Nepal is considered as a land of helicopters. In the space of just two years, over 450 helicopters have landed on the heli roof of the Nepal Mediciti Hospital.
On Friday 19th July, the Nepal Mediciti Hospital received a call for a heli-evacuation like no other.
This is the story, as told by Dr Sanjaya Karki:
The patient, Mr Somasundaram aged 74 and a doctor himself, suddenly fell sick in Tibet and was taken to the local hospital where medics ascertained the severity of his illness – his GCS was poor and hemodynamically unstable and most of the blood parameters were not in place. Family members were worried and wanted to take the patient back to Malaysia. However, transport home was no easy task – a trip home would be full of risks for both patient and the attending medics.
On 20th July, the Mediciti-HEMS team including team leader Dr Sanjaya Karki and head paramedic Mr.Ramesh Neupane, were ready to be deployed. By this stage, the patient was on a mechanical ventilator due to the deterioration of the condition.
The plan was to transfer a ventilated case all the way from Tibet to Hilsha by the Chinese doctors. The responsibility of the Nepalese team was to transfer the patient from Hilsha to Kathmandu via Helicopter and handover to the air ambulance, led by a Singaporean doctor who would transfer the case from Ktm to Malaysia.
From Nepal Mediciti, the flight was straightforward enough- the team made it to Surkhet in under two hours, refuelled and headed on to Hilsha. By the time the Nepalese team reached Hilsha, the patient was in a critical condition. He was on mechanical ventilator and pressure support with other supportive medications in 4 syringe pumps.
The intention was to take off for Kathmandu as soon as the team shifted the patient from the Chinese ambulance to the customised helicopter ambulance. However, as the team headed backand reached Dang valley, the weather turned and they were not able to move forward.
With conditions worsening, the team had to figure out a solution in order to try and save the patient’s life.
After a brief consultation with the patient’s family, the team decided to transport the patient to Kohalpur medical college. The team were told that Emergency and Intensive Care Unit doctors were standing by on the helipad, ready to receive the patient.
The patient’s condition was deteriorating quickly but the team were thwarted yet again by the weather, forcing another diversion towards Nepalgunj Airport. A second delay created problems of its own, as the batteries supporting the ventilator and cardiac monitor were drained and oxygen was running low.
After an hour waiting at Nepalgunj airport, the team set off again and finally landed on Kohalpur Medical College. The patient was successfully shifted to I.C.U and treatment was continued overnight. The following morning, with weather improving, the patient was taken back to the heli-ambulance to continue the arduous journey. At around 1pm, the team reached Tribhuwan International Airpot at Kathmandu, from which the Singaporean Air Ambulance was ready to transport him to Malaysia. After 28 hours of travel, the patient was in the helicopter that would carry him back to his homeland.
Nepal Mediciti, although still relatively in it’s infancy, has been operating for many years and providing rescue services to hundreds of patients, but for Sanjaya Karki, this case was different
“The involvement of medical teams from China, Nepal, Singapore and Malaysia, health care techniques provided by those teams, not being able to reach our destination on time which forced us to opt for alternate measures through rescue and the time invested in it were the major factors that made this rescue different . But whatever was the time and situation, the coordination and decisions we made in that emergency condition of rescue and treatment of the patient turned beneficial which made this mission of mediciti hospital a huge success”.
This incredible tale was highlighted by Dr Sanjaya Karki, former winner of the David Weil Extreme Medicine Award.
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