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I started this blog entry on an entirely different topic last night. While at the office late working on some much needed website maintenance though life decided to change both my plans and the tone of what was a well developed article with the interjection of a phone call. 

At 11:00pm a call on the main line is not unusual for our office with the various global time zones we support. 

"Hello," the voice said in a tired voice, "Does your company know anything about ECMO?"

Extracorporeal Membrane Oxygenation, ECMO, is a specialty involving an oxygen bypass circuit being placed into the body to continue to sustain life. It is a delicate procedure that requires a series of surgical interventions, medical logistics transport, and most importantly timing. Castle International has managed to successfully complete 20 ECMO transports of patients safely in the last year and a half where most air ambulance companies have never seen a case. 

"Yes we do," I respond thinking back to our own internal training of the perfusion circuit placement, equipment needed, and aircraft considerations required for the mission. Asking our own internal list of questions to identify the airframe and other support our client needed I heard relief in her voice as she answered the questions.

"You guys are amazing," she responded. "You're asking all of the questions that would have prevented all of my headaches over the last week. Everything you asked I've had as a problem because other companies were unaware." 

Explaining our history with the procedure I explained how intimately familiar we are with the special equipment and space considerations that certain ECMO setups require. Hearing a momentary pause on the other end I could hear her voice crack as she began to cry again, "thank you so much for understanding what I'm going through. I'll call you guys first thing in the morning. Thank you so much."

Signed copies of the most critical papers hit my inbox less than 5 minutes later and I started waking people up. 


A team that works well together under pressure is invaluable. Whenever we come together on an operations move stakes are high because lives are on the line. Gaining approval for the appropriate aircraft, obtaining documentation, and coordinating flight times efficiently all translates to a safer move for the patient. Being able to separate work into our individual specialties is what enables our global response capability. 3 hours after beginning activation for our ECMO flight I received a contact from Hero Client Rescue, our ground ambulance partner in Haiti.

One of our Connect Membership clients had become ill and was requiring emergency transport back to Miami and with the weather systems that were blanketing both launch and landing facilities I guess you could say that when it rains, it pours. 

Sourcing alternate launch points and aircraft to attempt to circumnavigate the storm systems between the team and Haiti the chosen team eventually became stalled due to the weather. Hero Client Rescue had already done the impossible and convinced the Government of Haiti to keep the airport open to support this critical lifeflight and the plane was stuck on the ground. Sourcing a nearby backup airframe that was coming up on an earlier launch window we put the flight in motion early the next morning. 

The Patient made it back to the United States for treatment and is recovering well. 


While obtaining approval from the client to utilize our aircraft at no cost to the patient, hospital administration optioned for a separate air transport provider. For the team at Castle though it was excellent operations planning experience to identify and improve where our own weaknesses are to better support future flights for our clients.