WEBVTT 00:00.000 --> 00:02.056 I received a phone call around eight 00:02.056 --> 00:04.222 p.m. On a Tuesday evening to report to 00:04.222 --> 00:06.630 Joint Base SAn Antonio to go on an ECMO 00:06.630 --> 00:08.686 mission for me , this was a lifelong 00:08.686 --> 00:10.797 dream coming true . I had just joined 00:10.797 --> 00:12.908 the Air Force in january and I wanted 00:12.908 --> 00:15.290 to do this kind of work . The ECMO team 00:15.290 --> 00:17.401 is a special team comprised of highly 00:17.401 --> 00:19.346 trained nurses and doctors that go 00:19.346 --> 00:21.520 around and save some of the sickest 00:21.520 --> 00:23.760 patients in the world . The ECMO team 00:23.760 --> 00:26.190 in the United States Air Force is a 00:26.190 --> 00:29.810 great team because they are one of the 00:29.810 --> 00:32.810 only teams that are able to 00:32.820 --> 00:36.240 fly with ECMO and have the capabilities 00:36.240 --> 00:40.030 for air transport . They operate with 00:40.030 --> 00:43.180 the Air Force is 59th Medical Wing as 00:43.180 --> 00:45.610 well as the Army . We had to do a lot 00:45.620 --> 00:49.480 of preparing and gathering of supplies . 00:49.490 --> 00:51.546 We not only had to take the supplies 00:51.546 --> 00:53.820 that we needed to do the operation and 00:53.820 --> 00:57.820 the surgery . We also needed to uh 00:57.830 --> 00:59.830 take enough supplies for the return 00:59.830 --> 01:02.260 trip home back to san Antonio . The 01:02.260 --> 01:04.371 number one thing is we need to get to 01:04.371 --> 01:06.700 the patient as fast as possible . 01:06.710 --> 01:09.780 Therefore we are under a time crunch , 01:09.790 --> 01:11.957 the faster we can get to the patient , 01:11.957 --> 01:14.260 The faster we can put them on ECMO and 01:14.260 --> 01:16.660 the greater of the chances of survival . 01:17.940 --> 01:21.230 We flew all night through Wednesday and 01:21.230 --> 01:23.174 we arrived on Wednesday morning in 01:23.174 --> 01:25.900 Washington and we evaluated the patient . 01:25.910 --> 01:29.360 He was experiencing respiratory 01:29.360 --> 01:33.020 distress from covid related symptoms . 01:33.030 --> 01:36.310 Although the ECMO machine has been used 01:36.320 --> 01:39.150 in many different critical illnesses , 01:39.340 --> 01:43.220 Covid has been a illness that 01:43.220 --> 01:46.210 has really influenced the ECMO world . 01:46.220 --> 01:49.620 We have seen a lot of success of ECMO 01:49.630 --> 01:53.140 throughout the covid pandemic . The 01:53.140 --> 01:55.420 surgery with ECMO is known as a 01:55.420 --> 01:57.850 calculation calculation is the surgery 01:57.850 --> 02:01.060 that we use to put a patient on ECMO . 02:01.240 --> 02:04.260 It is where we put one tube in the body 02:04.270 --> 02:07.390 to drain deoxygenated blood and then it 02:07.390 --> 02:10.690 goes through the ECMO circuit and re 02:10.690 --> 02:13.400 oxygenates the blood . And the second 02:13.400 --> 02:15.830 tube that we put in the body is what 02:15.830 --> 02:19.000 returns the blood the oxygenated blood 02:19.010 --> 02:22.440 back to the body so it works as a lung 02:22.450 --> 02:25.190 outside of the body . The calculation 02:25.190 --> 02:28.730 normally takes a few hours to complete 02:28.740 --> 02:30.518 and in this case we were really 02:30.518 --> 02:33.090 successful in our mission of putting 02:33.090 --> 02:35.530 the patient on ECMO . However with 02:35.530 --> 02:38.370 every ECMO calculation there are 02:38.380 --> 02:41.940 problems and issues that arise because 02:41.950 --> 02:45.200 every patient is different . For this 02:45.210 --> 02:47.600 particular instance . We had to give a 02:47.600 --> 02:49.711 lot of blood products and we also had 02:49.711 --> 02:52.450 to go down to C . T . To take some 02:52.460 --> 02:55.490 images before we were able to even 02:55.490 --> 02:57.712 think about our