International Medical Evacuation: planning for the unexpected


When it comes to international medical evacuation, there are two critical areas to take into consideration when choosing a partner. You need to evaluate the efficiency, reliability and global reach of the medevac service provider, and have total assurance of the professionalism and expertise of the medical care delivered. Both need to function seamlessly whatever medevac situation arises.

Medevac is never a routine operation.  However, it needs well-planned systems in place that can be activated instantly, calmly and confidently, wherever the medevac is required, however remote or extreme the location.

International Medical Evacuation Services - Medilink

At Medlink, we’ve been providing international medical evacuation services for two decades. We have faced almost every type of call for emergency medical evacuation, but we never take anything for granted. We provide exceptional levels of reliability and efficiency and the ultimate assurance to patients that they will have professional assistance with guaranteed high levels of safety and medical care.

We organise international transfers in air ambulances if the patient is in need of intensive care, and on scheduled commercial flights if the medical situation is less acute. Medilink operates a 24/7 emergency hotline that is staffed by medics experienced in accident and emergency and in delivering topside support.

Medilink works with an extensive global network of aviation service providers to ensure we provide a truly international medical evacuation service. All medical personnel forming part of the flight crews are proven professionals with aero-medical training.

On the Job with our Medevac Crew

Medilink works within strict and rigorous parameters in providing medevac services. To provide an insight into how this operates on the ground, our Chief Medical Officer, Dr Kevin Crockford, walks us through a typical international medical evacuation.

1st Stage – Request for Medical Transfer and Selection of Medical Team

Once we receive a request for medical transfer and have the patient’s details and specific location, we communicate with the medical team on the ground so as to get an accurate picture of the patient’s status. The next steps entail expertise and swift decision-making skills, bearing in mind that our target timing to take off is 45 minutes in emergency situations.

Due to the nature of our work, and our unique capabilities to extract patients from specific locations, we are called upon to carry out both primary medevacs to collect patients directly from the scene of the incident, as well as secondary medevacs to transfer patients from one medical facility to another. This means that we need to be prepared to transfer patients in conditions which sometimes are far from ideal. On many occasions, our medical team needs to stabilise the patient as optimally as possible before we make the actual transfer.

The flight medical team is selected on the basis of the patient’s condition, making sure that the appropriate skill set is available to provide the necessary care to the patient. The team is generally composed of a flight physician and a nurse who provide continuous, in-flight monitoring and any medical assistance the patients may require en route.

2nd Stage – Planning and Preparation

In the second stage of the procedure, the Chief Medical Officer outlines the plan for the transfer of the patient and makes sure that all necessary preparations for the mission are made. These decision and plans need to be made in a short time and entail a lot of work in order to ensure that the patient’s safety is secured.

This preparatory stage is essential for the success of a medical evacuation procedure and demands the availability of ready-to-use oxygen and ventilatory equipment, cardiac support, and sedation and pain relief medications. It is important to keep in mind that once airborne you are totally on your own so it is important to anticipate patients’ needs based on their illness and morbidity.

The flight crew is supported continuously by Medilink International’s Alarm Centre on the ground. This service plays a major role in coordinating the bed-to-bed transfer, assuring admission to the receiving hospital, alerting ground ambulance services on both the sending and receiving end and also in coordinating timings. Other things taken into account during the planning include the location of airfields en route should the need arise to land.

3rd Stage – Final Assessment

Once the patient is met by the transfer team at the destination, the medical team assesses and optimises the patient ready for transfer. In rare cases, flight plans and final destinations might need to be changed depending on the patient’s medical condition. Medilink’s Chief Medical Officer is consulted throughout regarding any queries and amendments to plans at any stage of the medical evacuation.

What makes a successful International Medical Evacuation?

Coherent, calm and efficient communication

This is paramount and a key element of any successful medevac. This ranges from communication with the treating medical team before the medevac to maintaining up-to-date, thorough communication with all parties throughout the transfer.

Expecting the unexpected

Ultimately, what make a medical evacuation successful are the attention to detail in preparing for medevac and the entity and team’s readiness to cope with any unforeseen situations.

Continuous Improvement Process

After each mission, we hold a debriefing to assess the outcome and provide feedback that can assist us in continually improving our medevac services.

For more information on our International Medical Evacuation services, please see Medilink’s subsidiary Medilink International Air Ambulance (MIAA).


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