Back to Top Skip to main content

Army & Navy providers team up to save soldier’s life

Military personnel sitting around a table, exhibiting medical items U.S. Air Force Col. (Dr.) Phillip Mason, medical director, BAMC Adult ECMO Program, and other BAMC personnel instruct medical staff on proper extracorporeal membrane oxygenation, or ECMO, cannulation technique at Naval Medical Center San Diego, Dec. 11, 2019. (Photo by Elaine Sanchez, Brooke Army Medical Center.)

Recommended Content:

Research and Innovation | Technology

A specialized team from Brooke Army Medical Center at Joint Base San Antonio-Fort Sam Houston in Texas virtually supported a heart-lung bypass on the West coast, saving a soldier’s life and marking a first for this lifesaving program. 

BAMC teamed up with Naval Medical Center San Diego (NMCSD) in California in May to administer extracorporeal membrane oxygenation, or ECMO, treatment to a patient with presumed viral myocarditis, an inflammation of the heart muscle.

“This was BAMC’s first time virtually supporting ECMO and it was highly successful,” said Colleen Mitchell, ECMO primer, U.S. Army Institute of Surgical Research Burn Center at BAMC. “It is a game changer for critical care.”

Physicians first pursued conventional therapy when the young active duty soldier was admitted to the naval medical center. However, with the soldier’s condition declining, all signs began to point to ECMO as the best course of treatment.

ECMO is a heart-lung bypass system that circulates blood through an external artificial lung, oxygenates it, and delivers it back into the bloodstream. Rather than treat the condition, ECMO performs the job of the patient’s heart and lungs, buying the patient precious time to respond to treatments and heal. Established in October 2012, BAMC has the only adult ECMO center with full capability in the Department of Defense and remains one of the few centers in the world with air transport capability.

“The sooner the patient is on ECMO and stabilized, the less time vital organs are without oxygenation or necessary blood pressure support and the quicker the recovery,” said Bernadette Elliott, Adult Extracorporeal Life Support (ECLS)/ECMO transport program manager.

With increasing evidence of its lifesaving properties, in recent years adult ECMO has become a hot commodity around the world, and other military medical centers have expressed interest in the capability. NMCSD was one of the first military hospitals to purchase ECMO equipment that would enable short-term care prior to a patient transfer, noted Army Lt. Col. (Dr.) Robert Walter, chief, Pulmonary/Critical Care Medicine.

Last December, a team of BAMC physicians and nurse specialists flew to the NMCSD to provide training in ECMO administration, patient transfer, and telemedicine-based mentoring to 25 personnel.

“Fast-forward to now, and that initial training was incredibly beneficial,” Walter said. “With the patient in this case clinically declining, the physicians in San Diego were able to recognize at a critical moment that ECMO was indicated and feel confident they could provide appropriate care.”

In close coordination with the San Diego-based team, BAMC offered to virtually assist with cannulation, which is the insertion of tubes into a patient, and other ECMO management as the center coordinated a patient transfer to a local hospital.

In the absence of a specialized team and full capability, the aim is for military medical professionals to have the skillset to stabilize patients on ECMO for transfer to a local facility for shorter-term care, such as in this case, or flown to BAMC when a longer course of treatment is indicated, which is typically the case with illnesses such as influenza, Walter explained.

Mitchell was the primer on call at BAMC the day the call came from San Diego. The primer is responsible for ensuring fluid is smoothly flowing throughout the circuit.

“I walked them through cannulation and priming the circuit, while closely monitoring the patient’s vital signs,” she explained. “It went very well.”

The soldier was successfully transferred and removed from ECMO after a few days and is expected to fully recover, Mitchell said. “There’s no better feeling than to have the skillset needed to contribute to someone’s survival,” she said.

Teamwork was key to this success, Walter said. “This was a terrific example of collaboration across facilities,” he said. “And it was one of the most avant-garde telemedicine application I’ve seen. There’s nothing in medical literature regarding virtual support of adult ECMO cannulation and management. BAMC is truly at the tip of the spear.”

Further down the road, Walter said the team hopes to become the hub of virtual ECMO support to other military medical facilities around the world, providing tele-mentoring and virtual biophysical monitoring of patients both stateside and downrange.

The goal is to have consistent, quality ECMO care and capability throughout the Military Health System, explained Elliott, noting that BAMC can fly a patient to the hospital from a combat zone in 18-36 hours. “Whenever we hear a patient is alive today because of our support … that is what it’s ultimately about. It’s real-time critical care support.”

You also may be interested in...

Solution Delivery Division

Fact Sheet
1/21/2021

The mission of Solution Delivery Division (SDD) is enhancing Health Service Delivery through exceptional Information and Technology.

