EMS Ambulance 25 Aug 2022
Suffering a stroke abroad is a nightmare scenario for international travellers, and for their relatives at home.
Thrown into the care of a foreign medical centre – where the language, culture and treatment may be very different – most families just want to get their loved one back to their home-country hospital as soon as possible.
But that’s where things often get confusing. When exactly can you transfer a patient after they’ve had a stroke? And what happens if the local medics are saying it will be several weeks before they can be moved? Or are just being vague about the timescale?
Since strokes and cardiovascular accidents (CVAs) lead to more medical repatriations than almost any other emergency event, it’s worth understanding the arguments – and the potential answers.
Why repatriate after a stroke?
All things being equal, EMS Ambulance believes it’s better to bring a stroke patient home for treatment. We say this for two main reasons for this. The first is logistical – back home your patient will be near you, in a hospital they trust, with doctors who can clearly communicate what’s going on.
The second is the longer-term implications. Most of us know that providing emergency treatment – ideally within hours – is vital for stroke patients. But research has also shown that starting high-quality rehab within the right timeframe can have a dramatic impact on recovery outcomes too.
“People who have had a stroke appear to regain more hand and arm function if intensive rehabilitation starts two to three months after the injury to their brain,” says one article by US outlet NPR, citing a study by the Center for Brain Plasticity and Recovery at Georgetown University Medical Center.
“A study of 72 stroke patients suggests this is a ‘critical period’, when the brain has the greatest capacity to rewire,” they explain.
Bringing a stroke patient home means you can take full charge of their ongoing recovery, with multidisciplinary care and a properly considered plan for the weeks and months to come.
But is it safe to fly?
The advice around when you can fly after a stroke or CVA varies quite a lot depending on the context. For instance, the UK’s Stroke Association says it’s usually best to avoid flying for the first two weeks after an attack: “This is the time when your problems are likely to be most severe and other conditions related to your stroke may come up,” they explain.
But this general rule usually applies to regular commercial flights, where there’s no comprehensive medical backup if an emergency develops en route. Given the risk, many foreign doctors will argue – sometimes correctly – that it’s not possible to let the patient fly out to another country.
An international medical repatriation, however, is very different from a regular flight. With an experienced medical team caring for your patient – supported by the right equipment, oxygen support, medication and transport type – the options for getting home are totally different. Once the critical first hours have passed, it’s usually possible to fly within days of the stroke or – with a high-care air ambulance – sometimes even sooner.
What are the flight options for a stroke?
There are actually several different possibilities:
High-care air ambulance – for the most serious cases, with ICU-level facilities on board
Medium-care air ambulance – for patients in a more stable condition, on a private aircraft
Medical escort – for patients in a stable condition, on a regular flight with a doctor or paramedic
We can also offer sea-level flights for patients whose condition means they need to avoid flying in a pressurized cabin at high altitude. For more detail, see this blog: What is a sea-level medical flight?
Finally, there’s the ground-only option. A long-distance road ambulance can transport stroke patients for several thousand kilometres, with advanced in-cabin care and a specialist medical team.
Who makes the decision?
When it comes to deciding whether a patient is safe to travel on an international medical flight, EMS Ambulance’s own doctors are able to make the final call. That’s because the flight doctor is ultimately responsible for the health and safety of the passengers in his or her care. You can read more about this in the following article: Is your patient fit to fly?
We do this in remote consultation with the local doctors – reassuring them about the level of care we can offer during the flight – and with the doctors at your patient’s destination hospital. But we’ll carry out a live assessment when we reach your patient too. On the ground and at your patient’s bedside, our experts will be able to do a full physical examination of your loved one, speak to the local doctors in person, and judge whether it’s appropriate to go ahead with the planned mode of transport.
When it comes to transferring stroke patients, safety is the number one consideration and we will never compromise that. That said, we’ll do everything we can to help your patient get home if we can. Doing a full and proper assessment of your loved one’s condition is an important part of that. As one of our customers put it, “It felt so good finally to have someone “on our side”.”
Interested in reading more about medical transport for stroke patients? You may find this case study blog helpful:
Do you need help with a medical transport question – or are you searching for help getting a loved one back home after a stroke or CVA? Just drop our team a line today. We’re available 24/7, wherever you are in the world. Head to our Contact page for the details. You can also get a free cost estimate for your repatriation with our online pricing calculator.
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