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Medical crisis: one family's story
Being faced with a medical emergency and receiving the right urgent medical attention is a major concern for people living and working abroad.
If they have an accident, or if they fall seriously ill, they need to know they have a private medical insurer that can trigger a rapid response from doctors who have the experience and resources to give them the best available care.
And if the right specialists aren’t available, or if the health care system of the country they’re living in is under resourced, they need the reassurance of knowing they’ll be evacuated home, or to a doctor in another country who can take care of them.
Calm in a crisis
Medical Director, Dr Mitesh Patel, leads the group of clinical specialists within Aetna International’s Care and Response Excellence (CARE) team, and is one of the people responsible for giving its members that peace of mind.
“I have undertaken around 200 evacuations personally and managed thousands more,” says Dr Patel. “But my current job is about coordinating and directing emergency responses globally, dealing with crisis situations as they’re called in.”
International response
The CARE team receives members’ requests for assistance through Aetna International call handlers, who provide an initial report and help set up conference calls with the member’s treating doctor and medical staff around the world. Working together, they discuss the patient’s history, evaluate the best treatment options and organise a response.
“We have our CARE teams based in the U.K., so if we need to we can deal directly with some emergencies,” he says. “But a lot of our cases are in Africa and Asia, so we work with local partners who, if required, can reach an incident more quickly to administer treatment or support a medical evacuation.”
Aetna International members know they can rely on the CARE team to act quickly. Dr Patel talks through a recent case, where a slow reaction would have been fatal.
From their base in the UK, Dr Patel and the CARE team deal with international emergencies daily. Whether it’s transporting sick children half way across the world for a consultation with a world class specialist, or organising a rapid medical response for member’s impacted by a terrorist attack or natural disaster, the focus for the team is on making sure Aetna members get the best treatment as quickly as possible.
Employers and brokers can find out more about our services including the CARE team, by contacting an expert advisor in their region.
Handlebar horror
“We got a call in around 11.30 GMT, from the father of a fifteen-year-old boy who’d been riding his quad bike around the family farm in Zambia. He’d crashed the bike, been catapulted over the handlebars, and as a result of his injuries had been rushed to one of the local clinics. His father told us his son was conscious, but had a lot of stomach pain, as well as a possible fracture to his left hand.
“This was a very rural area and the clinic didn’t have the resources we needed to find out the full extent of his injuries. The treating doctor sent an X-ray over, and we arranged to move him to a larger facility where we could get more detailed scans. At this point, his observations were fairly normal, and we asked the attending medical team to call back in a couple of hours so we could check the scans and decide if we needed to move him to a bigger hospital for specialist treatment.
Authorised airlift
“The family called back in less than an hour. The boy’s condition was getting much worse. The scans showed there was bleeding between the kidney and the spleen; his abdomen was full of fluid, which is a sign of internal bleeding; his blood pressure was dropping significantly; and he was going into shock. He was in a lot of pain and it was touch and go whether he’d survive.
“We knew he needed emergency surgery, but I’d been talking to the local doctor and knew they didn’t have either the equipment or the experience to do the kind of operation the patient required.
“We authorised an air ambulance to pick him up and transfer him down to a specialist hospital in Johannesburg. Unfortunately, the plane was delayed. It was supposed to arrive in Zambia around 17.00 SAST, but couldn’t get there until 20.20. And the airport was due to close at 20.00.
Delayed takeoff
“Our team was in constant contact with the paramedic on the ground and we knew the patient was in a critical condition. If we couldn’t get him to a hospital that night, his chances of survival weren’t good.
“Our only option was to persuade the airport to stay open long enough to allow our ambulance to land, get the boy and his mother on board and take off again. The airport agreed, we paid the airport bill, and later that night we safely delivered him into an intensive care unit in Johannesburg. We’d been in touch with the receiving hospital, so they were prepared for his arrival, and ready to try and stabilise him.”
Assessing the damage
“Once we had the patient in hospital we were able to run more comprehensive tests. It wasn’t good news. His spleen and liver were both torn; blood and fluid were continuing to build up in his abdomen and he’d developed bowel gangrene.
“He’d also fractured three ribs, which was causing a pocket of air to build up between his lungs and his ribcage. Too much air and it would compress on his lungs and stop him breathing. Doctors stabilised him overnight and we arranged for emergency surgery the next day.
Emergency surgery
“I’d briefed the surgeon before the boy’s arrival and we discussed a planned laparoscopy — keyhole surgery that would allow us to try and fix the organ damage without opening the abdomen completely. They were able to fix the tear in the bowel, clean out the blood and fluid, and remove a section of the damaged bowel.”
In recovery
“A week later and our patient was up and moving, taking part in physiotherapy, and getting ready to fly home. He’d need to take things extremely gently for at least three weeks, staying at home rather than going back to school. His mother met with the school doctor to talk through his needs, and we suggested he stay off all sport for three months, with no heavy lifting or vigorous walking.
“In time, he’ll recover, but in many ways it was a lucky escape. With a less rapid response the outcome could have been very different.”
Epilogue: Rapid responses
From their base in the UK, Dr Patel and the CARE team deal with international emergencies daily. Whether it’s transporting sick children half way across the world for a consultation with a world class specialist, or organising a rapid medical response for member’s impacted by a terrorist attack or natural disaster, the focus for the team is on making sure Aetna members get the best treatment as quickly as possible.
For more information about how the CARE team supports our members in a medical emergency, talk to our expert consultants.
The more engaged a patient is, the less likely they are to need urgent care.
