From crisis to recovery – managing a high-altitude emergency

Consuelo had just arrived in Cusco, Peru, excited to begin her trek to Machu Picchu. A fit and healthy woman, aged 52 years old, she initially felt the normal effects of altitude: slight headache and shortness of breath. However, in three days, her condition deteriorated and she started coughing. She did not pay much attention to her symptoms, until the fourth day when she developed a persistent, hacking cough, became increasingly breathless even at rest, and felt a tightness in her chest. Alarmed, her tour guide recognised the signs of severe altitude sickness and rushed her to the nearest clinic.

An alarming diagnosis

The diagnosis was critical: high-altitude pulmonary edema (HAPE), a life threatening condition where fluid fills the lungs, preventing oxygen from entering the bloodstream. Her oxygen saturation levels were dangerously low. The first, and most critical treatment was an immediate descent to a lower altitude, and oxygen therapy.

Thankfully, Consuelo had a valid travel insurance policy. The clinic admin, following procedure, contacted the emergency number on her policy. The call was instantly routed to AP Companies’ 24/7 operations centre.

Consuelo’s body was literally drowning. The absolute priority was getting her to a lower altitude to reverse the pathology. Time was critical. While the clinic in Cusco could provide initial oxygen, it lacked the advanced pulmonary intensive care units needed for a case this severe. She needed to get to sea level in the city of Lima.

AP Companies instantly became the communication centre, managing information between the struggling patient (Consuelo), the treating doctors in Cusco, the insurance company, and Consuelo’s panic-stricken family in Madrid.

A two-stage evacuation

A direct air ambulance from Cusco’s highaltitude airport to Spain was impossible both for medical and logistical reasons. A careful, two-stage medical evacuation was the only solution.

AP Companies’ response was immediate, leveraging its understanding of high-altitude medicine and local logistics. Our dedicated case manager first confirmed with the doctors that Consuelo was on the appropriate oxygen mask.

While a ground ambulance was organised for the initial journey to a lower city, AP Companies’ case manager simultaneously called Consuelo’s sister in Madrid. She explained the nature of HAPE in clear, calm terms, established herself as the single point of contact, and promised hourly updates.

Once stabilised at a lower altitude, Consuelo needed advanced care. Using its vetted network in Peru, AP Companies arranged a dedicated air ambulance with a pressurised cabin capable of simulating a lower altitude. It was equipped with full intensive care capabilities, and staffed with a specialised medical team to fly her from Cusco to a top-tier pulmonary and critical care hospital in Lima. AP Companies guaranteed all payments directly to the facility.

Returning home

After several days in Lima, once the fluid in her lungs had resolved and she was weaned off oxygen, Consuelo was strong enough to travel home. AP Companies devised a meticulous repatriation plan, approved by the insurance company.

AP Companies maintained daily communication with Consuelo, who was relieved but weak, explaining each step of the journey home. AP Companies deployed a critical care nurse from its own regional office to act as her medical escort. His expertise was in pulmonary care, ensuring her stability throughout the long-haul flight.

AP Companies’ operations team booked three business class seats on a commercial flight from Lima to Madrid for complete comfort and privacy. All ground ambulances and airport logistics were pre-arranged.

After several days in Lima, Consuelo was strong enough to travel home

Consuelo’s journey home was smooth and without incident. She arrived in Madrid breathing easily and was transported to a hospital for final evaluation, thrilled to be reunited with her family.

The insurance company received a detailed final report and a transparent invoice. The strategic, phased approach – using a ground transfer for immediate lifesaving descent, followed by a domestic air ambulance and a commercial flight with medical escort – provided the highest level of care while achieving significant cost savings compared to an unplanned and unfeasible direct evacuation from Cusco.

The case demonstrated a successful application of AP Companies’ comprehensive service model. From the initial emergency response to the final handover to local medical teams in Spain, the situation was managed through precise coordination and deep regional expertise.