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Air Ambulance Evacuation

Case Study

Seamless Repatriation of a Patient in Need of Continuous Life Support



Diagnosed with a severe lung condition, a 61-year-old South Korean patient was identified to be in a critical state. It was identified that an extracorporeal membrane oxygenation (ECMO) machine, which aids in the removal of carbon dioxide from the blood exiting the heart and adding oxygen to the blood being re-introduce to the body, was required for life support. This led to a highly complicated and challenging repartition process as multiple qualified health providers and logistical support would need to be aligned to minimise the potential health complications that would occur because of a failing ECMO machine.  


With the patient’s reliance on an ECMO machine for life support, it was crucial that an ECMO machine and medical services was available for the patient during the entire transition from the local hospital in Singapore to the treatment facility in South Korea. Most critically, the International SOS’s in-house medical team needed to anticipate and prepare for the scenario that the ECMO machine malfunctions. Such scenarios extended to the potential pit stops the aircraft would take during the estimated 7-hour flight to South Korea. Moreover, the presence of a perfusionist, who is tasked with operating the ECMO throughout the journey, was required.  


To overcome these challenges, International SOS’s in-house medical team employed the operational risk management framework, resulting in a comprehensive and meticulous 3-day pre-departure operational plan.

On 7 March, working closely with our network providers, a direct and transparent communication channel was quickly established amongst several stakeholders, this included the perfusionist, the hospitals in both Singapore and South Korea, and the aircraft provider. This was essential as the logistical and medical requirements needed to be aligned at every stage, most particularly during the transfer between each stakeholder. Some of the logistical and medical requirements included ensuring sufficient hospital resources, such as an available hospital bed, and a portable ECMO machine upon the aircraft’s arrival in South Korea. On 25 February, a 1-day trial run of the ECMO machine was conducted to verify the compatibility of the ECMO machine with the aircraft's power supply and International SOS's external battery.

Lastly, a contingency plan for potential pit stops for the aircraft was developed. This involved identifying alternative hospitals and airports along the current flight path and securing additional oxygen tanks to accommodate any unforeseen delays. This contingency plan proved invaluable as a pit stop for refuelling in Manila became necessary. On 7 March, the evacuation team was ready to begin the repatriation process. 


As a result of the quality of service of the International SOS’ medical and operations team, the transfer to the client’s home country was made successfully within 11 hours, enabling the patient to receive further treatment and recover in a comfortable environment - alongside his family and free from any language barriers.