When U.S. Marine Cpl. Michael Meyer woke up at University of Iowa Hospitals and Clinics in early May, he remembers being told, “You’re in Iowa.” His first thoughts were “Where?” and “Why?” Iowa, Meyer would find out, was a key destination on a road to recovery from severe respiratory failure that nearly took his life. How he ultimately came to the UI is a story of personal strength, family devotion, and the collaboration between UI Heart and Vascular Center specialists and medical personnel from the U.S. Army, Navy, and Air Force. For the 23-year-old Meyer—a bright, dedicated, and physically fit Marine from Florida who could easily finish a 15-mile run while he was stationed at Camp Schwab on the island of Okinawa, Japan—what had begun as a cough in early March quickly progressed to a serious lung infection. During a training mission on March 13, Meyer felt winded to the point where he could barely stand. Immediately he was evacuated to U.S. Naval Hospital Okinawa.
“I sat down in a wheelchair, and they started taking off my boots. The next thing I know, I was being sedated,” Meyer recalls. “I went from an oxygen mask to anesthesia. I don’t remember a whole lot after that.” Despite being placed on a ventilator (breathing machine) and receiving powerful antifungal and antibiotic medications, Meyer’s health grew worse. His condition was critical, according to his mother, Laurie Meyer Cox, of Pensacola, Fla. The Marine Corps had contacted Cox and Meyer’s father after the Marine was hospitalized and arranged travel visas and transportation for the parents to be at their son’s bedside.
“Being a nurse myself, I knew what the vent settings meant,” Cox says. “Michael needed a lot of oxygen. He was fighting for his life, yet he continued to get sicker and sicker.” Several days later, Meyer “blew a hole in his lung,” Cox says, referring to a pneumothorax, or collapsed lung. It was the first of several serious complications that had the hospital staff working around the clock to keep Meyer alive.Add a comment
The aeromedical evacuation of a U.S. Marine, March 26, who suffered complications from pneumonia marked the first ever extracorporeal membrane oxygenation, or ECMO, transfer performed with an adult in the Western Pacific region. An ECMO provides cardiac and respiratory oxygen support to patients with damaged or diseased heart and lungs that can no longer function for themselves. To complete an ECMO a surgeon inserts tubes into the large blood vessels of the patient. With the help of blood thinners to prevent clotting, the machine will then pump blood through the patient with a membrane oxygenator, removing carbon dioxide and adding oxygen, returning it back into the patient. The Marine was being cared for at the Lester hospital Intesive Care Unit, Camp Lester, Okinawa, for several days before being transferred to Kadena Air Base and then boarding a C17 that would take him to recieve specialized treatment in Hawaii. The medical team transporting the victim was composed of not only Air Force critical care air transportation nurses, but also Army soldiers who are part of theTripler Army Medical Center joint medical attendant transport team. Although the medical team members did not belong to the same branch of service as the patient, they came together to perform what needed to be done to help save his life.
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Aviation Week & Space Technology
Monday, 28 July 2014
USAF’S ‘CARE IN THE AIR’ EXCEEDS EXPECTATIONS
U.S. armed forces quietly made medical history in March, when statisticians recorded zero combat-related fatalities among American service members deployed in Afghanistan. To be sure, the pace of operations has slowed from its peak a few years ago and that can partly account for the drop, but forces continue to engage and troops continue to be in harm’s way. In fact, during that record-setting March, seven American battle injuries were severe enough to require aeromedical evacuation. So far in 2014, 23 U.S. service members have died, and 93 suffered battle injuries that prompted an air evacuation. Even so, the statistics for the duration of the wars show that the risk of dying in combat for U.S. military personnel wounded in Afghanistan and Iraq was almost half that faced by service members wounded in Vietnam in the 1960s and 1970s, and about 45% of that for World War II combatants. While there are many reasons for this—simple things such as soldiers’ improved self-care and buddy-care training along with widespread adoption of tourniquets play a role—perhaps the most decisive has been a shift in thinking about how to use helicopters, turboprop transports and long-range airlifters to project very sophisticated and complex medical care deeper into the battlespace than ever before, even to the point of injury. We have spent 13 years developing the most complex and the most effective by far deployed trauma system in the history of warfare,” says Air Force Col. (Dr.) Mark Ervin, a general surgeon who oversees the medical aspects of three Air Mobility Command programs that fuse airpower with doctors, nurses, medics and technicians. The Critical Care Air Transport Team (CCATT) (see WWW.CCATT.INFO), the Tactical Critical Care Evacuation Team (Tccet) (see http://ow.ly/zt1zC) and En Route Critical Care programs send surgeons, trauma nurses, nurse-anesthetists, operating-room technicians and paramedics far forward to deliver care comparable to that received in an intensive-care unit or a Level I trauma center emergency room, either at the point of injury or in the air. It is difficult, complex and—until these conflicts—unheard of. “Part of why we’re so good today is [nearly] 14 years of practice,” says Air Force Brig. Gen. (Dr.) Kory Cornum, Air Mobility Command surgeon. Cornum, a pilot and an orthopedic surgeon by training, shares the concern of many in the military medical community that with the coming drawdown, maintaining that combined clinical and aeromedical evacuation know-how could be a challenge.