Interview: Stephan Klose, AMTRAS | AirMed&Rescue

Air ambulances tend to get a lot of publicity, but not commercial medical escorts – why do you think that is?

Air ambulance is more visible to the public with its special jets and adventurous destinations that no commercial airline can fly to. However, the greatest success of commercial repatriation is when you provide the highest level of professional care possible and no one else in the area notices. Importantly, you can provide excellent specialist care and medical treatment on board commercial aircraft, including ECG monitoring, continuous medication administration, oxygen administration and more. Even a stretcher on a commercial plane is not always the best solution for a patient. Many transports can be done much better and more comfortably in business class seats by experienced personnel.
For commercial airlines, it is important that their operations are not disrupted, that their flight schedule is maintained and that their passengers are satisfied. Therefore, we do not emphasize flashy attire, but rather good preparation and a professional appearance.

Commercial Medical Escorts (CMEs) play an essential role in the repatriation process. How has it changed over the past 12 months?

Of course, preparations for each mission took longer to obtain permits, perform PCR tests or find suitable flight routes. Some destinations, such as China, were more or less inaccessible during the pandemic. For others, such as Thailand in 2021, we were forced to find creative solutions (stopover in Singapore at the transit hotel and then airside patient care in Bangkok). But we were also able to help clients on assignments who would otherwise have needed an air ambulance, as we contacted embassies early on and were able to arrange some important visas (eg, for the United States). We were one of the few providers able to operate some flights from Europe to the United States without delay during the border closures.

Have the types of patients you carry on commercial aircraft changed?

We have seen a few cases of Covid-19 during commercial repatriations after patients partially recovered and were no longer considered contagious. Otherwise, we find more or less the same type of injuries and illnesses, and especially in recent months we have seen an increase in typical holiday-related medical problems. Medical tourism is also a growing field, which sometimes requires specialist medical escorts for very complex cases that need to be taken away from home for specialist treatment. Finally, patients who, because of their need for care, wish to settle permanently in a retirement home close to their family on another continent or to spend the last part of their life close to home.

Are airlines more or less willing to accept critical patients than before the pandemic?

As before, this still depends on the airline’s internal policies. Some airlines carry out a very thorough examination with their own medical team. Others give permission when it is guaranteed that qualified medical attendants equipped with the appropriate equipment will take care of the patient. So, in almost all cases, we can find a suitable flight route with a top-rated airline that will provide fast and comfortable transportation.

Can you tell us about a case you took on recently that was particularly difficult, and how you overcame those obstacles?

A patient was stranded in the Caribbean with a very painful injury, and the handling company’s flight nurse was unable to fly the lady back to Europe with her business class ticket. The handling company turned to AMTRAS to arrange a medical escort and possibly stretcher transport. We held a conference call with the local nurse and planned to send our doctor to the Caribbean island with full intensive care equipment and medication. Just two days later, the lady was flown in her originally reserved business class seat with the nurse and our doctor escort to Europe. She was fully monitored and treated with strong painkillers and supplemental oxygen so that she could adjust to sitting or lying in business class as needed. It was a very safe (and most comfortable) transport for the patient, and the insurance company was able to save tens of thousands of dollars on stretcher transport that was ultimately not necessary.

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