Last chance for a critical patient
Barcelona, October 4, 2023
Dr FERNANDO JUAN GERBER
On September 2023, we carried out a secondary transfer of a 45-year-old patient from Senegal to Spain.
Status report
The patient was a patient with a history of pleural tuberculosis in 2016 and COVID-19 lung disease in June 2023.
Currently, the patient was admitted to the intensive care unit in Senegal with a requirement for invasive mechanical ventilation since September 9 with a diagnosis of diffuse lung disease without associated organ failure.
Preparation for the transfer
The collection of information was quite difficult, the language barrier, the disparity of pathophysiological concepts for the diagnosis and treatment of the pathology to be treated and the availability of resources at the destination, made it difficult to diagnose the patient’s real situation.
With the information collected, we defined that the patient was a 45-year-old patient with a history of acute lung disease and who was currently experiencing adult respiratory distress syndrome with persistent hypoxemia and hypercapnea, associated with pneumothorax of the right lung field without associated organ failures.
The day before departure, at the Aeromedical and Marine TRI facilities, we held a mission briefing based on the information collected at the time. Transfer decision, modality, requirements, etc. a check of electromedicine and supplies, including verification via checklist of medication and consumables as well as testing of electronic equipment, batteries and connections to an electrical source.
Already at the airport we transfer electromedicine and supplies to the aircraft, we check respirator connections and electrical connectivity to the aircraft stretcher.
Crew briefing
Pilots present flight plan, schedules, flight profile, safety measures.
Aeromedical personnel raised the secondary transfer situation, aircraft requirements for the transfer, updating information on the patient’s global situation and the family and hospital environment.
We arrived at the airport in Senegal without incident. The transfer picked us up on time and took us to the hospital where the patient was for an assessment prior to the transfer.
Once there we prepared to enter the intensive care unit, we corroborated the information previously received but the severity of the situation was underestimated by the unit’s treating staff.
This was a 45-year-old patient with a history of acute lung disease who was currently experiencing adult respiratory distress syndrome with refractory hypoxemia and a large bronchopleural fistula.
Transfer
On October 23, early in the morning, we met on the tarmac with the ambulance that brought us the patient from the ICU. The patient was in the same condition as the night before. The ambulance doctor told us that the patient spent the entire night awake, struggling with mechanical ventilation and having an oxygenation crisis.
Before boarding the aircraft, we explained to the patient that we would put him to sleep and that we were going to travel by plane to another country to help resolve his condition.
We did a quick briefing of the crew, pilots and aeromedical personnel, we explained to the ambulance and runway personnel the steps to follow for the transfer. We established an action plan.
We performed deep sedation and neuromuscular blockade on the patient, then we transferred electromedicine. We optimized mechanical ventilation and quickly obtained respiratory improvement.
Once on the plane we conditioned all the devices, vascular access, respiratory orotracheal tube and pleural drainage, we replaced fixations, we sanitized the oral cavity that had large pressure ulcers from the oral device. Bladder and nasogastric tube.
During the transfer we reinforced prophylactic anticoagulation and stimulate a diuretic rhythm. We reinforced corticotherapy.
Finally, after 7 hours 50 minutes, requiring a stopover in the Canary Islands to supply fuel and oxygen, we arrived in Madrid. We transferred her to an ambulance that took her to the ICU at her destination without incident.
Final diagnosis
1) ARDS with refractory hypoxemia
2) Bronchopleural fistula
Dr FERNANDO JUAN GERBER
Successful Repatriation to Northern Ireland
Hello again, dear friends,
from Aeromedical and Marine, we feel very proud and satisfied that Dr Monica Fortea has carried out a new successful repatriation collaborating with 247 Aviation. We share through the blog the comments of the Fallon family about the operation to return to Northern Ireland
We are very happy to have been part of the repatriation process for Chris Faloon, who suffered an accident during his holidays in Portugal.
Chris is already in his city, after the family started a collection process to start the repatriation.
We wish them a speedy recovery and share their story on our blog as one more case of a successful repatriation.
Here you can see the news published by the press about the case:
Here are the family’s comments through a publication on the social network Facebook. This is the transcript of the message:
Next stop, Northern Ireland!! Don’t think anyone has ever been so happy to get home from their holidays!
This wouldn’t have been possible without the support from everyone back home and with saying that we would once again like to thank each and every person with our whole hearts for your help! ❤️
Many Thanks,
Chris and the Faloon Family
In this LINK you can see the Facebook post
Thanks to you Chris and family.
Aeromedical and Marine TRI, Team
Repatriation Mission of a Paediatric Patient from Bed to Bed
We are very glad to inform about the successful repatriation mission of a paediatric patient from bed to bed. This was a mission that required meticulous planning, coordination, and execution to ensure the safe and timely transfer of the patient.
The mission involved a young patient who required specialized paediatric care.
To ensure a successful transfer, from Barcelona to Abu Dhabi, a team of medical professionals and support staff of Aeromedical and Marine TRI, was assembled to manage the mission.
The team worked closely to coordinate the transfer and ensure that all necessary medical equipment and supplies were available at the destination, always advised and in constant communication by us Medical Director and our Chief Flight Nurse.
The transfer was carried out with precision and efficiency, and the patient was safely transferred.
Throughout the transfer, the patient was monitored closely to ensure their safety and comfort.
The successful repatriation mission is a statement to the dedication, professionalism, and teamwork of the Aeromedical and Marine TRI professionals and support staff involved.
Thank you all for this successful mission.
At Aero Medical & Marine Training and Rescue International, we handle diverse and complex missions across the globe, each one with its unique challenges and moments of deep human connection.
One recent mission took us to Kilimanjaro, Tanzania, where a patient sustained serious injuries after a fall during a safari expedition. Thanks to the incredible expertise and dedication of Alexia Hartmann Fernández, who traveled from Spain to personally lead the repatriation, the patient and her family were safely transported to Denmark.
From remote terrain and cross-border coordination to detailed medical planning, this mission was a testament to the resilience of our team and the strength of collaboration. Every procedure, every detail, every mile handled with care, precision, and compassion.
This is just one of many stories that remind us why we do what we do.
