REISTERSTOWN, Md. – Dave Williams thumbed through a reference binder as a defibrillator beeped away in the background.
After tapping on a few buttons, the machine warned him to "stand clear" before it printed out a long receipt of sorts, indicating it was functioning normally and ready to use on a patient.
Williams is part of a small team of biomedical equipment specialists from the U.S. Army Medical Materiel Agency's Medical Maintenance Operations Division that visits dozens of National Guard units around the eastern United States to ensure medical equipment for the units of part-time Soldiers is ready to go at a moment's notice.
"We're working across the whole scope," Williams said, including pulmonary equipment, mobile X-ray machines and lab equipment for medical facilities like aid stations and field hospitals.
With the overall goal of ensuring readiness for National Guard units across 23 states and territories, teams from Tobyhanna Army Depot in northeast Pennsylvania spend roughly 17 weeks a year on the road to handle medical maintenance tasks.
They aim to service 6,000 to 8,000 pieces of equipment twice annually, supervisor Isaac Newman said.
"We have close to 50 technicians at Tobyhanna, and from November until July, we have three to four, two- to three-man teams on the road for that entire time frame to take care and maintain the National Guard medical equipment," Newman said.
The mission falls under USAMMA's Medical Maintenance Management Directorate (M3D), which oversees depot-level medical maintenance operations for the organization.
M3D has three divisions across the country that dispatch regional teams to serve the National Guard. The service visits ensure high levels of medical readiness for the Guard despite having far fewer trained maintainers compared to their active-duty counterparts.
In addition to Tobyhanna, USAMMA's MMOD operates at the Defense Distribution Center in Tracy, California, and Hill Air Force Base in Utah.
Across all three sites, technicians completed 16,231 maintenance actions for National Guard medical equipment this past fiscal year.
For the 104th Area Support Medical Company, based at Camp Fretterd Military Reservation near Reisterstown, USAMMA's support provides a valuable resource because they have just one medical maintainer in the unit of about 75 Soldiers.
Staff Sgt. Patrick Cadden said the service is invaluable for the unit to maintain readiness.
"Typically, just like anybody in the Guard, we all have other jobs," said Cadden, who serves as the noncommissioned officer for supply for the unit. "And for that Soldier (who handles medical maintenance), it's roughly 16 hours a weekend that he has time to get his hands on the equipment.
"Having subject matter experts come in and just kind of verify that he's on track and good to go is invaluable," he said.
During the weeklong visit to the 104th completed Feb. 14, Williams and fellow technicians Juan Olguin-Martinez and Dean Edwards tested 150 to 200 pieces of medical equipment.
As they worked under fluorescent lights in a large room in the main building on the small rural installation northwest of Baltimore, team members certified and returned equipment and components found to be in proper working order to ready stocks for the unit. For devices that needed repairs, workers either fixed them on-site or tagged them to send back to Tobyhanna.
Newman said the teams' visits also serve to educate each unit about the services USAMMA can provide.
"It doesn't cost them anything except the cost to get the equipment to us," he said. "We'll replace all the parts, cover all the labor, all the repairs and the shipping back."
For the workers, a mix of civilian employees and contractors, each has a different reason why they enjoy the work. Williams, an Army veteran, said he loves his job because it allows him to be a part of "something bigger than me."
Like with active-duty units, medical support plays a key readiness role because it enables Soldiers to respond immediately and have confidence that they have the protective equipment and access to the world-class medical care needed to sustain the fight or support other missions, like humanitarian aid deployments.
"National Guard units are deployed into theater a lot more than they ever used to … and this is the equipment that they pick up before they move out," Newman said. "Their mission doesn't stop if they have a lack of medical support.
"The support we provide greatly increases the medical readiness of the units and their ability to deploy anywhere, anytime with confidence," he said. "The National Guard sustainment maintenance program is a crucial readiness component."