From falling from a bunk bed to jungle rescue

During an adventurous backpacking trip through the remote jungles of Vietnam, a 35-year-old female patient from a small village in east Germany faced a life-threatening medical emergency that highlighted the often unusual and challenging aspects of bringing patients home safely.

The incident occurred when the patient fell from a height of over three metres while climbing down from a bunk bed in a remote town in Vietnam. This severe fall resulted in immediate and alarming symptoms, including seizures, indicative of possible severe intracranial injury. Her shocked boyfriend had to witness the aftermath of her fall and immediately alerted the local authorities. The remote location of the accident posed significant challenges, as there was no immediate access to advanced medical care.

The locals and the patient’s boyfriend had to make an urgent decision to seek help with no direct streets or helicopter evacuation possible. Thus, they arranged for an improvised transport – a tuk-tuk – navigating through the challenging jungle terrain to the nearest medical facility. This arduous journey lasted about three hours, during which the patient’s condition remained precarious, requiring careful monitoring and management through a local doctor and the patient’s boyfriend.

Upon arrival at the local hospital, the diagnosis was severe: the patient had sustained significant head trauma with intracranial haemorrhage in the cerebellum, a vertebral compression fracture at LIII, and was experiencing ongoing seizures. The local facility, while competent for basic care, lacked the specialised resources required for such critical conditions.

Realising the gravity of the situation, Malteser AeroMedical was mobilised to manage the patient’s evacuation. This process required meticulous planning to ensure the patient’s safety and comfort. The primary concern was to stabilise the patient sufficiently for the lengthy air transfer, particularly due to her spinal injury.

Mission planning involved several crucial steps. The team coordinated with the local hospital to stabilise the patient as much as possible before evacuation. This included administering medications to manage seizures and ensure she was fit for transport. The complexity of her condition demanded that every detail of the evacuation plan be thoroughly vetted, from the stabilisation protocols to the specifics of her air transport.

Given the patient’s spinal injury, special attention was given to her comfort and safety during the critical loading and unloading processes. The air ambulance plane, a Learjet 45, was equipped with advanced medical facilities to support her throughout the flight. The medical team ensured that the patient was carefully positioned and secured in a way that minimised risk and discomfort, utilising a customfitted stretcher and spinal supports.

However, the evacuation was not without its challenges. The local hospital, while well-equipped for basic care, was not entirely cooperative in providing additional diagnostics that could have been useful for the patient’s ongoing treatment. This lack of cooperation created additional hurdles for the evacuation team, who needed to rely on their own assessments and available information to plan the repatriation effectively.

Though surgery was not deemed necessary, the patient was required to wear a corset to stabilise her spinal injury during her hospital stay and would be transported in a vacuum mattress during the flight. The repatriation flight from Vietnam to Germany was carefully orchestrated to mitigate risks and ensure continuous care. The Learjet 45 provided a controlled environment for the patient, equipped with the necessary medical equipment to monitor and manage her condition throughout the trip. The flight team maintained constant communication with the receiving hospital in Germany to prepare for the patient’s arrival.

Upon arrival in Germany, the patient was transferred to a local hospital where she could receive comprehensive care. The treatment plan included advanced neurological and spinal care aimed at stabilising her condition and managing the traumatic injuries sustained during the fall. Despite the challenges encountered during the evacuation, the patient’s condition was carefully managed to ensure a safe and effective transition to further treatment.

This case once more highlights the complexity of handling severe medical emergencies around the world, often under the most unusual circumstances. Thanks to the great collaboration between experienced partners, the patient was not only able to be brought home safely but made a full recovery following her lengthy hospital stay.