A cardiac patient’s journey across borders

Medical repatriations require meticulous planning, particularly for patients with multiple comorbidities. This case, managed by Marm Assistance, showcases the complexities involved in transferring a 63-year-old male cardiac arrest survivor from Istanbul to Ashgabat, highlighting the expertise of Dr Batyr Kurbanov and his team in ensuring a safe and smooth repatriation.

The patient

The patient had a history of chronic kidney failure requiring regular haemodialysis, cerebrovascular disease, coronary heart disease (post-CABG), hypertension, cholecystectomy, and Type 2 diabetes. His deteriorating health led to a cardiac arrest due to hyperkalemia, which necessitated successful cardiopulmonary resuscitation (CPR) and intensive medical intervention. He was intubated, admitted to the intensive care unit (ICU), and later underwent haemodiafiltration for sepsis management.

Upon receiving the repatriation request, Marm Assistance swiftly mobilised its medical team

After emerging from a coma, the patient regained consciousness but faced persistent swallowing difficulties, requiring a PEG catheter for nutrition. Although he made significant progress with rehabilitation, limited mobility, intermittent aspiration pneumonia, and the need for continued dialysis necessitated his return home for further treatment.

Upon receiving the repatriation request, Marm Assistance swiftly mobilised its medical team. Dr Kurbanov assessed the patient, reviewing medical records, lab reports, and imaging results, and consulted with the treating physicians. The decision was made that the patient was fit to travel, provided that appropriate in-flight medical support was arranged.

Given the patient’s condition, a commercial airline repatriation was deemed feasible under specific medical precautions. The patient was approved to travel in business class with a dedicated medical escort and supplementary oxygen at 2 litres/min to mitigate altitude-related risks.

The mission

The Marm Assistance operations team meticulously coordinated every aspect of the mission. Ensuring compliance with airline medical regulations, the team arranged a seamless transfer, overseeing hospital discharge, special flight clearances, and medical equipment provisions. Marm’s in-house travel desk managed logistical arrangements for the patient, his accompanying family members, and the attending physician.

On the day of travel, Dr Kurbanov conducted a final pre-flight assessment, confirming the patient’s haemodynamic stability (GCS score: 14; SpO2: 96%). To prevent complications, he administered pre-flight medications, with additional supplies prepared for in-flight intervention if necessary.

During the flight, continuous monitoring and proactive interventions ensured a stable journey. The medical team remained vigilant for potential respiratory distress, electrolyte imbalances, or circulatory complications. By closely managing the patient’s condition, the team ensured a safe and uneventful flight.

Upon arrival in Ashgabat, Dr Kurbanov personally handed over the patient in stable condition to the receiving medical facility, marking yet another seamless international medical transfer orchestrated by Marm Assistance. This case underscores Marm Assistance’s expertise in high-risk patient repatriations, demonstrating precision, dedication, and unwavering commitment to patient safety.