APRIL 27, 2016, JOINT BASE SAN ANTONIO-LACKLAND, Texas (AFNS) – The nature of military operations dictates the need for immediate, professional health care that’s available globally at any time. When that needed care is more extreme, the 59th Medical Wing’s Extracorporeal Membrane Oxygenation team stands ready.
A mission exclusive to the wing, headquartered at the Wilford Hall Ambulatory Surgical Center, the ECMO team is bedded down at the San Antonio Military Medical Center on nearby Joint Base San Antonio-Fort Sam Houston. Together, the integrated team of Air Force and Army medical professionals delivers unique life-saving procedures both on the ground and in the skies.
The ECMO process circulates blood through a machine that removes carbon dioxide and adds oxygen back, reducing stress on a patient’s damaged lungs. This technique allows diseased or injured lungs to heal. It’s this capability that gives an ECMO team the ability to transport critically ill patients around the world.
“We work to keep the patients alive, keep their other organs going,” said Lt. Col. Phillip Mason, the ECMO team lead. “Typically, we can reduce a patient’s chance of dying from 80 to 90 percent down to 30 to 40 percent. When you’re talking about people this sick, the difference is actually a major victory.”
Kathryn Naagard, the 59th MDW’s extracorporeal life support program manager and senior team member, was a nurse for seven years at the wing’s neonatal intensive care unit. Initially, the adult ECMO program started as an extension of the neonatal program that was still operating at Wilford Hall, she explained.
In 2011, the wing took the adult ECMO program to SAMMC. Today, the team is capable of providing 24-hour care to two patients simultaneously, both at their facility and aboard military transport planes.
At a minimum, the ECLS has 10 medics always on standby. Within 12 hours, the team can be airborne with all of the equipment necessary for aeromedical patient care.
From Landstuhl to the 59th MDW
In 2005, a group of Air Force critical care transport specialists operating out of Landstuhl Regional Medical Center in Germany, first explored a technique to transfer patients in pulmonary failure using a Novalung membrane device.
The Novalung membrane ventilator was successful early on, and enhancements in medical technology led to using ECMO in 2010. With a decreased patient stream from Operation Enduring Freedom, there was no longer a significant need for this process. Eventually, the mission capability was phased out at Landstuhl. The 59th MDW revived the technique soon after.
Since then, the team has been building on those concepts to improve the capability.
“The good news about ECMO is that there is no one way of doing it. Depending on the situation and patient needs, optional equipment and setups can be incorporated into the system,” said Maj. James Lantry, the ECMO transport team vice director.
The ECMO program has expanded rapidly since the late 1990s when the 59th MDW only provided this air transport capability with the neonatal unit.
“We’re the only full-fledged medical team in the (Defense Department) that can go all over the world,” Naagard said. “There are a few other EMCO transport teams out there but they have limited capabilities. Some can only travel 60 miles from their home base, or can only transport patients by ground.”
The 59th MDW continues to secure its place as the DOD’s only ECMO hub by expanding training opportunities for those who chose to deliver military health care across the globe.
“We train 10 new specialists every year,” Naagard said. “The ECMO program will only continue to grow and save lives around the world.”