65-Year-Old Patient With Cystic Fibrosis Successfully Evacuated by Medcall
Overview
Medcall successfully carried out an ICU-level air ambulance evacuation for a 65-year-old Indonesian patient suffering from cystic fibrosis complicated by community-acquired pneumonia. The patient was initially admitted to Adam Malik General Hospital (AMGH) in Medan after experiencing worsening respiratory distress.
With his condition deteriorating and limited treatment options available, the family requested a transfer to Mahkota Medical Centre (MMC) in Melaka, Malaysia, and engaged Medcall Air Ambulance for urgent medical evacuation.
Clinical Challenges
Upon assessment, the patient was found to be on a high-flow mask at 15 LPM, yet his respiratory status continued to worsen. The treating team at AMGH had reached the limit of available interventions, and only comfort care measures were feasible on-site.
A joint evaluation between AMGH and Medcall’s Clinical Director concluded that the patient required urgent international medical evacuation due to:
- Worsening respiratory distress
- Low oxygen saturation despite maximal oxygen therapy
- Visible use of accessory muscles to breathe
- ABG confirming Type 1 respiratory failure
Medcall deployed a Learjet 60 air ambulance, staffed by an Emergency Medicine Specialist and an IBSC-certified Flight Paramedic, to conduct the transport.
Within 12 hours of case confirmation, the flight medical team arrived at the patient’s bedside to initiate stabilisation and prepare for transfer.
Solution & Execution
1. Immediate Stabilisation at AMGH
Upon bedside reassessment, the Medcall team determined the patient was initially unfit to fly due to critical hypoxemia.
The team immediately initiated treatment and commenced High-Flow Nasal Cannula (HFNC) at:
- Flow: 60 LPM
- FiO₂: 1.0
After initiation of HFNC therapy, the patient’s oxygenation improved, respiratory effort decreased, and he became stable enough for medical flight.
2. Seamless Air Ambulance Transport
Once stabilised, the patient was transported on the same day via ICU-configured air ambulance, equipped for:
- High-flow oxygen delivery
- Advanced airway management
- In-flight critical care monitoring
The medical coordinator completed cross-border immigration clearance, ensuring uninterrupted transfer between Indonesia and Malaysia.
3. Direct Hospital Admission
Upon arrival in Melaka, the patient was directly admitted to Mahkota Medical Centre (MMC) for continued specialist care, ensuring a smooth end-to-end clinical handover.
Outcome
Thanks to rapid deployment, ICU-grade stabilisation, and coordinated logistics, Medcall successfully transported a high-risk respiratory patient across borders within hours—demonstrating our capability in handling complex, time-sensitive international medical evacuations.
