February 2014 Issue
Table of Contents
Comparing Medivac Services
Tom Milne, relationship manager for corporate logistics and executive services at Seattle-based Remote Medical, a company providing on-site and telecommunicated emergency medical services in far-flung regions of the world, said sailors must prepare for more than evacuation.
According to Milne, sailors must consider the distance their boat will be from the nearest medical help and take every precaution necessary before embarking on their journey.
“We operate in remote areas to provide medical support to our clients. These are locations that don’t have direct access to the Western healthcare structure,” he said.
Milne said many travellers mistakenly believe all bases will be covered if they purchase travel insurance that includes a medical evacuation plan. “People think, if I get this in place, I’m taken care of. That is dangerous thinking,” he said.
Remote Medical looks at the integrated package, he said, explaining that training, provisioning, and medical and logistics planning are as important as the evacuation plan.
“It’s not Disney World. Things go wrong,” he said. “Evacuation can be part of the mix, but medivac is typically complex, can take a long time, and whether or not you have insurance it can be costly.”
To illustrate his point, Milne hypothesizes an accident aboard a sailboat in the South Pacific. “If you have the proper training, you can identify what might become a bigger issue later on,” he said. “For example, you need to know how to treat a wound effectively. In tropical areas, it takes only 12 to 24 hours to become a systemic infection that can be fatal.”
Milne offered another scenario. “If somebody has an allergy or is stung by an insect, it’s going to require immediate treatment with the right equipment. If you don’t have (an epinephrine) pen on site, your window of opportunity is closed in 20 minutes. So one of the first things we do at Remote Medical is get people to understand the context of their challenge.”
Remote Medical staffers routinely discuss these possibilities with cruisers, he said, adding, “We want to understand what their trip is about, their existing capabilities, and what their goals are.”
Proper provisioning, multiple medical kits, a logistics support package, and a subscription to an associated telemedicine service are key, as is emergency medical training, Milne said.
“Remote Medical will fly an instructor to the yacht’s location before its crew departs. Typically it’s a medical instructor. We have a family right now doing a three-year boat trip to South America, the Caribbean, and then the Northwest Passage. We are flying an instructor down to meet them in Southern California. We have flown instructors recently to New Zealand and Fiji,” he said.
If a medivac is possible, several considerations will impact its speed and effectiveness, including the availability of the appropriate aircraft; the aircraft’s point of origination; the capability of its crew to handle a medical transfer; rules governing medical flights; and any existing airspace issues where the political climate is less collaborative.
“You might be a slam dunk and have a plane on site in 24 hours. But in remote areas of the South Pacific or Antarctica, a straight shot with a big plane might be seven hours. And then there’s the weather. You can experience no-fly weather in Antarctica for more than a week,” Milne said.
When Remote Medical receives a call for a medivac, depending on location, it can contact Cega Group, its UK-based business partner.
“Cega owns a variety of air ambulances,” Milne explained. “The company provides medical and security evacuations on a global scale, doing 50 evacs a month and 2,000 repatriations each year.” (Repatriation means moving a person who needs medical care but is not in critical condition).
“We can access their medivac assets,” he said. “People need to understand that in the interest of patients, companies look at the worldwide network of medivac providers. Any provider with a dedicated fleet would be a finite asset. Most important is to have the coordination. People should also understand that some patients are not good to fly. Once we understand a client’s circumstances, we can set them up to go to a specific medical facility or pharmacy.”
Remote Medical also has the option of diverting patients to another partner, the Columbia Asia network of hospitals.