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Wilford Hall ECMO team helps save baby

Airman 1st Class Andrew Pamintuan suctions the infant's endotracheal tube on the Wilford Hall Medical Center's extra corporeal membrane oxygenation transport cart in the neonatal intensive care unit at the Kapiolani Medical Center in Honolulu July 22. The ECMO team was needed to transport the critically ill infant to California for advanced medical treatment. Airman Pamintuan is a neonatal intensive care unit respiratory therapist assigned to the 59th Medical Operations Squadron. (U. S. Air Force photo/Maj. Kreangkai Tyree)

Airman 1st Class Andrew Pamintuan suctions the infant's endotracheal tube on the Wilford Hall Medical Center's extra corporeal membrane oxygenation transport cart in the neonatal intensive care unit at the Kapiolani Medical Center in Honolulu July 22. The ECMO team was needed to transport the critically ill infant to California for advanced medical treatment. Airman Pamintuan is a neonatal intensive care unit respiratory therapist assigned to the 59th Medical Operations Squadron. (U. S. Air Force photo/Maj. Kreangkai Tyree)

The Wilford Hall Medical Center's extra corporeal membrane oxygenation team stabilizes the infant on the ECMO transport cart in the neonatal intensive care unit at Kapiolani Medical Center in Honolulu July 22. The ECMO team flew to Hawaii to transport the critically ill infant to Rady Children's Hospital in California for advanced medical treatment. Left to right, NICU Respiratory Therapist Airman 1st Class Andrew Pamintuan, 59th Medical Operations Squadron, senior ECMO coordinator Cheryl Collicott, 59th Medical Inpatient Squadron, Neonatal Fellow Capt. (Dr.) Jennifer Pirato, 59th Maternal/Child Care Squadron, Nurses Aida Yumol, Bernadette Elliott, 59th MDIS, Maj. (Dr.) Melissa Tyree, 59th MCCS, Nurse Capt. Terry Bailey, 59th MDIS. (U.S. Air Force photo/Maj. Kreangkai Tyree)

The Wilford Hall Medical Center's extra corporeal membrane oxygenation team stabilizes the infant on the ECMO transport cart in the neonatal intensive care unit at Kapiolani Medical Center in Honolulu July 22. The ECMO team flew to Hawaii to transport the critically ill infant to Rady Children's Hospital in California for advanced medical treatment. Left to right, NICU Respiratory Therapist Airman 1st Class Andrew Pamintuan, 59th Medical Operations Squadron, senior ECMO coordinator Cheryl Collicott, 59th Medical Inpatient Squadron, Neonatal Fellow Capt. (Dr.) Jennifer Pirato, 59th Maternal/Child Care Squadron, Nurses Aida Yumol, Bernadette Elliott, 59th MDIS, Maj. (Dr.) Melissa Tyree, 59th MCCS, Nurse Capt. Terry Bailey, 59th MDIS. (U.S. Air Force photo/Maj. Kreangkai Tyree)

The Wilford Hall Medical Center's extra corporeal membrane oxygenation team cares for the critically ill infant team cares onboard the C-17 Globemaster III en route to San Diego, July 22, where the infant will receive advance medical care to replace a shunt in her heart. Left to right, Maj. (Dr.) Melissa Tyree, 59th Maternal/Child Care Squadron, George Brandon, pediatric intensive care unit nurse, Capt. Terry Bailey, 59th Medical Inpatient Squadron and Master Sgt. Thomas Kamin, 349th Aeromedical Evacuation Squadron. (U.S. Air Force Photo/ Maj. Kreangkai Tyree)

The Wilford Hall Medical Center's extra corporeal membrane oxygenation team cares for the critically ill infant team cares onboard the C-17 Globemaster III en route to San Diego, July 22, where the infant will receive advance medical care to replace a shunt in her heart. Left to right, Maj. (Dr.) Melissa Tyree, 59th Maternal/Child Care Squadron, George Brandon, pediatric intensive care unit nurse, Capt. Terry Bailey, 59th Medical Inpatient Squadron and Master Sgt. Thomas Kamin, 349th Aeromedical Evacuation Squadron. (U.S. Air Force Photo/ Maj. Kreangkai Tyree)

LACKLAND AIR FORCE BASE, Texas (AFPN) -- A crew of Air Force and civilian medical specialists flew to Honolulu July 21 to transport a 12-day-old baby girl to Rady Children's Hospital in California for advanced medical care.

The 11-member critical care air transport team, which included a neonatal critical care physician, neonatology fellows, neonatal intensive care nurses, and respiratory therapists along with a pediatric intensive care nurse, boarded a C-5 Galaxy at Kelly City USA, Texas, with their battery-operated portable ECMO equipment.

ECMO, or extra corporeal membrane oxygenation, is a heart-lung bypass device which circulates and oxygenates the blood, giving diseased or damaged lungs a chance to heal.

The shunt that was keeping the then 10-day-old infant suffering from a congenital heart defect alive failed. She needed care and treatment that was not available in Hawaii. A request for help to get her to San Diego was sent to the 59th Medical Wing's ECMO team.

"As soon as everyone realized the life of a 12-day-old infant hung in the balance, it stopped being just a normal duty day and turned into the mission of a lifetime," said Maj. (Dr.) Melissa Tyree, medical director ECMO and neonatal intensive care unit transport services at WHMC.

Despite a delay due to engine trouble on the KC-135 Stratotanker, the team still was able to get to the C-17 Globemaster III that was waiting for them in Hawaii on time and complete the transfer from the Kapiolani Medical Center in Honolulu July 22.

"The 167th Aeromedical Evacuation Squadron worked tirelessly to off-load our 2,000 pounds of equipment and expeditiously transferred us from the grounded KC-135 to the mobilized C-5 with temperatures as high as 110 degrees on the flightline. The 433rd Airlift Wing scrambled to put together a last-minute mission to get us to Hawaii in time to still board the C-17 from the 535th Airlift Squadron awaiting us at Hickam Air Force Base," Dr. Tyree said.

After landing in Hawaii, the WHMC ECMO team completed a delicate procedure lasting six hours to move the infant from the hospital's life support system to the team's portable system.

The team continued to monitor and treat the baby during the flight to San Diego.

"The 349th AES crew and C-17 pilot took off and landed with such precision and stability that it was nothing short of perfection," Dr. Tyree said.

As the team left Miramar Naval Air Station headed toward Rady Children's Hospital in a caravan of ambulances with blazing lights and sirens, the baby's mother expressed through tears of joy that she was most moved by the fact that so many people from across the United States came forward to save her baby's life, said George Brandon, pediatric intensive care unit nurse, 59th Medical Inpatient Squadron.

Still on the WHMC's portable ECMO circuit, the baby was taken for surgery July 24. Once in the operating room, she was transferred to its bypass circuit and underwent a successful shunt replacement.

"The infant is now stable in the intensive care unit off ECMO and doing very well," Dr. Tyree said.

No other hospital has global air transportable ECMO capability. Wilford Hall staff place four to eight patients on ECMO each year, and two to four require long-distance transport. 

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