Lifesaving Adult ECMO Transport First in WESTPAC

Story Number: NNS120403-12Release Date: 4/3/2012 1:38:00 PM
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By A1C Brooke Beers, 18th Wing Public Affairs and Brian J. Davis, U.S. Naval Hospital Okinawa Public Affairs

OKINAWA, Japan (NNS) -- The aeromedical evacuation of a critically ill U. S. servicemember from U.S. Naval Hospital (USNH) Okinawa to Tripler Army Medical Center (TAMC) in Hawaii March 26, marked the first extracorporeal membrane oxygenation, or ECMO, transfer performed with an adult in the western Pacific region.

An ECMO unit provides cardiac and respiratory oxygen support to patients with damaged or diseased heart and lungs that can no longer function for themselves.

According to Cmdr. Joon S. Yun, director of Medical Services at USNH Okinawa, until now the only patients that had ever been transferred in the Western Pacific while attached to an ECMO unit were severely ill infants. The procedure also has been done with war casualties in Iraq and Afghanistan being transferred to Landstuhl Army Medical Center in Germany. This was the first time in the entire western Pacific theater that the transfer procedure had been done with an adult. The servicemember was the first adult ECMO patient to be sent to Tripler for treatment.

Two weeks earlier, the servicemember, suffering from a severe fungal pneumonia, was transported by helicopter to USNH Okinawa from a 7th Fleet ship operating in the vicinity of Okinawa. Placed on a ventilator and dealing with a severe lung infection, the servicemember began to develop serious complications that had hospital staff working around-the-clock to keep him alive. Physicians caring for the servicemember began discussing the possibility of moving him to a higher level of specialized care.

"Although the care provided by the ICU (intensive care unit) staff and all of the members of the USNH Okinawa team have given [the servicemember] a fighting chance to survive his tremendous lung infection. At this point, he suffered a complication that cannot be fixed here in Okinawa," said Yun. "Fortunately, [Army] Lt. Col. Erik Osborn, a TAMC pulmonary intensivist, has built a lung transport team for this very special situation," he said.

After receiving the initial call from Yun, ECMO Team Leader Osborn gathered his team of nine highly specialized doctors, nurses, and technicians and, within 24 hours, the ECMO team and their gear were airborne enroute to Okinawa.

The ECMO team arrived March 26 at 4 a.m., and went right to work. While they were receiving a brief and status update from the ICU staff, the hospital's General Surgery staff prepared a room for the team's thoracic surgeon to perform the ECMO procedure.

To provide ECMO, a surgeon inserts tubes into the large blood vessels of the patient. With the help of blood thinners to prevent clotting, the machine will then pump blood through a membrane oxygenator, removing carbon dioxide and adding oxygen, then return it back into the patient.

Once the servicemember was connected to the ECMO unit and was stable enough for transport, the ECMO team and hospital staff immediately set about the complex and delicate task of preparing him for transfer to Kadena Air Base where he would board a C-17 Globemaster that would take him to receive specialized treatment in Hawaii. The ECMO team would remain by the servicemember's side throughout the entire journey.

The medical team transporting the servicemember was composed of not only Air Force critical care air transportation nurses and Army soldiers, but also civilian nurses from Kapi'olani Women's and Children's Medical Center, who are part of the Tripler Army Medical Center joint medical attendant transport team.

According to Capt. Pius A. Aiyelawo, commanding officer, USNH Okinawa, the efforts of everyone involved working to save the servicemember's life was no less than a miracle.

"Miracles don't just happen; it takes hard work, training and always being ready," said Aiyelawo.

Although the medical team members did not belong to the same branch of service as the patient, they came together to perform what needed to be done to help save his life.

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U.S. Army, Air Force and Navy personnel move a Marine patient from his bed to a stretcher to transport him to Kadena Air Base.
120326-F-ZT401-018 OKINAWA, Japan (March 26, 2012) U.S. Army, Air Force and Navy personnel move a Marine patient from his bed to a stretcher to transport him to Kadena Air Base from U. S. Naval Hospital Okinawa, on Camp Lester, Japan. (U.S. Air Force photo by Airman 1st Class Brooke P. Beers)
April 2, 2012
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