CASE STUDY: Air Rescue bed-to-bed road-ferry-air transfer
Dr Ulrich Carshagen, Air Rescue Group Lead Flight Physician, Africa, describes transporting a complicated malaria case from Freetown to Johannesburg.
Air Rescue Group is devoted to upholding the safety and wellbeing of every patient. As part of our commitment, we prioritise bed-to-bed patient transfers, which has been the foundation of our service – even in remote and challenging environments. A recent air ambulance mission from Freetown, Sierra Leone to Johannesburg, South Africa exemplified our dedication to this principle.
Our team responded quickly to the case of a middle-aged woman with complicated malaria in Freetown, who urgently needed a care upgrade due to the rapidly deteriorating medical condition. Amongst all the considerations relating to organising a long-haul international air ambulance retrieval was attaining blood products to be taken to Freetown, as the patient’s haemoglobin and platelet counts were rapidly decreasing.
One of the primary logistical challenges was the need to reach Freetown, separated from Lungi airport by the Sierra Leone River. Since travel by road takes about three to four hours due to the absence of a direct road connecting Freetown and the airport, the medical crew had to rely on travel by boat. The ferry, a public service that poses numerous challenges, such as unreliable scheduling, the potential for overcrowding, breakdown and difficult access, still remains the only realistic option for getting to Lungi timeously.
Despite these difficulties, our medical crew, comprised of a flight physician and an ICU nurse, promptly reached the patient in Freetown, efficiently conducted a bedside assessment, collaborated with the local medical team, and devised a robust medical management plan.
Early the next day, the patient was prepared for the transfer. Making use of a ground ambulance with 4x4 capability, our medical crew transported the patient from the clinic to the port of the local ferry between Freetown and Lungi. Due to ambulance space limitations and the amount of required equipment, our Mission Control Centre ensured the team had access to two ambulance vehicles. Situational awareness and careful on-the-ground planning by the medical crew ensured the two-vehicle proximity on the ferry for easy equipment access, despite the boat being overcrowded.
The ferry ride takes about 45 minutes, but the departure is quite often delayed. This time was no exception and there was indeed an hour’s delay. Due to the nature of a mission like this, the medical crew had many redundancies in place, since running out of oxygen or critical medication could have been detrimental.
After the 45min ferry ride, the medical crew had to ensure safety during the 5h25min flight to Luanda, Angola for a technical stop, and the last 3h10min of the trip to Johannesburg. Finally, after spending about 15 hours with the patient, the team safely handed the patient over to the medical professionals at the receiving facility in Johannesburg.
At Air Rescue Group, we guarantee bed-to-bed patient transfers to ensure that our patients receive the best care they deserve, even in the most challenging circumstances and despite remoteness.