“A patient who suffered severe respiratory complications from the H1N1 virus, or ‘swine flu’, was in a critical condition at Netcare Greenacres Hospital last winter. His life was hanging in the balance as he could no longer breathe, even with the assistance of a normal ventilator, and was beginning to suffer severe respiratory failure,” recounts David Stanton, Netcare 911 head of clinical leadership.
Within a few hours of being alerted to the patient’s condition, an extracorporeal membrane oxygenation (ECMO) life support team consisting of a cardiothoracic surgeon and a specialist anaesthetist from Netcare Milpark Hospital in Johannesburg, as well as two Netcare 911 paramedics, was mobilised and dispatched to Port Elizabeth with a mobile ECMO system aboard a Netcare 911 Hawker air ambulance.
“Using a transportable version of the specialised ECMO equipment, the team was able to stabilise the patient, who almost immediately regained his colour, thanks to the ECMO equipment which artificially maintains a supply of oxygen to the brain and other vital organs for patients who require either, or both, respiratory and cardiac support,” adds Stanton.
Pic 1: Netcare and Netcare 911 have established highly trained ECMO (extracorporeal membrane oxygenation) rapid reaction transfer teams who can be dispatched via intensive care road and/or air ambulance to ensure this life-saving technology is as accessible as possible to patients in need throughout South Africa and other African countries.
“The team then, that same day, airlifted the patient to Lanseria airport and from there by a Netcare 911 ICU ambulance to the dedicated ECMO unit at Netcare Milpark Hospital in Johannesburg where he eventually made a full recovery.”
According to the Netcare Group’s medical director, Dr Anchen Laubscher, the trained and specially equipped Netcare and Netcare 911 ECMO teams are able to mobilise at short notice, and are dispatched via intensive care air or road ambulance, to ensure this life-saving technology is as accessible as possible to patients in need throughout South Africa and other African countries.
“Many hospitals in South Africa lack the resources and expertise needed to provide this highly specialised form of treatment to patients. This is one of the reasons why Netcare and Netcare 911 have developed specialist ECMO transfer teams, who have been trained and are highly experienced in the use of the system,” she notes.
“Having identified a tremendous need for the provision of specialised ECMO treatment, the Netcare Group has established a comprehensive integrated ECMO programme, which in addition to the ECMO rapid reaction transfer teams, has resulted in the establishment of dedicated ECMO centres of excellence at facilities such as Netcare Milpark Hospital, which houses the largest unit of this kind in the country,” observes Dr Laubscher.
She says that, in addition to the unit at Netcare Milpark Hospital, Netcare has over the last eight years also established adult ECMO units at Netcare Unitas Hospital in Centurion and UCT Private Academic Hospital in Cape Town. There is also a paediatric ECMO unit at Netcare Garden City Hospital in Johannesburg.
“These centres are registered with the Extracorporeal Life Support Organisation [ELSO], which means they are benchmarked against other ECMO units globally to ensure the highest quality of care. Large numbers of patients who require ECMO support are consequently referred to them from around the country.
“International studies have shown that ECMO life support treatments are best undertaken at dedicated ECMO facilities, as they have the necessary expertise, experience and equipment available to successfully provide this form of therapy.
“More than 280 patients in need have been assisted as a result of the comprehensive Netcare ECMO programme, which has proved life-saving for many adult and paediatric patients, and we are hoping to further extend its reach.”
She says patients who have suffered from, for example, lung collapse due to complications from infections such as pneumonia or heart failure, resulting in their vital organs receiving insufficient oxygen naturally, require urgent transfer to the closest dedicated ECMO unit. Most of those treated have suffered pulmonary collapse, but many were cardiac patients.
“ECMO transfers invariably involve critically ill patients, and the ECMO system itself, which artificially pumps and oxygenates up to two-and-a-half litres of blood a minute, requires careful monitoring throughout the journey. ECMO transfers therefore require experienced teams with specialised skills to safely transport these high-risk patients,” explains Stanton.
Mande Toubkin, Netcare’s general manager: emergency, trauma, transplant and CSI, says the ECMO transfer teams receive ongoing training to update and hone their skills. Numerous missions have been successfully completed including to countries such as Zimbabwe and Kenya, using Netcare 911’s long-range Hawker jet air-ambulance.
Pic: The ECMO life support system artificially pumps and oxygenates up to two-and-a-half litres of blood a minute, and can be life-saving for patients who require either, or both, respiratory and cardiac life support. The Netcare Group has established a comprehensive integrated ECMO programme, which in addition to the ECMO rapid reaction transfer teams, has resulted in the establishment of dedicated ECMO centres at selected Netcare hospitals.
“Early referral to an ECMO unit is critical to good outcomes and often to the very survival of patients who, for one reason or another, have failing or highly compromised respiratory or cardiovascular systems. Unfortunately, ECMO treatment in South Africa is still sometimes only called for when it is already too late for patients. They should be referred as soon as other life support systems, such as traditional ventilation, are no longer effectively sustaining the patient,” Toubkin points out.
“This is particularly important for doctors to note during our winter influenza season in South Africa, when there is an increase in the number of people suffering serious complications, such as pneumonia.”
She says the Netcare/Netcare 911 ECMO transfer teams are adapted according to the requirements of each particular case, but usually consist of a medical specialist such as a cardiothoracic surgeon or pulmonologist, an anaesthetist, as well as two life support paramedics. Most of these transfers are undertaken using the well-equipped Netcare 911 ICU ambulances, while air ambulances are used for long-range transfers.
“ECMO is providing a valuable lifeline to patients who are left with no other means of survival. It is an important medical technology that, when appropriately used by dedicated life support specialists, can save many lives,” concludes Toubkin.
To find out more about the services offered through Netcare hospitals and the Group’s other facilities, please contact Netcare’s customer service centre either by email at [email protected] or phone 0860 NETCARE (0860 638 2273). Note that the centre operates Mondays to Fridays from 08:00 to 16:30.
For more information on this media release, contact MNA at the contact details listed below.
Issued by: Martina Nicholson Associates (MNA) on behalf of Netcare and Netcare 911
Contact: Martina Nicholson, Graeme Swinney, Meggan Saville or Estene Lotriet Vorster
Telephone: (011) 469 3016
Email: [email protected], [email protected], [email protected] or [email protected]