Critical Medevac on Commercial Flights: a case study


Medilink recently carried out a successful medevac on commercial flights from Kuala Lumpur to Tunis of a patient in a critical condition. While every medevac has its own exigencies, this particular case was exacting and uniquely challenging given the length of the mission, some 26 hours, the unstable medical condition of the patient and the technical and logistical capabilities required to carry it out. Commercial airlines were the only viable option as the family was seeking a cost-effective solution due to the patient’s lack of medical travel insurance cover.

This mission required immense stamina from those with first-hand responsibility for the patient’s immediate medical care as well as precision planning of complex logistics. We undertook the evacuation as much on humanitarian grounds as commercial given the specific circumstances facing the patient and his family.

The Case History

The patient had arrived in Kuala Lumpur from Africa on a personal visit three months prior to the medevac. He was taken ill with malaria contracted in Africa and over the course of a three-month hospitalisation in Kuala Lumpur had developed septicemia which necessitated the amputation of a leg. The patient had also suffered multiple organ failure on more than one occasion.

We had to assess the viability of any medevac given the instability of the patient. Medilink’s Senior Medical Advisor Dr Nuno Cosmelli, a highly-experienced flight medic, arrived in the Malaysian capital to carry out a critical first-hand assessment of the patient.

Dr Cosmelli, who joined our team in April 2017 after over 20 years on the ground in Africa, is a specialist in aeronautical medicine.

Putting Medevac Plans into Action

We updated our risk analysis on a daily basis, all the while in constant negotiation with commercial airlines serving the route from Kuala Lumpur to Tunisia. The state of the patient required precision planning in order to ensure the best possible medical care and service on two commercial Turkish Airline’s flights during the 26-hour operation. The mission also included procuring local medical services for the four-hour stopover in Istanbul.

One more than one occasion, our team had to abort the mission and restart the entire logistical planning on account of the patient’s instability. In flight, the patient required continuous medical care and monitoring to maintain a stable condition and to mitigate flight fatigue.

Medilink medevac using commercial airlines Services from across Medilink were engaged, starting with our Emergency Alarm Centre which was the first point of contact for the patient’s family. Their request was immediately passed to the Emergency Response Planning unit which activated the critical assessment of the situation, as well as setting in motion clinical governance procedures and the planning and deployment of appropriate medevac services, equipment and personnel.

The Outcome

Medilink succeeded in transferring the patient in a stable condition back home to Tunisia. Evacuation on commercial flights is a service we provide as routine in cases not requiring immediate emergency transfer.

However, this particular case shows our commitment to seeking the most viable, cost-effective and safe option however demanding the individual circumstances. Finally, we would like to extend our gratitude to our Turkish Airlines who were committed partners throughout and without whom this operation would not have been possible.


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