process with the help of his family and care team.

"After such a long time in that position I forgot about eating. I forgot the taste of food, color and aroma. So I had to kind of rearrange my brain...and go through the learning process like a baby learning to eat," Garcia said.

Shaffer explained that when a ventilator tube is removed some people may have issues with eating, and swallowing. Patients sometime have to relearn those skills and with ventilation they are not using their muscles so they may lose muscle strength.

Once he was able to breathe on his own Garcia's ventilator feeding tube was replaced with a thinner feeding tube through his nose. This tube would allow him to begin the process of learning to eat and feed himself again. Shaffer continued tube feeds to meet his energy needs until he was able to meet them through eating on his own.

The treatment team used a multi-disciplinary approach for Garcia's nutrition and self-feeding rehabilitation.

A speech pathologist performed a swallow evaluation to determine the texture of foods that Garcia could tolerate and provided the information to Shaffer so her team in nutrition care could create foods he could consume. Shaffer did daily calorie counts to assess how much Garcia was eating by mouth. As that improved she began taking him off tube feeds and protein supplements.

He started with thickened liquids and after his first swallow study he was able to have pureed foods and mechanically softened foods like applesauce, as well as puddings and gelatin.

"A lot of times a patient will want a specific food but you have to change the texture of it, so our patient food service team would blenderize or modify it to get it to the right texture," Shaffer said. Once Garcia progressed to scrambled eggs and grounded meat with gravy he no longer required tube feedings.

Meanwhile the hospital's occupational therapy and physical therapy personnel also played a large part in helping Garcia regain his self-feeding skills.

"Many times it was like turmoil because you would expect that I could [feed myself] very easy, but it wasn't. I didn't have the strength in my hands. I didn't have the balance in my hands," said Garcia.

After several weeks from coming off the ventilator, Garcia was healthy enough to transition to a rehabilitation facility where he continued his regain strength and the daily living skills he had before contracting COVID-19.

"Our whole team was rooting for him and his recovery. So it feels great to know he's improving and that we played a part in it," said Shaffer. "I am so incredibly proud of him."

In the Army, the field of nutrition is vast and Army registered dieticians can do a number of different jobs, from clinical to food production and humanitarian missions. Army dietitians also work closely with Army physical therapists through the Army's Holistic Health and Fitness Program to help educate Soldiers on performance nutrition to meet the physical demands of field training and combat.

You also may be interested in...

Top Military Health Care officials visit Naval Hospital Bremerton

Article
7/17/2020
Place and colleagues learn about Bremerton

"[W]hat’s most important to military health is not headquarters, but where that military health is delivered."

Recommended Content:

Combat Support | Coronavirus

Military Medicine Joining Forces to Fight COVID-19 All Around the World

Article
7/17/2020
A group of military personnel posing for a picture

Multiple commands from the Navy and Air Force responded to the request with personnel from all over the country.

Recommended Content:

Coronavirus | Combat Support

Army Healthcare Professionals share their call to serve

Article
7/16/2020
Scientist looking at samples in test tubes in a lab.

The Army provides no cost job training with pay and benefits to those who enlist for healthcare specialties.

Recommended Content:

Coronavirus

DoD Leverages GEIS Respiratory Surveillance to Respond to COVID-19

Article
7/15/2020
Three men in a pig pen taking samples

AFHSB’s Global Emerging Infection Surveillance (GEIS) program manages a global laboratory network to detect emergent diseases and track respiratory illnesses such as influenza.

Recommended Content:

Armed Forces Health Surveillance Division | Coronavirus

Innovative RX pad creates path for prescribing mobile health technology

Article
7/15/2020
Military health care provider demonstrates the use of the T2 Mood Tracker app to a patient.

Technology and healthcare are constantly evolving fields.

Recommended Content:

Coronavirus | Public Health

DHA Director and Senior Enlisted Leader visit Branch Health Clinic Everett

Article
7/15/2020
Army Lt. Gen. Ronald Place viewing a drive-through pharmacy

NHB, along with Branch Health Clinics Bangor, Everett and Puget Sound Naval Shipyard transitioned administration and management oversight to DHA in the fall of 2019.

Recommended Content:

Coronavirus

BAMC adapts to support greater San Antonio community during COVID-19 pandemic

Article
7/15/2020
Doctor checking soldier's heartbeat

BAMC is the only Level I Trauma Center within the Department of Defense and one of two within San Antonio.

Recommended Content:

Coronavirus | Coronavirus

U.S. military deploys to Texas and California in support of COVID-19 operations

Article
7/14/2020
Image of medical personnel in a hospital room. Click to open a larger version of the image.

[A]pproximately 740 Department of Defense medical and support professionals from the Army, Navy and Air Force deployed to support COVID-19 operations in Texas and California.

Recommended Content:

Coronavirus

Life support training continues for MHS clinical staff

Article
7/14/2020
Students are socially distanced in a life support training class

How do clinical staff social distance and deliver CPR training?

Recommended Content:

Coronavirus

Applying COVID-19 innovations to the future of MHS medicine

Article
7/14/2020
Virtual health visits are expanding in response to COVID-19.

COVID-19 has already irrevocably changed how we deliver care and will continue to do so.

Recommended Content:

Coronavirus | Research and Innovation

Defending the Homeland: COVID-19 Asymptomatic Testing Clinic opens at NMRTC Bremerton

Article
7/13/2020
Soldier getting a nasal swab test for COVID-19

[S]tanding up the CAT clinic will assist in identifying asymptomatic COVID-positive individuals and assist the continual effort to stop the spread of the pandemic.

Recommended Content:

Coronavirus

For some, working from home brings neck and back pain

Article
7/10/2020
Chiropractor adjusting another man's back

"[T]he most common complaint of teleworkers is neck and upper back pain between the shoulder blades."

Recommended Content:

Coronavirus | Public Health

DHA's new app assists providers with treating infectious diseases

Article
7/10/2020
Medical personnel putting gloves on

This progressive web application provides faster updates to content and function than traditional apps.

Recommended Content:

Coronavirus | Health Care Technology

Defending the Homeland: New Invention Helps Protect Healthcare Workers During COVID-19 Pandemic

Article
7/9/2020
Image of medical personnel in hospital room

"[T]he team realized that while the CAMIC would function well for tracheostomy, its true use would be for intubation..."

Recommended Content:

Coronavirus | Research and Innovation

Defending the Homeland: Fort Knox Safety Official Donates COVID-19 Convalescent Plasma to Help Others

Article
7/8/2020
Woman sitting in chair giving blood

[T]he process involves a machine that uses three bags to collect and separate the plasma from the blood.

Recommended Content:

Coronavirus | Convalescent Plasma Collection Program
<< < ... 21 22 23 24 25 > >> 
Showing results 331 - 345 Page 23 of 25
Refine your search
Last Updated: March 31, 2021

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.