In January 2015, a team from the Alfred ICU performed a retrieval of a 41 year old Queenslander who had been admitted to ICU in Japan with heart failure and could not be weaned from ECMO. He needed a ventricular assist device.
After much planning and discussion and dealing with logistics by Vin Pellegrino, Steve Philpott and Paul Nixon left on what was to be a 3 day mission to retrieve the patient and deliver him to Prince Charles Hospital in Brisbane. The patient was ventilated, needing renal replacement and on ECMO.
Due largely to the expertise of the team, the mission was uncomplicated
leaving home at about 5am Sunday morning and taking a commercial flight to Brisbane. They took two circuits and some ECMO gear in a suitcase. When they arrived in Brisbane, they were picked up at the airport and driven to the careflight hangar in Brisbane. It took about 2 hours to load all the equipment onto the careflight jet and meet the rest of crew. A representative from Maquet met Steve and Paul in Brisbane and provided two cardiohelp modules for the retrieval.
The team then flew to Cairns (2.5 hours) to re-fuel, but didn't get off the plane. They went through customs procedures at this point for Australia departure.
Then flew to Tokyo airport (7 hours). They were picked up at the tarmac by a Japanese escort and taken through customs, then driven to the Hospital to meet the patient and medical team. One hour was spent at the bedside discussing logistics of transfer and planning the next day's routine, then they were driven to a hotel nearby.
They arrived at the hotel about 11pm, slept, and had miso soup and dumplings for breakfast at the hotel before being driven back to the hospital at 8.30am. Five hours were spent at the hospital to change the ECMO circuit, change the ventilator, including an ETT change due to concretions within ETT, change infusions, change monitoring over, move to stretcher.
Ambulance x 2 to travel to airport
loaded patient onto plane. customs processed them on the tarmac.
Departed tokyo about 3.30 pm, flew back via Cairns.
Customs processed them again on the tarmac in Brisbane, ambulance to Prince Charles Hospital.
Paul and Steve then returned to airport by taxi for commercial flight home.
In total, they left home 5am Sunday morning, returned home about 12noon Tuesday
Pilots did not change - they also slept in Tokyo.
There were 2 pilots, and a third pilot who was being supervised on his first flight in this particular plane. One of the pilots (the first officer) was the owner of the plane and was extremely helpful.
There were 2 careflight staff - one ICU nurse, who was absolutely outstanding, the other one was a careflight retrieval doctor.
There were no major issues with the patient - 2 episodes of hypoxia, one of hypotension, all resolved with minimal intervention. No ECMO issues at all.
Handover to Prince Charles was uneventful - consultant ICU and surgeon both waiting for us on our arrival (at about 2am).
Attached is a letter from the Chief Medical Officer of Careflight (Queensland)
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