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Bascetta T, Bolton L, Kurtzman E, Hantzos W, Standish H, Margarido P, Race K, Spencer J, Baker W, Gluck J. Air Medical Transport of Patients Diagnosed With Confirmed Coronavirus Disease 2019 Infection Undergoing Extracorporeal Membrane Oxygenation: A Case Review and Lessons Learned. Air Med J 2021; 40:130-134. [PMID: 33637278 PMCID: PMC7698678 DOI: 10.1016/j.amj.2020.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/20/2020] [Accepted: 11/23/2020] [Indexed: 01/07/2023]
Abstract
The coronavirus disease 2019 pandemic disrupted health care delivery in every respect, including critical care resources and the transport of patients requiring extracorporeal membrane oxygenation. Innovative solutions allowing for safe helicopter air transport of these critical patients is needed because extracorporeal membrane oxygenation resources are only available in specialty centers. We present a case demonstrating the interfacility collaboration of care for a patient with coronavirus disease 2019 infection and the lessons learned from the air transport. Careful planning, coordination, communication, and teamwork contributed to the safe transport of this patient and several others subsequently.
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Affiliation(s)
- Thomas Bascetta
- LIFE STAR, Hartford Hospital, Hartford, CT,Address for correspondence: Thomas Bascetta, LIFE STAR Hartford Hospital, 80 Seymour Street, Hartford, CT 06102
| | - Lauri Bolton
- LIFE STAR, Hartford Hospital, Hartford, CT,Department of Emergency Medicine, Hartford Hospital, Hartford, CT,University of Connecticut School of Medicine, Farmington, CT
| | - Ethan Kurtzman
- Heart and Vascular Institute, Hartford HealthCare, Hartford, CT
| | | | | | | | - Kathleen Race
- Care Logistics Center, Hartford HealthCare, Hartford, CT
| | - John Spencer
- Emergency Communications Center, Hartford Hospital, Hartford, CT
| | - William Baker
- Department of Pharmacy, Hartford Hospital, Hartford, CT
| | - Jason Gluck
- Heart and Vascular Institute, Hartford HealthCare, Hartford, CT,University of Connecticut School of Medicine, Farmington, CT
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Schmalzle SA, Tabatabai A, Mazzeffi M, Matta A, Hollis A, Zubrow M, Rajagopal K, Thom K, Scalea T. Recreational 'mud fever': Leptospira interrogans induced diffuse alveolar hemorrhage and severe acute respiratory distress syndrome in a U.S. Navy seaman following 'mud-run' in Hawaii. IDCases 2019; 15:e00529. [PMID: 30976519 PMCID: PMC6441746 DOI: 10.1016/j.idcr.2019.e00529] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 03/20/2019] [Accepted: 03/20/2019] [Indexed: 01/23/2023] Open
Abstract
A 23-year-old man with a viral-like prodrome developed sudden severe dyspnea and was found to have renal failure, anemia, shock, and diffuse alveolar hemorrhage with acute respiratory distress syndrome, requiring emergent endotracheal intubation and extracorporeal membrane oxygenation (ECMO). Travel and exposure history from peripheral sources revealed that the patient had participated in a 'mud-run' in Hawaii two weeks prior to symptom onset. The patient was subsequently diagnosed with leptospirosis and treated with ceftriaxone and doxycycline. He was discharged on hospital day 13 with full recovery. Leptospirosis is associated with exposure to water, soil, or other matter contaminated with urine of carrier animals. It has been associated with a multitude of activities over time; most recently recreational water-based activities including 'mud-runs' in endemic areas have been added to the list of routes of exposure. This case underscores the importance of obtaining a thorough epidemiological exposure and travel history and being aware of areas of endemicity for life-threatening infections. Additionally, to our knowledge this is the second case of a patient in the United States treated with ECMO for leptospirosis induced pulmonary hemorrhage.
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Affiliation(s)
- Sarah A Schmalzle
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
- Division of Infectious Diseases, University of Maryland School of Medicine, Baltimore, MD, United States
- University of Maryland School of Medicine, Baltimore, MD, United States
- Corresponding author at: Institute of Human Virology, 725 West Lombard St, N147, Baltimore, MD, 21201, United States.
| | - Ali Tabatabai
- University of Maryland School of Medicine, Baltimore, MD, United States
| | - Michael Mazzeffi
- University of Maryland School of Medicine, Baltimore, MD, United States
| | - Ann Matta
- University of Maryland School of Medicine, Baltimore, MD, United States
| | - Allison Hollis
- University of Maryland School of Medicine, Baltimore, MD, United States
| | - Marc Zubrow
- University of Maryland School of Medicine, Baltimore, MD, United States
| | - Keshava Rajagopal
- University of Texas, Houston and Memorial Hermann,Texas Medical Center, Houston, TX, United States
| | - Kerri Thom
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Thomas Scalea
- University of Maryland School of Medicine, Baltimore, MD, United States
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