Recommended Content:

Technology

NAMRU-SA partakes in virtual San Antonio postdoctoral research forum

Article
1/19/2021
Military officer sitting at her desk and smiling

For NAMRU-SA it was an opportunity to highlight the unit’s battlefield health and trauma care initiatives.

Recommended Content:

Research and Innovation

Joint Warfighter Medical Research Program

Congressional Testimony
1/11/2021

S. 3159, SAC Report for FY 2019 , 115-290 , Pg. 210

Recommended Content:

Research and Innovation

MHS operational innovations continue in battle against COVID-19

Article
1/5/2021
Two medical personnel, wearing full PPE, in an operating room

MHS innovations in 2020 include a new registry for real-time COVID-19 data and a system to free up hospital beds and protect patients from the disease.

Recommended Content:

Coronavirus | Research and Innovation | Innovation | Technology

DHA’s IT innovation continues during COVID-19 pandemic

Article
12/31/2020
Three military personnel, wearing masks, in front of a computer screen

IT innovations keep pace despite COVID-19 road blocks.

Recommended Content:

Coronavirus | Research and Innovation | Technology | MHS GENESIS

MTFs respond to COVID-19 with increased telehealth, drive-thrus

Article
12/29/2020
Military physician sitting at desk, talking to patient on his computer

COVID MTF innovations include more virtual health options and drive thrus.

Recommended Content:

Coronavirus | Technology

MHS Team Resiliency Awards recognize medical response to COVID-19

Article
12/22/2020
Sailors wearing masks, leaning on a table and writing on sheets of paper

Outstanding efforts recognized during Resiliency Awards

Recommended Content:

Coronavirus | Research and Innovation

Nurse-led research aims to improve battlefield medicine

Article
12/21/2020
Military nurses working on a simulated patient in a helicopter

[O]ne of their goals is to create novel solutions to optimize survival and functional recovery of burn casualties.

Recommended Content:

Combat Support | Research and Innovation

TRICARE Online Patient Portal

Fact Sheet
12/21/2020

TRICARE Online Patient Portal (TOL) is the Department of Defense (DoD) online patient portal providing eligible beneficiaries access to military hospital and clinic appointing, prescription (Rx) refill, DoD PP Health Record personal health data, Secure Messaging, Service Separation/Retirement and Nurse Advice Line.

Recommended Content:

Technology

USAMRIID scientist recognized by French for distinguished service

Article
12/4/2020
Two military officers on stage; one handing the other a certificate

Kugelman...identified genetic markers of persistence of the Chikungunya virus.

Recommended Content:

Health Readiness | Research and Innovation | Technology

METC improves surgical tech training with new laparoscopy standard

Article
12/1/2020
Surgical team in operating room

A laparoscopy is a low-risk, non-invasive surgical procedure used to examine organs inside the abdomen and repair or remove tissue.

Recommended Content:

Combat Support | Health Readiness | Research and Innovation | Technology

DHA improves financial efficiency with consolidated funding system

Article
11/20/2020
Soldier wearing mask, marking items off in supply room

The conversions enable GFEBS financial structure and funding control by the DHA.

Recommended Content:

Technology

Walter Reed, VA focus on joint efforts in 3D medical application

Article
11/9/2020
Three physicians wearing masks; one sitting at a desk, two standing

The JIF award focuses on the Department of Defense/VA 3D Printing Consortium for Medical Applications.

Recommended Content:

Research and Innovation | Technology

DHA IPM 18-017: Military Health System (MHS) Information Technology (IT) Investment Management Framework

Policy

This Defense Health Agency-Interim Procedures Memorandum (DHA-IPM), based on the authority of References (a) through (c), and in accordance with the guidance of References (d) through (v), establishes Defense Health Agency's (DHA) procedures to: .Establish the overarching guidance to implement policies and procedures for managing DHA Deputy Assistant Director, Information Operations (DAD IO)/J-6Defense Health Program (DHP) IT resources. The DHA Investment Management Framework is used as an enabler for MHS leadership to make informed transparent financial decisions associated with the DHA DAD IO/J-6 systems, services, and capabilities and will continue to be used in the foreseeable future.

  • Identification #: 18-017
  • Date: 11/7/2020
  • Type: DHA Interim Procedures Memorandum
  • Topics: Technology

Military Health podcasts provide resources for patients and providers

Article
11/6/2020
Hands holding a smartphone with the Living Beyond Pain podcast playing on the device.

Podcasts have become an increasingly popular way of getting information.

Recommended Content:

Technology | Pain Management | Connected Health
<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 15

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.