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...

Improving Defense Health Program Medical Research Processes

Report
8/8/2017

A report from the Defense Health Board (DHB) that summarizes the findings and recommendations from its independent review of Improving Defense Health Program (DHP) Medical Research Processes.

Recommended Content:

Research and Innovation | Health Readiness

Continuing Education for Department of Defense Health Professionals

Report
11/24/2015

Continuing Education for Department of Defense Health Professionals Report

Recommended Content:

Research and Innovation

Sustainment and Advancement of Amputee Care

Report
4/8/2015

This report provides Defense Health Board findings on amputee care and research in the Department of Defense.

Recommended Content:

Conditions and Treatments | Technology

Ethical Guidelines and Practices for US Military Medical Professionals

Report
3/3/2015

Defense Health Board (DHB) report summarizing the findings and recommendations from the DHB's independent review on Ethical Guidelines and Practices for U.S. Military Medical Professionals

Recommended Content:

Research and Innovation | Quality and Safety of Health Care (for Healthcare Professionals)

Form Follows Function Pursuing a World Class System for Health

Report
2/1/2015

Form Follows Function: Pursuing a World-Class System for Health

Recommended Content:

Research and Innovation | Access, Cost, Quality, and Safety

2013 MHS Innovation Report

Report
3/3/2014

2013 Military Health System Innovation Report. This report contains information about MHS innovations in clinical care, research and development, and healthcare management. It also provides an overview of the MHS Innovation Program and information on the future of MHS innovation.

Recommended Content:

Innovation | Innovation | Innovation | Access, Cost, Quality, and Safety | Technology

Dover Port Mortuary Independent Review Subcommittee Report Errata Sheet

Report
2/27/2012

Defense Health Board: Dover Port Mortuary Independent Review Subcommittee Report Errata Sheet

Recommended Content:

Quality and Safety of Health Care (for Healthcare Professionals) | Research and Innovation

Dover Port Mortuary Independent Review Subcommittee Final Report

Report
2/27/2012

Defense Health Board: Dover Port Mortuary Independent Review Subcommittee Final Report

Recommended Content:

Quality and Safety of Health Care (for Healthcare Professionals) | Research and Innovation

Battlefield Trauma Care Research Development Test and Evaluation Priorities

Report
6/14/2011

Defense Health Board: Battlefield Trauma Care Research Development Test and Evaluation Priorities

Recommended Content:

Research and Innovation

Review of the Department of Defense Center for Deployment Health Research

Report
8/18/2010

Defense Health Board: Review of the Department of Defense Center for Deployment Health Research

Recommended Content:

Deployment Health | Research and Innovation

Vaccine Safety and Effectiveness Recommendation Memo

Report
6/4/2009

Defense Health Board: Vaccine Safety and Effectiveness Recommendation Memo

Recommended Content:

Immunizations | Immunization Healthcare | Research and Innovation

Design Plans for Walter Reed and Fort Belvoir

Report
5/1/2009

Defense Health Board: Design Plans for Walter Reed and Fort Belvoir

Recommended Content:

Access to Health Care | Research and Innovation

DHB Task Force Review of DoD Biodefense Infrastructure and Biological Research Portfolio

Report
4/29/2009

Defense Health Board: DHB Task Force Review of DoD Biodefense Infrastructure and Biological Research Portfolio

Recommended Content:

Research and Innovation
Showing results 1 - 13 Page 1 of 1

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.