A complex commercial escort from Thailand

In early February 2024, a 75-year-old male patient from Germany found himself in a precarious situation following a motorcycle accident in Thailand, when he collided with a car in oncoming traffic. The patient would later find out that the incident resulted in massive polytrauma, including a series of rib fractures, skull fracture, pneumothorax, and subarachnoid haemorrhage.

However, when the patient was initially admitted to a local hospital, he was only diagnosed with rib fractures and a pneumothorax. After two days of treatment and a noticeable improvement in his condition, he was discharged and sent home to his hotel with pain medication for further care.

Recognising the need for further help in his situation, Malteser AeroMedical, a global assistance and medical transport company based in Cologne, Germany, was contacted by the patient’s insurance to support the patient with his medical needs while being abroad.

Following several calls with the treating doctor in the local hospital and the patient himself, Malteser’s assessment doctors advised the patient to closely monitor his condition and to contact them immediately if his condition worsened.

New medical complications emerge

It was within a few days of his release when the patient began experiencing difficulties walking and breathing, prompting him to seek medical attention again and immediately contacting Malteser’s medical operations centre for further support.

A comprehensive examination revealed a more complex scenario than initially diagnosed: a subarachnoid haemorrhage and skull fracture. Major intervention was deemed necessary, and it was decided to transfer the patient to a renowned hospital in Bangkok for further care and surgery.

The patient’s health continued to deteriorate during the course of his treatment in Bangkok and additional complications arose, including a recurrent pneumothorax and worsening brain injury, necessitating a double craniectomy. Furthermore, a thorax surgery was required to stabilise his lung following the recurrent pneumothorax.

Returning home with a medical escort

Following several days of treatment and hospitalisation and multiple medical evaluations done by Malteser, in consultation with the treating doctors, it was determined that the patient was fit to fly back to Germany – but could only be transported with a medical escort on a commercial airline. Swiftly, Malteser coordinated the mission and dispatched an experienced flight doctor to accompany the patient back to Germany.

After arriving and conducting a preevaluation before the flight, the patient remained stable – until the transport to the airport, where a sudden drop in oxygen saturation to 88% led to an immediate abort of the mission.

A setback – and a second attempt

Upon the patient’s readmission to the hospital, further consultations failed to reveal any obvious reason for the sudden decline in oxygen saturation, leaving both treating doctor and flight doctor unsure what the cause of his prompt change of status was.

Stabilisation efforts were initiated, and after two days of monitoring and treatment, a second attempt at transporting the patient was made. This time, the journey remained uneventful, with Malteser’s flight doctor providing oxygen support and coordinating wheelchair services during a business class flight back home.

After a lengthy journey, the patient was readmitted to his hometown hospital for continued care. The collaboration between Malteser AeroMedical, the treating physicians, and the patient’s insurer proved instrumental in orchestrating a complex medical transport, overcoming unforeseen challenges.

The case highlights the critical role of specialised assistance in managing patients with severe polytrauma and the need for a comprehensive approach to ensure the safety and wellbeing of the patient throughout the entire process.

A successful operation

This was definitely one of the more complex medical escort cases for Malteser AeroMedical; however, thanks to a decade-long experience, highly skilled flight physicians and the hard work and flexibility to adjust to situations back in the operations centre in Germany, the team at Malteser AeroMedical once again assured a safe and successful reunion with the patient’s loved ones. Another one in the books – and the next one is already on the way.