The Caribbean Islands are a popular vacation hotspot for many American travelers who are seeking a tropical paradise for an affordable price. Island life is ripe with excursions and unique travel experiences. Unfortunately, fun adventures like scuba diving, zip-lining, and hang gliding come with a certain amount of risk. As such, our medical crew is often called upon to fly into the Caribbean for International Repatriation back to the U.S. (bring injured Americans back to the United States).
Vacationers are often swept up in the beauty of the islands and want to experience as much as possible during their vacation. While this can lead to rewarding and memorable experiences, it can also result in life-long injuries for those who test their limitations and venture outside their skill level. The most common accidents we treat in the Caribbean are head and neck injuries. Some of our more recent patient injuries include a cervical spine fracture and subsequent paralysis from diving into shallow ocean waters. A spontaneous hemorrhagic stroke while hiking, and a multi-system trauma from a hang gliding crash. Many people tend to adopt a sense of invincibility while on vacation and think, “That will never happen to me.” Unfortunately, for many people, this is not the case.
Medical Repatriation Means Returning Home for Proper Care
Rescuing Patients From the Caribbean Islands
Rescuing patients from the Caribbean Islands is of utmost importance. When our patients suffer a severe injury in the islands, they are suddenly confronted with the harsh and terrifying reality of needing emergency treatment outside of the United States. While healthcare professionals all around the world are caring and compassionate, many hospitals outside the U.S. are simply not well funded and are forced to re-sterilize and reuse gloves and needles. Many hospitals in the Caribbean Islands and Mexico require patients to pay for services before they can receive treatment. For those unfortunate patients who cannot afford to pay upfront, they are denied treatment and, in some cases, discharged to the street regardless of health status. Please understand that Caribbean and Mexican hospitals are not being vindictive. They lack sufficient resources to provide medical treatment without payment. For this reason, it is imperative that Angel MedFlight transports these patients back to the United States as soon as possible.
Differences in healthcare from one country to the next are vast. These differences are mainly attributed to hospital resources. While our healthcare system is far from perfect, America is fortunate enough to have sufficient funds to provide our hospital patients with top tier care. In Caribbean hospitals, many invasive procedures and surgeries are unavailable to patients due to a lack of skilled personnel and equipment. It is the quality and quantity of available resources that is the driving force behind standards of care. For this reason, healthcare in impoverished countries leaves a lot to be desired.
In addition to the lack of supplies and resources, patients and their families often experience a substantial language barrier in foreign hospitals. Being unable to communicate effectively adds an overwhelming amount of tension to an already stressful situation. Not only are our patients suffering from a severe injury in a foreign country, but due to the communication barrier, they often have no idea what treatment they are receiving. They are also confronted with bill collectors each day demanding payment to keep their loved ones in the hospital. In one situation, we had a family member who could no longer afford the daily payments call us while hiding in a hospital bathroom begging us to come to get them before the hospital staff throws them out. In these situations, Angel MedFlight works closely with the local hospital to prevent any lapse in treatment while we coordinate a medevac flight.
As described above, standards of care differ significantly in the islands. Minimal blood tests are ordered, critical care medications are dosed differently; questionable sterilization techniques are common practice. A massive amount of IV fluids are used to correct hypotension, which often leads to flash pulmonary edema and other cardio-respiratory complications. When the Angel MedFlight crew arrives at the bedside, it is often necessary to remove all current drips, correct any hemodynamic imbalances caused by the current treatment, and reapply the correct drips with correct dosages. This is an extremely complicated process that far exceeds the skillset of any normal nurse or paramedic. For this reason, Angel MedFlight hires only the very best healthcare professionals from around the country. Angel MedFlight provides them with an extremely rigorous training program and continuously evaluates them to ensure their skills are always up to date.
Due to the remote nature of the Caribbean Islands and the severity of our patients’ injuries, medevac transport is the only viable option when they need to return to the United States. On average, our medevac team can be at the patient’s bedside within 24-48 hours of the initial call. First, our flight coordinators will gather all the necessary patient information and medical records. Next, our medical director will carefully review the patient’s medical chart to ensure there are no direct contraindications to air travel, such as low hemoglobin levels and free air in the brain or chest cavity that will expand at altitude. The medical director will then work with the hospital staff to correct these contraindications so that the medical team can safely transport the patient back to the U.S. Finally, our dispatchers will contact the flight team, and together, they will draw up and execute the flight plan. This can be a very cumbersome process, but Angel MedFlight is full of extremely experienced and compassionate team members that come together to assist our patients in their hour of need.
Since 2015 Anthony Price has been a Flight Nurse, CFRN, with Angel MedFlight.