Back to Top Skip to main content

MHS - Defending the Homeland: Proning made easy at Keesler Air Force Base

Image of a dummy laying face-down on a hospital bed A simulation model at Keesler Air Force Base lies on a newly designed pronating shelf, designed to assisted COVID-19 patients with their breathing.

Recommended Content:

Coronavirus

COVID-19 has presented many challenges to the medical community. Among those challenges is treating patients with respiratory failure. Adult respiratory distress syndrome, or ARDS, is a complication of COVID-19 among intensive care unit patients. To address this issue, a team from the Air Force’s 81st Medical Group, or MDG, at the Keesler Medical Center aboard Keesler Air Force Base near Biloxi, Mississippi, prototyped a “proning shelf” that can be attached to an ICU bed. The shelf helps ARDS patients rest in a position that allows easier breathing.

“Our Keesler Medical Center medics are leading the way in innovating new care techniques for COVID-19 patients,” said Air Force Col. Beatrice Dolihite, service commander of the MDG at Keesler. “The ability to place patients in a proning position was seen by our team as part of the medical care plan needed to treat COVID-19.  We are very excited to have this capability in our ICU.”

ARDS is a respiratory illness that reduces the working area of the lungs. That reduction causes low oxygen levels in the body. Patients with ARDS are placed on a ventilator and sedated for comfort. However, ICU patients rest on their backs in bed, causing gravity to pool fluids and increase pressure at the base of the lungs. Providers reverse that gravitational pull by placing patients in a "pronated position," or face down.

Placing a sedated, ventilated patient face-down results in additional challenges, such as making sure ventilator tubes are secured and free from bends or obstructions. Hospitals normally lease specialty beds for the few patients that may need pronation. Now these beds are in short supply as the country combats the COVID-19 pandemic.

The MDG’s Education and Training Flight, led by Air Force Maj. Mark Gosling, developed instructions for how to use normal ICU beds to prone patients. The process uses pillows, multiple layers of sheets, and procedures to safeguard all IV lines and tubing necessary to treat the patient.

"Our education department works with other departments on a routine basis, as we are a supportive department for the MDG,” Gosling said. “My team is excellent at pulling together resources to solve problems.”

The team later discovered that the prone position leaves the head and neck turned to one side. Long periods of time in such a position lead to problems for the airway and neck. Ideally the patient’s head would face straight down and still be supported. The position must also leave the airway tubing free and able to ventilate.

Experts at the fabrication shop from the 81st Training Support Squadron at Keesler AFB were contacted for help. The team members were each working from home when the call came in. Led by Thomas Lassabe, the team arrived early in the morning to assess the situation and hatch a plan.

“We’ve worked with Major Gosling’s team on multiple projects in the past to produce training items for the MDG Simulation Lab,” Lassabe said, “so when the call came in to help with this request, the team jumped in and knocked it out.”

Within two and a half hours, the team went back to the MDG Simulation Lab with a prototype shelf that used the support posts from patient headboards as attachments. This shelf, along with a gel head support from the surgery department, cradled the patient's head and neck in the proper position for easy breathing. With minor adjustments, the skilled craftsmen had produced seven more “proning shelves” by the end of the day.

The team later discovered that the shelf needed an opening for ventilator tubing to pass through and not bend severely. With the help of the respiratory therapy department, the team modified the shelf to make room for tubing. The proning shelf project, started on a Tuesday morning, was fully operational and tested by close of business the next day. ICU nursing staff trained on the proning procedure and knew how to use the equipment the day after that.

“As we started to create the prone positioning training, our simulation element knew the skills that the fabrication guys could bring to our team,” Gosling said. “It was awesome to see this group quickly gel and put together not only training but design and build equipment specific for our program.”

Keesler Medical Center remains ready to provide top notch critical care for the COVID-19 pandemic. That care involves dedicated teams who bring with them a can-do mentality and willingness to try out-of-box ideas.

“We like to say that we have the best job on Keesler Air Force Base,” Lassabe said. “It’s requests like this that solidify the important role we play in providing high-quality training devices and real-world requirements to Team Keesler and customers across the DoD.”

“A group commander once told me we need to have a ‘why’ story to tell the reason you joined the military,” Gosling continued. “This is why, to work with outstanding people while making a difference in patients’ lives."

You also may be interested in...

