EMS Ambulance 8 Sep 2022
Repatriation Stories: transporting a stroke patient
Repatriation Stories: transporting a stroke patient
Not long ago, a family from the UK called us for urgent advice. Their father had just fallen gravely ill abroad and they wanted to get him home ASAP. Unfortunately, the local hospital wouldn’t let him leave.
“My father was holidaying alone in Italy when he had a stroke and suspected heart attack,” explains Dominic, writing about the incident afterwards in a Google Review.
“My sister and I flew out immediately but were getting very little information from the Italian hospital and were concerned at his treatment… The situation was complicated as we had so little information from the[m] about my father’s condition, and the doctors were insisting he shouldn’t be moved.”
In desperation, Dominic called EMS Ambulance. Was there anything we could do to help?
To transfer or not to transfer?
Strokes and cardiovascular accidents (CVAs) are, unfortunately, some of the most common drivers of international medical transports. But they cause a lot of confusion too. In the first minutes and hours after a stroke, time is critical: the earlier a patient receives treatment, the better the likely outcome. This will almost always be in a local emergency unit. But once the patient has been stabilised, how long should they stay in hospital? When is it safe to transfer them elsewhere? It’s not uncommon for families to find themselves at odds with the local hospital, where there are often language barriers and communication breakdowns. Needless to say, this is extremely stressful for all involved.
Contacting the foreign doctors
When Dominic called EMS for help, our in-house doctors immediately contacted his father’s hospital department in Italy. We have a wide range of languages on the team – with backup translators – which makes communication far easier. Our medics were able to reach the local doctors, get the latest detail on his condition, and remotely assess his fitness for transport. They then rang Dominic to update him.
“We contacted EMS Ambulance in the morning and immediately got more information from them than we had received from the Italian hospital in two days,” Dominic recalls. “That same evening we decided to proceed and they already had the ambulance on the road to Italy.”
A late-night assessment in Italy
While the road ambulance was en route, we dispatched Dr Nabil Mani – EMS Operations Director, and a cardiology specialist – to meet Dominic’s father. A key issue for stroke patients is that hospital staff often aren’t aware how advanced a medical repatriation can be. In person, Dr Mani was able to tell the local doctors about the specialist support and equipment that’s available to our critically-ill patients in transit. This is why companies like EMS are able to transport people securely from war zones and between intensive-care units. Where high-altitude pressurisation might cause issues for certain medical conditions, we can even organise alternative sea-level flights. Dr Mani was also able to carry out a full physical assessment of Dominic’s father before going any further.
“As soon as he arrived, he took charge,” Dominic explains. “He spent an hour with the (uncooperative) local doctors, making his own assessment of the medical records, examining my father and reaching his conclusions about the nature of his condition and the best way forward… It felt so good finally to have someone “on our side” after exhausting ourselves battling with the local hospital staff (further complicated by COVID restrictions). He was ably supported by the central EMS team in the Netherlands, who quite literally were working on his case 24/7.”
A last-minute change of plan
Having assessed Dominic’s father, Dr Mani decided it would be safer to transfer him to the UK by air rather than road. He then explained his thinking to Dominic.
“I’ll never forget him briefing my sister and me as we sat on the steps of the Italian hospital at 10pm,” Dominic recalls. “Based on his assessment, we had to change the repatriation plan and opted to get my father home more rapidly by air ambulance rather than by road (Dr Mani was able to assess – correctly – that this was possible given the exact nature of my father’s stroke).”
A positive conclusion
Once Dominic and his sister had given us the go-ahead, we prepared an emergency air ambulance at short notice. “Having changed the plan late on the Saturday evening, EMS managed to arrange the air ambulance super-fast, so that they collected my father by 12 noon on Sunday,” says Dominic. “By 2:30pm he was on the plane, and he was safely in a London hospital, close to home and his family, later that same afternoon.”
Reflecting on the experience afterwards, Dominic was relieved they had decided to order the repatriation and get their father home quickly for treatment. “I can’t thank EMS enough for the incredible service they provided but also the fantastic emotional support they provided to me and my family at such a stressful and uncertain time,” he says.
“Dr Mani is a real superstar of a doctor (if ever I have an emergency, I’d want him to be on the case!), but every member of the EMS team was impressive, from the learned central medical team (I must have spoken to them 20 times over the course of 3 days!), to the admin/logistics team organising every last detail and keeping us informed, to the super calm, qualified and capable nurse and paramedics. What a team! If you’re reading this, I hope you and your family never have to face a medical emergency like this but, if you do, you could not be in better hands than with EMS.”
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Interested in reading more about medical transport for stroke patients? You may find this article helpful:
Can air ambulances transport stroke patients?
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