next steps . So once we 02:57.712 --> 02:59.934 got the patient stabilized which took a 02:59.934 --> 03:03.490 few hours after surgery we had to get 03:03.490 --> 03:06.010 more people on our team , Also known as 03:06.010 --> 03:08.066 the C . Cat Team , the Critical Care 03:08.066 --> 03:10.177 air transport team . To help us bring 03:10.177 --> 03:12.399 the patient back to SAn Antonio and get 03:12.399 --> 03:14.399 them all caught up on the procedure 03:14.399 --> 03:16.510 that we had done . It's very risky to 03:16.510 --> 03:20.030 transport a patient uh in the air on 03:20.040 --> 03:23.480 ECMO . It's also very risky to just 03:23.480 --> 03:26.710 transport a patient within the hospital 03:26.720 --> 03:29.180 on ECMO . There's a lot of things that 03:29.180 --> 03:31.236 need to go in it . And if one of the 03:31.236 --> 03:34.550 cannula smoove during transport , the 03:34.550 --> 03:37.010 patient's ECMO run would have to stop . 03:37.020 --> 03:39.380 We need to get a patient onto a 03:39.380 --> 03:42.670 stretcher . And that means all the 03:42.670 --> 03:44.820 equipment , the ECMO machine , the 03:44.820 --> 03:48.530 chest tubes , uh every ivy pump , 03:48.540 --> 03:50.707 everything that has to travel with the 03:50.707 --> 03:52.484 patient . We travel through the 03:52.484 --> 03:54.596 hospital and take an ambulance . Then 03:54.596 --> 03:56.820 to the C-17 airplane . From there we 03:56.820 --> 03:58.709 have to put the patient on what's 03:58.709 --> 04:02.220 called a litter and that is a stretcher 04:02.230 --> 04:04.850 that we have to carry onto the airplane . 04:05.340 --> 04:08.140 This litter Kerry is done by multiple 04:08.140 --> 04:10.670 individuals . As you can see about 10 04:10.670 --> 04:13.810 individuals who hoist the patient onto 04:13.810 --> 04:16.040 the airplane along with all the 04:16.040 --> 04:19.740 equipment . This litter then attach is 04:19.740 --> 04:23.600 into the airplane to ensure safety for 04:23.600 --> 04:27.170 the individual while en route . Then we 04:27.170 --> 04:30.630 can adjust our ivy pumps and our ECMO 04:30.630 --> 04:33.760 machine . So when we fly , uh what 04:33.760 --> 04:35.816 makes it difficult is you can't hear 04:35.816 --> 04:37.982 anything . We do have headsets so that 04:37.982 --> 04:39.982 we can talk to one another , but we 04:39.982 --> 04:42.204 can't hear the beeps of the alarms . We 04:42.204 --> 04:45.250 can't hear the patient's lungs or heart 04:45.250 --> 04:46.972 if we were to listen through a 04:46.972 --> 04:49.730 stethoscope because the airplane is so 04:49.730 --> 04:51.690 loud , so we have to really be 04:51.690 --> 04:55.080 cognizant with our eyes so that we can 04:55.090 --> 04:57.840 uh watch the patient and examine the 04:57.840 --> 04:59.930 patient the best of our abilities . 04:59.940 --> 05:02.630 Also being a covid patient . This 05:02.630 --> 05:04.980 transport was more difficult because we 05:04.980 --> 05:08.960 had to maintain our proper PPE for our 05:08.960 --> 05:12.010 protection as well . Along with this 05:12.010 --> 05:14.180 flight we had infection control nurses 05:14.180 --> 05:16.850 that were with us that watched us dawn 05:16.850 --> 05:20.140 on and gone off our PPE and made sure 05:20.140 --> 05:22.251 that we were safe as a team as well . 05:22.251 --> 05:26.120 So when we landed um in san Antonio we 05:26.120 --> 05:28.130 then had to get the patient off the 05:28.130 --> 05:31.040 plane and take him to Brooke Army 05:31.040 --> 05:33.207 Medical Center . Although it will be a 05:33.207 --> 05:36.010 long journey for him . I saw we were 05:36.010 --> 05:39.210 able to give hope back to his family 05:39.220 --> 05:42.610 and I am so proud to be on this 05:42.610 --> 05:45.470 team and I am honored to serve 05:45.470 --> 05:48.840 alongside members of this team . Yeah . 05:49.540 --> 05:51.350 Mhm . Mhm .