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Impacts de l’épidémie COVID 19 sur la chirurgie digestive en France et perspectives : une enquête de la FCVD. LA PRESSE MÉDICALE FORMATION 2021; 2:225-228. [PMCID: PMC8175101 DOI: 10.1016/j.lpmfor.2021.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 02/26/2021] [Indexed: 12/03/2023]
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Ikeda DS, Dryden JR, Van Gent JM, Benzer E, Praske SP, Ravindra VM, Miller CA, Curry BP, Bell RS. Transpacific Aeromedical Evacuation for a Ruptured Brain Arteriovenous Malformation During the COVID-19 Pandemic. Mil Med 2021; 186:e632-e636. [PMID: 33252667 PMCID: PMC7798835 DOI: 10.1093/milmed/usaa531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/06/2020] [Accepted: 11/20/2020] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 pandemic has altered preexisting patient treatment algorithms and referral patterns, which has affected neurosurgical care worldwide. Brain arteriovenous malformations are complex vascular lesions that frequently present with intracerebral hemorrhage. Care for these patients is best performed at large medical centers by specialists with high volumes. The authors describe the care of a patient who presented in extremis to a resource-limited, community-sized military treatment facility (MTF) in Southeast Asia. In the MTF, the patient underwent emergent neurosurgical therapy. However, given newly implemented restrictions enacted to mitigate COVID-19 spread, local transfer for definitive care to a tertiary care facility was not possible. In order to attain definitive care for the patient, a transpacific aeromedical evacuation augmented with a critical care air transport team was utilized for transfer to a tertiary care, teaching hospital. This case demonstrates the safe treatment of a patient with hemorrhagic arteriovenous malformations and postoperative management under limited conditions in an MTF outside the CONUS. Given the unique circumstances and challenges the pandemic presented, the authors feel that this patient's outcome was only possible by leveraging all the capability military medicine has to offer.
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Affiliation(s)
- Daniel S Ikeda
- Departments of Surgery, US Naval Hospital Okinawa, Okinawa, 96362, Japan
| | - John R Dryden
- Departments of Radiology, US Naval Hospital Okinawa, Okinawa, 96362, Japan
| | | | - Emily Benzer
- Departments of Surgery, US Naval Hospital Okinawa, Okinawa, 96362, Japan
| | - Steven P Praske
- Departments of Pulmonary and Critical Care Medicine, US Naval Hospital Okinawa, Okinawa, 96362, Japan
| | - Vijay M Ravindra
- Department of Neurosurgery, Naval Medical Center San Diego, San Diego, CA 92134, USA
| | - Charles A Miller
- Department of Neurosurgery, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
| | - Brian P Curry
- Department of Neurosurgery, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
| | - Randy S Bell
- Department of Neurosurgery, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
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