Air Force's largest NICU staff cares for tiniest patients

Published Dec. 17, 2009
By Staff Sgt. Vanessa Young
Defense Media Activity-San Antonio

SAN ANTONIO (AFNS) -- In the midst of life saving machines, sensors and IVs is a swaddled, sleeping baby girl who weighs little more than 2 pounds.

Forty times a minute a ventilator pumps about a teaspoon of air into her tiny lungs to keep her alive. Each breath is closely monitored by Cheryl Collicott, the baby's primary care neonatal nurse at the Neonatal Intensive Care Unit at the Wilford Hall Medical Center here.

The NICU staff provides treatment to term babies who are born unexpectedly ill, premature babies, with birth defects or who require intensive medical care.

This is the largest NICU in the Air Force with six neonatal intensive care physicians, 40 neonatal nurses and 12 respiratory therapists. The facility also has the only extra corporeal membrane oxygenation machine in the Department of Defense. An ECMO machine is a form of heart-lung bypass which supplies blood flow to a baby's body and gives diseased or damaged lungs a chance to heal.

The unit is divided into two levels of care: Level 2 and Level 3. Level 2 babies are those born prematurely or ill who require specialized care. Babies in Level 3 cannot be treated in any other level and need technological equipment such as ventilators and incubators to stay alive.

"Most of our babies are admitted to Level 3, which is the most intensive area of the NICU, and would not survive without intensive care support," said Lt. Col. (Dr.) Daniel Dirnberger, the director of neonatology for the San Antonio Military Medical Center.

Members of the NICU have been able to help babies born as early as four months prior to their due dates, some of those weighing only 14 ounces at birth. On average, the NICU has nine or 10 babies a day in need of intensive care in Level 3. Each year the NICU staff admits more than 500 patients.

Each baby in the Level 3 area has a primary neonatal nurse, who literally sits arms-length of "their" baby at all times.

"Babies are just special and when they're in here they have special needs," Ms. Collicott said. "I feel like I can help them get a start in the world and a future they might not have otherwise."

Since some babies can spend weeks and sometimes months in the NICU, the staff not only has a responsibility to take care of their patients, but also to the parents of those patients.

"The technical aspects of what we do keep the babies alive and help them get better and go home, but we have to take care of the family as a whole," Doctor Dirnberger said.

Laura and Maj. Cory Middel expected twin boys, but didn't expect them to have to be delivered three months earlier than their due date.

Their sons, Aaron and James, were born at about 1.5 pounds and 2.5 pounds respectively. After their birth, the Middel family spent months with their boys in the NICU.

Ms. Middel said she couldn't hold one of her sons until he was about 40 to 50 days old. The nurses advised her to sing and talk to create a bond with her baby.

"It was very scary," Ms. Middel said. "It took us about two days to even want to touch them because of their size. The staff here is very informative; they are very good about educating the parents. It was a very personal experience."

Today, the Middel boys are 9 months old.

"The providers and staff here are very invested in their patients," Major Middel said. "There is certainly a bond that I think has to do with the connection that we all have as part of the large Air Force family."

USAF. (U.S. Air Force Graphic by Rosario "Charo" Gutierrez)