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

Army dietitian uses nutritional care to fight COVID-19

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...

200 new doctors, nurses to join military medical ranks early

Article
3/27/2020
Military medical professionals take their oath at their graduation from the Uniformed Services University of the Health Sciences during a ceremony in Washington, May 18, 2019. More than 200 USU military medical students and graduate nursing students will be graduating early in 2020 to support their colleagues in the U.S. military health system amid the global coronavirus pandemic. (DoD file photo)

Military medical students will be graduating early to support the Military Health System amid the coronavirus pandemic

Recommended Content:

Coronavirus | Nursing in the Military Health System

In a COVID-19 world, pace yourself to stay resilient and avoid burnout

Article
3/26/2020
Kelly Blasko, Ph.D., is a clinical psychologist and the lead for mobile health clinical integration at the Defense Health Agency Connected Health branch. She shares what providers can do to pace themselves and use self-care practices and tools to stay resilient and avoid burnout. (DoD photo by Savannah Blackstock)

Our response to COVID-19 is a marathon, not a sprint

Recommended Content:

Coronavirus | Coronavirus

Need for blood donations constant despite COVID-19

Article
3/26/2020
Medical soldiers from the 230th Brigade Support Battalion, 30th Armored Brigade Combat Team, North Carolina National Guard, host a blood drive at Fort Bliss, Texas. The need for donated blood is especially critical during the COVID-19 pandemic. (U.S. Army photo by Lt. Col. Cindi King)

Limited shelf life, canceled blood drives threaten supply

Recommended Content:

Coronavirus | Coronavirus

Nearly 10,000 Guardsmen called up for COVID-19 response

Article
3/25/2020
Army Sgt. Moises Castillo of the California Army National Guard helps an Amador County resident load food supplies into a vehicle at the Interfaith Food Bank in Jackson, Calif., March 23, 2020. (U.S. Army photo illustration by Army National Guard Staff Sgt. Eddie Siguenza)

The president left control of the National Guard to the governors and the adjutant generals

Recommended Content:

Combat Support | Public Health | Coronavirus | Coronavirus

USNS Mercy departs San Diego

Article
3/24/2020
The hospital ship USNS Mercy navigates the San Diego channel March 23. Mercy deployed in support of the nation’s COVID-19 response efforts, and will serve as a referral hospital for non-COVID-19 patients currently admitted to shore-based hospitals. This allows shore base hospitals to focus their efforts on COVID-19 cases. One of the Department of Defense’s missions is Defense Support of Civil Authorities. DoD is supporting the Federal Emergency Management Agency, the lead federal agency, as well as state, local and public health authorities in helping protect the health and safety of the American people. (U.S. Navy photo by Mass Communication Specialist 3rd Class Lasheba James)

Mercy's mission is to provide full hospital services to support U.S. disaster relief and humanitarian operations worldwide.

Recommended Content:

Civil Military Medicine | Civil Support | Public Health | Coronavirus | Coronavirus

DoD aims to fill medical gaps with military while states, cities ramp up

Article
3/24/2020
Defense Secretary Dr. Mark T. Esper speaks to reporters during a news conference at the Pentagon to discuss the department's efforts in response to the COVID-19 pandemic, March 23, 2020. (DoD photo by Army Staff Sgt. Brandy Nicole Mejia)

The secretary sees the military filling gaps in cities, states until they can deal with COVID-19 on their own

Recommended Content:

Combat Support | Public Health | Coronavirus | Coronavirus

A full night’s sleep could be the best defense against COVID-19

Article
3/23/2020
Sleep is critical for maintaining physical, cognitive and immunological dominance on and off the battlefield. Leaders must prioritize sleep as a valuable asset in maintaining readiness and resilience, especially in the context of multi-domain operations and increased health risks worldwide – including those risks associated with exposure to infectious diseases (U.S. Army photo by Robert Timmons)

Getting more sleep could dramatically improve your odds of avoiding infection

Recommended Content:

Combat Support | Public Health | Coronavirus | Coronavirus | Total Force Fitness

Air Force takes steps to assure ‘unblinking’ operations, readiness and capabilities amid pandemic

Article
3/23/2020
Air Force medics and health personnel around the globe are resolutely following and ensuring compliance with guidelines issued by the Department of Defense and Centers for Disease Control and Prevention according to Air Force Lt. Gen. Dorothy Hogg.