Genetic sequence data for SARS-CoV-2

Infographic
6/5/2020
Infographic describing how DoD was able to conduct genome sequencing on the COVID-19 virus

Genetic sequence data for SARS-CoV-2, the virus that causes #COVID19, plays a vital role in force health protection efforts within the DoD. To jumpstart sequencing efforts, the Armed Forces Health Surveillance Branch's Global Emerging Infections Surveillance and Response applied a collaborative approach to sequencing capabilities. Resulting sequence data will provide critical information about transmission patterns, track diagnostic effectiveness, and guide the development and evaluation of medical countermeasures.

Recommended Content:

Armed Forces Health Surveillance Branch | Coronavirus | Global Emerging Infections Surveillance

DoD Establishes Collaborative Virus Genetic Sequencing Capability for COVID-19

Article
6/5/2020
Image of two scientists in masks looking at a computer monitor

COVID-19 sequencing process will provide military commanders and other DoD leadership with critical information to guide force health protection decision-making.

Recommended Content:

Armed Forces Health Surveillance Branch | Coronavirus | Global Emerging Infections Surveillance

Putting talent to work

Article
6/5/2020
Three military personnel wearing masks

One seamstress took it upon herself to create face coverings for her colleagues.

Recommended Content:

Coronavirus

WRNMMC Operates Drive-Up Immunization Clinic

Article
6/3/2020
Nurse giving a shot to a girl; both wearing masks

Parents and others (are encouraged) to maintain their immunization health during COVID-19.

Recommended Content:

Coronavirus | Immunization Healthcare

TRICARE Reserve Select (TRS) Health Plan Reinstatement During COVID-19 National Emergency

Fact Sheet
6/2/2020

Fact sheet explaining that explaining that TRICARE Reserve Select beneficiaries now have five months to reinstate terminated coverage after their last paid-through date before a 12-month lockout period will apply.

Recommended Content:

Coronavirus | TRICARE Changes and You

The 150th Security Forces Squadron supports NM COVID-19 response effort

Article
5/29/2020
Group of military personnel posting for a picture

The 150th Security Forces Squadron and the New Mexico National Guard’s Joint Task Force COVID-19 are providing support that may not otherwise be available to New Mexico communities and their citizens.

Recommended Content:

Coronavirus

Building Your Mental Health Through Resiliency

Article
5/29/2020
Soldier walking through a maze

Being able to think about things from a different perspective is critical.

Recommended Content:

Coronavirus

DoD experts address COVID-19 effects on mental health

Article
5/29/2020
Image of soldier wearing a mask

As the world adjusts to a new normal, here’s how to keep mentally healthy.

Recommended Content:

Coronavirus

DoD launches effort to collect COVID-19 convalescent plasma

Article
5/29/2020
Image of man wearing mask and giving blood

Plasma donations needed in the fight against COVID-19

Recommended Content:

Coronavirus

DOD COVID-19 Survivor Gives Shoutout to Doctors, Plasma Donors

Article
5/29/2020
Image of soldier sitting on a bench with flowers and a balloon

Bright was the first person in the District of Columbia to receive convalescent plasma.

Recommended Content:

Coronavirus

MHS Minute: Military Leading the Charge on COVID-19 Research

Video
5/28/2020
Image of MHS Minute Carousel

The military continues to serve on the front lines of research and treatment in response to the COVID-19 pandemic. Tune in to the MHS Minute to learn more.

Recommended Content:

Coronavirus

'Home sweet home' leaves a sour taste for some quarantine-weary

Article
5/28/2020
Family playing board game

Mental health professionals offer tips on managing during uncertain times

Recommended Content:

Coronavirus | Mental Health Care | Mental Wellness

USU Aids Health Care Providers, Community in Pandemic

Article
5/27/2020
Image of two healthcare workers looking sad

USU’s Center for the Study of Traumatic Stress provides fact sheets as a resource for providers and the community.

Recommended Content:

Coronavirus | Public Health

Regional Health Command-Atlantic staff treat COVID-19 patients at NJ hospital

Article
5/27/2020
Three people in scrubs around a patient on a hospital bed

The officers assigned to the program were selected because they have medical specialties typically used in military forward surgical teams.

Recommended Content:

Coronavirus

Force Health Protection Guidance (Supplement 9) -Department of Defense Guidance for Deployment and Redeployment of Individuals and Units during the Novel Coronavirus Disease 2019 Pandemic

Publication
5/26/2020

This memorandum provides force health protection (FHP) deployment and redeployment guidance for Service members (including Reserve Component (RC) and National Guard members in a title 10 or title 32 duty status) and DoD civilian employees deploying within and outside the United States during the COVID-19 pandemic, consistent with references (a) and (b).

Recommended Content:

Coronavirus
<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 10

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.