In this episode of WarDocs: The Military Medicine Podcast, host Dr. Doug Soderdahl spoke with Dr. Joshua Anchan, the Neonatal Transport Director at the US Naval Hospital in Okinawa, Japan. They discussed the fascinating world of Military Neonatal Transport Teams, their history, roles, and training. They also explored the unique challenges these teams face when transporting critically ill newborns in military aircraft, including dealing with hypoxia and minimizing risks of intracranial hemorrhage. Dr. Anchan shared memorable stories from his experiences in Okinawa and Guam and emphasized the importance of innovation and preserving the mission in the future of neonatal military transport.
Neonatal Transport Teams
Dr. Anchan began by highlighting the importance of providing American-standard care for the families of service members stationed in remote locations without access to nearby ICU care. The military Neonatal Transport Teams were established in response to this need, with the first NICU established at Clark Air Force Base in the Philippines in 1982. These teams are responsible for transporting critically ill newborns from remote locations to facilities with the appropriate level of care. Currently, they perform around 30 missions per year, with each mission averaging over 5,000 miles and involving over 20 hours of patient care.
Unique Challenges in Neonatal Transport
Providing neonatal care in flight presents a unique set of challenges compared to traditional hospital settings. Hypoxia is a significant concern, as the need for oxygen increases at higher altitudes. Additionally, the noise and vibration of the aircraft can lead to decompensation in the babies, while the risk of intracranial hemorrhage is also higher due to the fragile vasculature in their developing brains.
The transport teams are made up of a Neonatologist, a NICU nurse, and a Respiratory Care practitioner, all of whom have at least six months of experience working in a NICU. They utilize a specialized Neonatal Transport System (NTS) that allows them to provide a high level of care while in flight. This NTS essentially functions as a NICU on wheels, complete with monitoring equipment, ventilators, and other critical care capabilities.
Dr. Anchan shared a few memorable experiences from his time working with Neonatal Transport Teams. One story involved a baby in Guam who developed spontaneous intestinal perforation, requiring urgent care that was not available locally. The transport team was able to safely transport the baby to a facility in Hawaii, where they received the necessary care and eventually recovered.
Another story involved a baby who lost their airway during a flight on a KC-135 refueling aircraft. Despite the challenging conditions, the team was able to successfully reestablish the airway and ensure the baby's safety.
Looking to the Future
As Dr. Anchan reflected on lessons learned during his time as transport director, he emphasized the importance of modernizing technology and partnering with private industry to develop innovative solutions. For instance, he mentioned the development of a new NTS that can be easily transported on a variety of aircraft, providing even greater versatility for these critical missions.
In conclusion, Military Neonatal Transport Teams play a vital role in ensuring that the families of service members receive the highest standard of care, no matter where they are stationed. Through continued innovation and dedication to their mission, these teams will continue to provide life-saving care for our military's most vulnerable members.
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