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Wartime Innovation: Travis medical developments contribute to the fight

The Special Operations Surgical Team, including Lt. Col. (Dr.) Benjamin Mitchell, poses at a forward location. Lt. Col. Mathew Uber, Maj. (Dr.) Justin Manley, Maj. Nelson Pacheco, Capt. Cade Reedy and Tech. Sgt. Richard Holguin are part of Mitchell’s SOST. (Courtesy photo)

The Special Operations Surgical Team, including Lt. Col. (Dr.) Benjamin Mitchell, poses at a forward location. Lt. Col. Mathew Uber, Maj. (Dr.) Justin Manley, Maj. Nelson Pacheco, Capt. Cade Reedy and Tech. Sgt. Richard Holguin are part of Mitchell’s SOST. (Courtesy photo)

The REBOA catheter is a device that is inserted into a hemorrhaging vessel and stops or slows the blood flow to that injury while allowing blood flow to continue to vital organs and body parts. (U.S. Air Force photo by Senior Airman Amber Carter)

The REBOA catheter is a device that is inserted into a hemorrhaging vessel and stops or slows the blood flow to that injury while allowing blood flow to continue to vital organs and body parts. (U.S. Air Force photo by Senior Airman Amber Carter)

Maj. Timothy Williams, left, and Maj. Lucas Neff, right, perform bench top testing of balloon catheters March 14 at Travis Air Force Base, Calif., using a custom-made blood flow simulator. The CIF, located at David Grant USAF Medical Center, is the research facility where the REBOA catheter came to fruition. (U.S. Air Force photo by Senior Airman Amber Carter)

Maj. Timothy Williams, left, and Maj. Lucas Neff, right, perform bench top testing of balloon catheters March 14 at Travis Air Force Base, Calif., using a custom-made blood flow simulator. The CIF, located at David Grant USAF Medical Center, is the research facility where the REBOA catheter came to fruition. (U.S. Air Force photo by Senior Airman Amber Carter)

Members of the Clinical Investigation Facility at Travis Air Force Base, Calif., pose with the 2016 60th Air Mobility Wing Team of the Year award. The CIF won the award for its mission contribution to developing the REBOA technique for worldwide use. (Courtesy photo)

Members of the Clinical Investigation Facility at Travis Air Force Base, Calif., pose with the 2016 60th Air Mobility Wing Team of the Year award. The CIF won the award for its mission contribution to developing the REBOA technique for worldwide use. (Courtesy photo)

This story was originally published by 24th Special Operations Wing Public Affairs on May 3, 2017. It has been localized by 60th Air Mobility Wing Public Affairs.

TRAVIS AIR FORCE BASE, Calif. – A breakthrough medical device studied extensively by the Clinical Investigation Facility at Travis Air Force Base, California, is now being used by deployed Special Operations Surgical Teams to save the lives of critically injured patients.

The Food and Drug Administration approved the REBOA catheter, or resuscitative endovascular balloon occlusion of the aorta, in January 2016. It is a device that is inserted into a hemorrhaging vessel and stops or slows the blood flow to that injury while allowing blood flow to continue to vital organs and other body parts. Researchers developed the REBOA after identifying a need for a device that can slow bleeding, without damaging vital organs, long enough for the patient to receive the life-saving care he or she needs.

Lt. Col. (Dr.) Benjamin Mitchell, an emergency medicine physician assigned to a SOST, spearheaded the use of the REBOA in deployed medical techniques as the primary care provider during deployments in support of operations Inherent Resolve, Resolute Support and Enduring Freedom.

SOSTs are Air Force teams of mobile surgical specialists with advanced medical and tactics training, employed in austere or hostile areas where there is little to no other surgical support. These teams train to save lives within the golden hour, and are placed close to the battle outside of any established healthcare facilities – reducing time between injury and care.

In a small, concrete house operating with tools from their rucksacks, Mitchell and his SOST used four ER-REBOA catheters on four seriously injured patients with a 100 percent survival rate. This was the first time in the Defense Department this was done outside of a hospital.

“In SOST, you get to work with some of the best medical care providers in the military,” said Mitchell. “We operate at a high level of readiness and focus, and my team reflects the highest professionalism under extreme conditions.”

The six-member SOST is composed of an emergency physician, general surgeon, nurse anesthetist, critical care nurse, surgical technician and respiratory therapist, and provides four unique medical capabilities: advanced trauma resuscitation, tactical damage control surgery, post-op critical care and critical care evaluation.

For his efforts with the REBOA and other techniques, Mitchell was recognized by the Jackson Foundation with the 2017 Heroes of Military Medicine Award at an annual awards banquet on May 4. The annual award is given to active-duty military medical professionals – one recipient each from the Army, Navy and Air Force.

The Heroes of Military Medicine Awards honors outstanding contributions by individuals who have distinguished themselves through excellence and selfless dedication to advancing military medicine and enhancing the lives and health of our nation’s wounded, ill and injured service members, veterans and civilians.

Mitchell credits the SOST as a whole over his individual contributions. Everything that happened required a highly-skilled team of specialists who could work under intense pressure in a combat zone.

Mitchell specifically remembers one moment when a local fighter arrived at the team’s makeshift operation room, shot through the collar bone and bleeding profusely. Their team was short on blood due to the constant flow of patients arriving at the casualty collection point, so a member of the SOST donated his own blood to save him.

“Our team was so well-trained and focused; we controlled the bleeding, got him in surgery and saved his life,” said Mitchell. “Ten days later that guy walked into our tent and thanked our team … it was incredible and rewarding.”

This REBOA development has significantly improved combat trauma resuscitation and directly saved a growing count of lives in the past year, said Dr. Bradley Williams, assistant director of medical education and research at DGMC. 

The Clinical Investigation Facility, located at David Grant USAF Medical Center, is one of seven Air Force medical facilities with formal clinical investigation programs and resources. The facility was recently awarded the 2016 60th Air Mobility Wing Team of the Year award, partly as a result of its contributions to the REBOA development.

The award recognized the mission contribution of the CIF and research surgeons in developing the REBOA technique for worldwide use.

This mission effectiveness award has never been given to the field of clinical research before, and recognizes the vital contributions of medical research to fulfilling the mission and projecting American power, said Williams.

The CIF is hosting an open house for all Travis personnel May 18 at Patio D of DGMC. Tours will be given at 9 a.m., 11 a.m., 11:30 a.m., noon, 12:30 p.m. and 3 p.m. For more information, contact Senior Airman Anna Ferro at (707) 432-7400 or email Anna.M.Ferro.mil@mail.mil

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