European Air Ambulance (EAA) offers swift evacuation from West Africa
West Africa is emerging as an area of great potential for international business. But setting up shop there requires companies to attract skilled and experienced expatriate employees. And that, in turn, means they must make assurances that those employees have the best possible medical cover. After all, many of the industries in this part of the world are high-risk enterprises such as oil exploration and extraction, mining and infrastructure development. Coupled with every day health and safety concerns such as malaria and unsafe roads, and a lack of high level medical care in many areas of the region, and it is clear that access to an air ambulance to evacuate patients involved in an accident or suffering from serious illness is essential.
Companies in the region have to rely on the services of international assistance providers, and their cooperation with air ambulance operators, to provide medical evacuation. The problem, however, is that conventional air ambulance companies from Europe have to fly to West Africa to pick up the patient, and that has often involved the crew taking a legally required overnight stay before embarking on the return flight. In many situations time can be of the essence - not only in saving lives, but also to be able to treat an injury or disease as fast as possible and thus reduce recovery time or even to prevent the patient suffering permanent damage. Two full days to repatriate a patient - from the first call out to hospital delivery - is simply too long in many cases.
European Air Ambulance (EAA) has recognised the need for a rapid response to evacuate patients either to Europe or, where appropriate, to the nearest specialist medical facility in cities such as Johannesburg or Nairobi. EAA has thus undertaken to locate a dedicated air ambulance aircraft in Accra, Ghana starting in February, 2011. EAA's Director Sales & Marketing, Patrick Schomaker, says the company wants to be able to provide faster medical evacuation "in order to improve the service to our clients and especially to save more lives and improve medical care for the affected patients."
EAA members DRF Luftrettung and Luxembourg Air Ambulance will supply the aircraft on a rotation basis. "This will allow the scheduled maintenance of the aircraft to be conducted at our dedicated and contracted premises in Germany and Luxembourg," says Schomaker. Crew, who will also be based in Accra on rotation, will comprise a flight physician and flight nurse/paramedic from the highly experienced, multilingual teams currently used on EAA missions. "With this new service, EAA will be able to provide a fast response for medical evacuation out of West Africa with solutions ranging from Mauritania to Angola to any place requested within Africa, to Europe, USA or any other place worldwide," Schomaker explains.
Medical reporting: the vital component
Few travel or health insurers or assistance companies would argue that patient safety and the health of those who come into contact with a patient during a repatriation flight is of paramount importance. It is therefore astonishing to note that air ambulance operators are more and more frequently receiving requests from clients to fly missions without being supplied in advance with adequate medical information. In fact, there have even been instances where no medical report has been available to the air ambulance operator at all.
The importance of receiving an accurate and comprehensive medical report on a patient’s status, however, cannot be emphasised enough. Before setting off on a mission, the air ambulance operator will, if correctly informed, contact specialist medical crew – for example paediatricians, gynaecologists or cardiac experts – who can deal professionally and efficiently with the patient’s needs. In many cases, special equipment and medicines will also be required to ensure the proper care of the patient, and these should be loaded before flying from home base as they may not always be readily available in the country or region where the patient is situated.
Due to space and equipment restrictions, it is very difficult for air ambulance crews to perform any primary care or conduct a thorough diagnosis when arriving to pick up a patient, especially when the patient transfer takes place at the airport. Time constraints, dictated by flight operations and crew schedules, also prevent the medical team from undertaking lengthy stabilisation procedures, so it is essential that an accurate medical report is available for the receiving flight crew.
Furthermore, the air ambulance crew may arrive to pick up a patient and find they are unable to fly for any number of reasons. For instance, they could have an infectious illness – open TB, measles, mumps, rosella – that was omitted from the medical report but that would place the flight and medical crew at risk of infection if they were to repatriate them. Other infectious illnesses, such as Ebola or SARS, of which the crew may not be aware until they arrive on site, can also restrict transportation back home. Often, these illnesses are omitted from reports as they have not yet been properly diagnosed.
Other patients are simply not fit to fly: in other words, it would be more dangerous for them to be flown back home than to stay at the foreign location. This situation is encountered if the air ambulance crew does not receive sufficient medical information in advance of their arrival or if the patient's condition has deteriorated since the time the crew received the medical report. In the latter case, the patient can sometimes be stabilised, for example overnight, and can fly back with the air ambulance crew the next day.
However, it is not just patient care that suffers from the lack of a well-prepared medical report. Economic and legal aspects must also be taken into consideration. It is a terrible waste of financial and personnel resources if a fully crewed air ambulance flies to a distant destination only to return empty. At the same time, questions of legal responsibility will be raised if a patient is cleared for transport but their condition deteriorates rapidly or they die during a flight, or if a medical crew unwittingly comes into contact with a patient carrying an infectious disease.
Thus, thorough preparation of a repatriation mission, of which an accurate medical report is a vital component, increases the safety and medical care of a patient, and consequently improves significantly their chance of recovering more quickly. A properly planned repatriation will therefore prove to be beneficial to the patient and, ultimately, to the travel insurer.
