Patient transfer after missile attack on a merchant ship

Introduction

Earlier this year, a merchant ship was hit by a missile attack off the coast of Yemen. Two survivors, both crewmembers, suffered severe injuries and were first treated and operated on in a hospital in Djibouti after being rescued. This case study describes the medical background and the transport of the patients for further treatment in the Philippines.

Patient description

Patient 1: The 48-year-old crewmember sustained an open fracture of the right leg of type III with severe crush injuries. The injuries were so severe that an amputation of the right thigh was necessary. After the operation, the patient required further intensive medical treatment and was described as stable but in a very critical condition.

Patient 2: A 31-year-old crewmember suffered third-degree burns on both forearms, hands, as well as on the scalp and face. Despite the severity of the injuries, the patient was awake, fully oriented, and able to breathe without additional oxygen.

Both patients were
taken over by the FAI
team at Djibouti–Ambouli
International Airport
and loaded onto the
air ambulance

Transport preparations and execution

FAI Air Ambulance was commissioned to transfer the patients. In the shortest possible time, all necessary overflight and landing permits, as well as ground transportation, were organised, allowing the departure from the home base in Nuremberg to proceed quickly. The mission was carried out with a Challenger 604 in double configuration, accompanied by a medical team consisting of two flight doctors and an intensive care unit (ICU) flight nurse.

Upon arrival in Djibouti, both patients were visited by the medical team and prepared for the upcoming transport. The team discussed further necessary preparations with the hospital staff to make the patients transportable.

On the day of transport, both patients were taken over by the FAI team at Djibouti–Ambouli International Airport and loaded onto the air ambulance.

Flight details and onboard care

The transport route covered 4,583 miles with a flight time of nine hours and 45 minutes. A refuelling stop was made in Hyderabad, India. During the flight, medical care was continuously provided to keep the patients stable.

Patient 1 received intensive medical care throughout the flight. Necessary wound care measures (dressing changes and wound cleaning), medication/pain management (ketamine, metamizole, lorazepam), and fluid therapy were carried out to prevent possible complications.

Patient 2 also received continuous medical care, primarily focused on pain management (piritramide). Despite his severe burns, he was able to move independently and required only minimal assistance.

Psychological care

Due to the physical and mental trauma suffered from the attack, it was important to provide emotional support to the patients. FAI medical teams are trained for such missions to address the psychological needs of the patients and provide them with a sense of security during the transport.

This case underscores the
importance of a swift and
coordinated response

Arrival and handover

Upon arrival at Ninoy Aquino International Airport in Manila, the patients were transferred to a medical centre and handed over to the medical staff there. The entire transport proceeded without complications, and the patients were handed over in a stable condition.

Conclusion

This case underscores the importance of a swift and coordinated response to urgent transport requests, in particular from crisis areas. The successful transport and continuous care of the patients demonstrate the importance of well-organised and professional medical evacuation. Psychological support played a crucial role in coping with the trauma suffered and contributed to the stabilisation of the patients.