Back to Top Skip to main content Skip to sub-navigation

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...

DoD aims to fill medical gaps with military while states, cities ramp up

Article
3/24/2020
Defense Secretary Dr. Mark T. Esper speaks to reporters during a news conference at the Pentagon to discuss the department's efforts in response to the COVID-19 pandemic, March 23, 2020. (DoD photo by Army Staff Sgt. Brandy Nicole Mejia)

The secretary sees the military filling gaps in cities, states until they can deal with COVID-19 on their own

Recommended Content:

Combat Support | Public Health | Coronavirus | Coronavirus

A full night’s sleep could be the best defense against COVID-19

Article
3/23/2020
Sleep is critical for maintaining physical, cognitive and immunological dominance on and off the battlefield. Leaders must prioritize sleep as a valuable asset in maintaining readiness and resilience, especially in the context of multi-domain operations and increased health risks worldwide – including those risks associated with exposure to infectious diseases (U.S. Army photo by Robert Timmons)

Getting more sleep could dramatically improve your odds of avoiding infection

Recommended Content:

Combat Support | Public Health | Coronavirus | Coronavirus | Total Force Fitness

Air Force takes steps to assure ‘unblinking’ operations, readiness and capabilities amid pandemic

Article
3/23/2020
Air Force medics and health personnel around the globe are resolutely following and ensuring compliance with guidelines issued by the Department of Defense and Centers for Disease Control and Prevention according to Air Force Lt. Gen. Dorothy Hogg.

Within the Air Force, our medics are executing all available measures to mitigate the spread of COVID-19

Recommended Content:

Combat Support | Public Health | Coronavirus | Coronavirus

Addressing emotional responses to threat of Coronavirus

Article
3/20/2020
U.S. Air Force Master Sgt. Kathleen A. Myhre, 446th Airman and Family Readiness Center noncommissioned officer in charge, meditates outside the 446th Airlift Wing Headquarters building on Joint Base Lewis-McChord, Washington, Feb. 12, 2020. Myhre traveled to India in 2016 to study to become an internationally-certified yoga instructor. She now shares her holistic training with Reserve Citizen Airmen of the 446th AW. (U.S. Air Force photo by Staff Sgt. Mary A. Andom)

Even if you’re feeling healthy, medical professionals recommend staying home and limiting social contact as much as possible

Recommended Content:

Medical and Dental Preventive Care Fitness | Psychological Fitness | Physical Fitness | Combat Support | Public Health | Coronavirus | Coronavirus

COVID-19 Life Support Training Extension

Publication
3/19/2020

The purpose of this memorandum is to set policy guidance within the Military Health System for American Red Cross life support training (First Aid/cardiopulmonary resuscitation (CPR)/automated external defibrillator (AED), Basic Life Support (BLS), Advanced Life Support (ALS), and Pediatric Advanced Life Support (PALS)).

Recommended Content:

Coronavirus

Place addresses DHA COVID-19 response

Article
3/19/2020
Lt. Gen. Ronald Place, director of the Defense Health Agency, and Rear Adm. Bruce Gillingham, surgeon general of the Navy, discuss plans for additional COVID-19 response efforts with the Pentagon Press Corps.

Crisis Action Team part of broad-based effort

Recommended Content:

Combat Support | Public Health | Coronavirus | Coronavirus

DoD ready to help with Coronavirus, but capability limited

Article
3/17/2020
Misook Choe, a laboratory manager with the Emerging Infectious Disease branch at the Walter Reed Army Institute of Research in Silver Spring, Md., runs a test during research into a solution for the new coronavirus, COVID-19, March 3, 2020. The Emerging Infectious Diseases branch, established in 2018, has the explicit mission to survey, anticipate and counter the mounting threat of emerging infectious diseases of key importance to U.S. forces in the homeland and abroad. (U.S. Army Sgt. Michael Walters)

The DoD has only about 2% to 3% of the number of hospital beds that the private sector has

Recommended Content:

