Bali Medical Evacuation — BIMC Hospital Bali

Bali Medical Evacuation

Posted on : June 24, 2010


Medical evacuation in Bali

Bali Medical Evacuation
Medical evacuation or often referred to as a “Medivac”, was initially developed to transfer injured soldiers from the battlefield to a proper medical facility for better treatment.  The military were first to establish a specially designed aircraft for medivacs.  By time, air medical evacuations have became available for civilians and operated by non-military companies.  Since the indication of evacuation is usually due to the necessity to get to another medical facility urgently and where time is also a crucial factor, most medivacs are by air, either by aircraft or helicopter.

Although it’s mostly for urgent or emergent cases, arranging a medical evacuation is not as easy as dispatching a ground ambulance in seconds after receiving an emergency call.  Many factors are considered, not only involving medical, but also technical and administrative aspects.
From the medical point of view….
Altitude causes changes in the human body.  Some important changes are:

  • Volume expands. Now imagine, if there was free air in the chest cavity or what is medically known as a pneumothorax.  This can be caused by many factors, one from a fractured rib puncturing the lung.  The free air that was initially a small volume giving no symptom, can expand severely pressing the lungs and heart.
  • Less oxygen in the blood. Now imagine, if someone had a heart attack and already does not have enough blood supply and oxygen to the heart muscles.  With additional reduction of oxygen, more heart muscles are in danger and at higher risk for heart failure.

The doctors need to anticipate all of these changes and the patient’s condition.
In addition to that, the medical staffs will need to consider which equipment to bring.  They have limited space to work, limited baggage to take and limited equipment suitable for the cabin air pressure.

From the technical and administrative point of view….
The team must evaluate the condition to transport the patient, i.e. is it possible to land an aircraft or helicopter, weather conditions, flight clearance, legal documents for inter-country medical evacuations, etc.
And the options are …

Commercial flight medical evacuation.
This means the patient’s transfer will be by a commercial flight with medical escort.  The patient can be seated in a regular seat and the medical escort seated beside the patient.  This is usually possible when the patient is able to mobilise, can sit in an upright position for a prolonged time, is not in a severe disabilitated condition and not anticipated for any severe deterioration during the flight.  When the patient is unable to mobilise or unable to sit in an upright position for a prolonged time, but is also generally stable, the evacuation team can also arrange for a stretcher case on the flight.  This involves putting a stretcher on top of some economy class seats (usually takes 6 seats).  Oxygen supply is also available, but in a specially designed container suitable for the cabin air pressure.  The medical staff will need to calculate how much oxygen supply is required and inform it in advance for the airline to prepare.
The plus is that it is a less expensive type of evacuation and more comfortable for the patient (only applies for the ordinary seat evacuation)
However, it is only for mild to moderate medical conditions where the patient can tolerate the altitude pressure, has limited area coverage depending on the flight route, the time of flight will depend on the flight schedule and usually takes a longer time to prepare, generally 24-36 hours.

Air ambulance evacuation.
A chartered aircraft will be arranged to transfer the patient.  The plane will be equipped with medical equipment and it will even be possible to be set up as a small intensive care unit for critical patients.
The good thing about this aricraft is that almost all patient conditions can be transported, though it’s usually not a priority for mild cases due to its expense.  The pilot can fly at a lower cruising altitude when the patient can not tolerate high altitude pressure.  The aircraft has a larger area of coverage, able to transport patients from remote areas, as long as there is suitable landing and take off area and is able to transport patients to far distances.   The aircraft usually takes less time to arrange, generally less than 24 hours and the flight schedule can be arranged accordingly.
The disadvantages, the flying time is longer time, especially at a lower cruising altitude.

Helicopter evacuation or Helivac.
The advantages of a helivac is its flexibility of access to remote areas, it’s usually faster to dispatch and you do not need to worry about altitude pressure.  It also can be arranged quickly, usually within hours.
Most helicopters however have very limited space thus limiting (medical) people and equipment to carry.  The helicopter is less comfortable because the patient will be strapped in to a secure position due to the unstable movement during flight.  It has limited time to travel, sometimes unable to operate after dusk, therefore also has limited range of distance.
Although a complicated process takes place once medical evacuation is recommended, it is not the patient’s or their family’s place to worry.  It is more important to anticipate any unwanted events because these unfortunate incidents are possible anywhere in the world, where ever you travel.

So when you plan to travel, one thing is to be sure is that you always take out a comprehensive travel insurance policy to be certain it also covers for you for a medical evacuation.

Should medical evacuation be necessary while you are in Bali, BIMC Hospital Bali will handle all arrangements, either by commercial airline carrier, helicopter or private air ambulance charter. Working closely with aircraft operators and insurance companies worldwide, BIMC fully facilitates the medical evacuation to place the patient in the safest hands

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