JOINT BASE SAN ANTONIO, Texas (Oct. 14, 2022) -- A team from Brooke Army Medical Center recently flew to Guam to transport a critically ill boy to Rady Children’s hospital in San Diego for treatment.
Aegon Pestanas was hospitalized in Guam after presenting with human metapneumovirus, which led to severe pneumonia and several other complications. Symptoms commonly associated with HMPV include cough, fever, nasal congestion and shortness of breath. HMPV infection may progress to bronchitis or pneumonia and is similar to other viruses that cause upper and lower respiratory infections.
“The patient was being treated via tele-critical care supported by Navy pediatric intensivists out of NMCSD with on-site general pediatricians and an adult intensive care unit team in Guam since there is no pediatric or neonatal critical care on the entire island,” explained U.S. Air Force Col. (Dr.) Renee Matos, pediatric intensivist and critical care air transport physician.
The six-person Critical Care Air Transport Team consisted of two pediatric physicians, Matos and pediatric resident U.S. Air Force Capt. (Dr.) Kevin Brinkman; two pediatric intensive care nurses, U.S. Air Force Capts. Nathalie Del Castillo and Gareth Politte; and two respiratory therapists, U.S. Air Force Staff Sgt. Veronica Sanchez and Senior Airman Nayelli Fuentes. The team, led by Matos, traveled nearly 16,000 miles over a four-day period to transport the critically ill child back to the states, providing 24 hours of continuous care.
“This little boy was critically ill, and we were very worried we wouldn't get to him in time given how far away he was,” Matos said. “However, we did a lot of coordination across the sites (Guam, Hawaii, San Diego) to optimize everything and plan for contingencies.”
The CCAT operates an intensive care unit in an aircraft cabin during flight, adding critical care capability to the U.S. Air Force Aeromedical Evacuation System. The 59th Medical Wing is tasked to provide 15 CCAT teams to support combat casualties being evacuated from the combat zone, peacetime movement of critically ill military beneficiaries, and humanitarian assistance such as airplane crashes and natural disasters.
“Tele-critical care and the teams in Guam were instrumental in saving this patient's life,” she added. “In addition to the medical teams, there were so many other people involved that worked so hard to safely move this patient, including the two aircrews, mission planners at TPMRC-W (Theater Patient Movement Requirements Center-West) and TRANSCOM (United States Transportation Command), airfield crews that stayed late, or managed the onload and offload, and so many more.”
The child’s mother Rio Pestanas traveled with the team to San Diego.
“I’m very thankful to the people that helped my son,” Pestanas said. “From the hospital corpsmen to the ICU nurses, respiratory therapists, surgeons, NMCSD PICU doctors, Naval Hospital Guam’s commanding officer, and the NHG pediatricians -- most especially to Dr. Kelly Richmond (NHG) who made the impossible mission possible. She helped us a lot in making sure Aegon stayed safe until his transport.”
“To the medevac crew, their hard work and expertise are out of this world,” she added. “We thank all of them from the bottom of our hearts.”
Pestanas said her son is doing much better now. He’s out of the ICU and was able to be removed from the ventilator. He just needs to regain his strength, so he can go home.
Matos agrees, “This was definitely a team effort and demonstrates the extent of the military medical capabilities and what we can do to ensure the best medical care for our patients across the globe,” the colonel said. “I think this also demonstrates one of the unique capabilities we have in San Antonio, which is the only center that can launch pediatric critical care and adult ECMO (extracorporeal membrane oxygenation) missions for the entire Department of Defense.”