Combat Support | Public Health | Coronavirus | Coronavirus

How DHA monitors the spread of health outbreaks

Article
3/13/2020
The Armed Forces Health Surveillance Branch (AFHSB) is the central epidemiologic resource for the U.S. Armed Forces, conducting medical surveillance to protect those who serve our nation in uniform and allies who are critical to our national security interests. AFHSB provides timely, relevant, actionable and comprehensive health surveillance information to promote, maintain, and enhance the health of military and military-associated populations. (U.S. Air Force photo by Tech. Sgt. Nathan Lipscomb)

The Defense Health Agency works as a combat support agency to the military services and Military Health System

Recommended Content:

Combat Support | Public Health | Coronavirus | Coronavirus

DoD issues flexible instructions on response to Coronavirus

Article
3/13/2020
This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses. The illness caused by this virus has been named coronavirus disease 2019 (COVID-19). (CDC Illustration)

The memo covers aspects from before the outbreak through all levels of infection

Recommended Content:

Combat Support | Public Health | Coronavirus | Coronavirus

Terry M. Rauch, Ph.D., M.P.H., M.B.A. Acting Deputy Assistant Secretary of Defense Force Health Protection and Readiness Regarding U.S. Biodefense and Response to the Novel Coronavirus Outbreak [Testified] Before the House Committee on Oversight and Reform

Congressional Testimony
3/11/2020

Recommended Content:

COVID-19 Vaccine Toolkit | COVID-19 Vaccine Toolkit | Coronavirus

COVID-19: Know what the terms mean

Article
3/10/2020
Image of a soldier taking the temperature of another soldier. Click to open a larger version of the image.

Learning the language can help you stay safe

Recommended Content:

Coronavirus | Public Health | Combat Support | Coronavirus

Coronavirus: What you need to know

Article
3/6/2020
A Guardsmen with the 341st Military Intelligence Battalion conducts translation work on a safety message regarding the best practices for avoiding the novel coronavirus for the Washington Department of Health on Feb. 9, 2020 at the Information Operations Readiness Center, Joint Base Lewis-McChord, Wash. (Courtesy Photo)

Although news stories and images contain many reports of people wearing surgical masks to ward off the virus, that's not recommended

Recommended Content:

Global Health Engagement | Public Health | Coronavirus | Coronavirus

DoD makes plans to combat Coronavirus

Article
3/4/2020
Defense Secretary Dr. Mark T. Esper and Army Gen. Mark A. Milley, chairman of the Joint Chiefs of Staff, speak to reporters at the Pentagon, March 2, 2020. (DoD photo Lisa Ferdinando)

The number one priority remains to protect our forces and their families

Recommended Content:

Coronavirus | Public Health | Combat Support | Coronavirus

MHS prepared to support interagency coronavirus response

Article
2/6/2020
Airmen assist one another in donning their personal protective equipment, while on-board an Air Force C-17 Globemaster III during transportation isolation system training at Joint Base Charleston, South Carolina. Engineered and implemented after the Ebola virus outbreak in 2014, the TIS is an enclosure the Department of Defense can use to safely transport patients with diseases like novel coronavirus. (U.S. Air Force photo by Senior Airman Cody R. Miller)

From R&D to force health protection, MHS protects DoD personnel and families

Recommended Content:

Global Health Engagement | Public Health | Coronavirus | Coronavirus

DoD releases guidance to protect forces from novel coronavirus

Article
1/31/2020
The novel coronavirus is a variant of other coronaviruses, such as this colorized transmission electron micrograph of Middle East respiratory syndrome (MERS) virus particles (blue) found near the periphery of an infected VERO E6 cell (yellow). Image captured and color-enhanced at the NIAID Integrated Research Facility in Fort Detrick, Maryland. (Photo by NIAID)

Basic infection controls offer best defense against illness

Recommended Content:

Global Health Engagement | Public Health | Coronavirus | Coronavirus
<< < ... 31 32 33 34 35  ... > >> 
Showing results 511 - 525 Page 35 of 36

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.