Case Study 5: Melbourne to Vientiane (Laos)
Royal Melbourne Hospital to Military Hospital Vientiane Laos
A 26-year-old male from Laos was on an exchange program from the Laos Army with the Royal Australian Air Force Defence International Training Centre (DITC), Laverton Victoria.
He presented to Royal Melbourne Hospital with a headache, nausea and with a Glasgow Coma Scale (GCS) of 14/15. A Computer Tomography (CT) scan of the brain followed by a Cerebral Angiography revealed a right frontal lobe Mid Cerebral Aneurysm (MCA) in the setting of multiple mycotic vascular aneurysms in the parietal region. Following the Angiography he rapidly dropped his conscious state to a GCS of 6/15 and was taken to theatre for decompression and evacuation of blood clots.
After surviving the initial cerebral bleed he was woken from his induced coma to assess his underlying neurological condition. At this time some purposeful bodily movement and eye opening was noted and a decision was made to continue medical treatment for possible rehabilitation, however, after two weeks no improvement was noted and the expert medical opinions concluded that his long term prognosis was poor and risk of vascular re-bleed was likely. As predicted, further CT-brain scans revealed new small basal ganglia hemorrhage and he remained at GCS 3/15.
A tailored risk assessment was conducted to premeditate transfer hazards and possible controls implemented to minimise adverse medical risks to the patient.
The patient showed improvement on arrival at Laos. He was able to open his eyes, obey commands, squeeze his left hand and move his left foot within days. The patient continued to show improvement over the next twelve months and is now a highly functionally individual and plans to return to Australia to complete his military course.
Medical Connect was recognised for this retrieval with awards for outstanding work from the Laos Department of Foreign Affairs and Defence International Training Centre Laverton.
“Our accompanying officer on the flight has reported that at every point during the flight and transfers your meticulous pre-planning professionalism and attention to detail ensured a totally smooth trip that concluded with the Captain’s safe return to his family in Laos. At all times the service provided by you during this difficult transfer was exceptional and that the successful outcome could not have been achieved without the care, kindness, and outstanding professionalism.”
S.A. UNWIN
Wing Commander
Commanding Officer
Defence International Training Centre Laverton Vic Australia.