Within the Air Force, our medics are executing all available measures to mitigate the spread of COVID-19

Recommended Content:

Combat Support | Public Health | Coronavirus | Coronavirus

Addressing emotional responses to threat of Coronavirus

Article
3/20/2020
U.S. Air Force Master Sgt. Kathleen A. Myhre, 446th Airman and Family Readiness Center noncommissioned officer in charge, meditates outside the 446th Airlift Wing Headquarters building on Joint Base Lewis-McChord, Washington, Feb. 12, 2020. Myhre traveled to India in 2016 to study to become an internationally-certified yoga instructor. She now shares her holistic training with Reserve Citizen Airmen of the 446th AW. (U.S. Air Force photo by Staff Sgt. Mary A. Andom)

Even if you’re feeling healthy, medical professionals recommend staying home and limiting social contact as much as possible

Recommended Content:

Medical and Dental Preventive Care Fitness | Psychological Fitness | Physical Fitness | Combat Support | Public Health | Coronavirus | Coronavirus

Place addresses DHA COVID-19 response

Article
3/19/2020
Lt. Gen. Ronald Place, director of the Defense Health Agency, and Rear Adm. Bruce Gillingham, surgeon general of the Navy, discuss plans for additional COVID-19 response efforts with the Pentagon Press Corps.

Crisis Action Team part of broad-based effort

Recommended Content:

Combat Support | Public Health | Coronavirus | Coronavirus

DoD ready to help with Coronavirus, but capability limited

Article
3/17/2020
Misook Choe, a laboratory manager with the Emerging Infectious Disease branch at the Walter Reed Army Institute of Research in Silver Spring, Md., runs a test during research into a solution for the new coronavirus, COVID-19, March 3, 2020. The Emerging Infectious Diseases branch, established in 2018, has the explicit mission to survey, anticipate and counter the mounting threat of emerging infectious diseases of key importance to U.S. forces in the homeland and abroad. (U.S. Army Sgt. Michael Walters)

The DoD has only about 2% to 3% of the number of hospital beds that the private sector has

Recommended Content:

Combat Support | Public Health | Coronavirus | Coronavirus

How DHA monitors the spread of health outbreaks

Article
3/13/2020
The Armed Forces Health Surveillance Branch (AFHSB) is the central epidemiologic resource for the U.S. Armed Forces, conducting medical surveillance to protect those who serve our nation in uniform and allies who are critical to our national security interests. AFHSB provides timely, relevant, actionable and comprehensive health surveillance information to promote, maintain, and enhance the health of military and military-associated populations. (U.S. Air Force photo by Tech. Sgt. Nathan Lipscomb)

The Defense Health Agency works as a combat support agency to the military services and Military Health System

Recommended Content:

Combat Support | Public Health | Coronavirus | Coronavirus

DoD issues flexible instructions on response to Coronavirus

Article
3/13/2020
This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses. The illness caused by this virus has been named coronavirus disease 2019 (COVID-19). (CDC Illustration)

The memo covers aspects from before the outbreak through all levels of infection

Recommended Content:

Combat Support | Public Health | Coronavirus | Coronavirus

COVID-19: Know what the terms mean

Article
3/10/2020
Image of a soldier taking the temperature of another soldier. Click to open a larger version of the image.

Learning the language can help you stay safe

Recommended Content:

Coronavirus | Public Health | Combat Support | Coronavirus

Coronavirus: What you need to know

Article
3/6/2020
A Guardsmen with the 341st Military Intelligence Battalion conducts translation work on a safety message regarding the best practices for avoiding the novel coronavirus for the Washington Department of Health on Feb. 9, 2020 at the Information Operations Readiness Center, Joint Base Lewis-McChord, Wash. (Courtesy Photo)

Although news stories and images contain many reports of people wearing surgical masks to ward off the virus, that's not recommended

Recommended Content:

Global Health Engagement | Public Health | Coronavirus | Coronavirus
<< < ... 26 27 28 29 > >> 
Showing results 406 - 420 Page 28 of 29

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.