Getting our patient, Mushir B., from a hospital in Chicago, IL back home to his family in Ramallah, Palestine after a cardiac arrest and a stroke.
When Mushir’s business trip in Chicago was cut short by a stroke and cardiac arrest, his sons Ahmad and Kaamil explored their options and chose the international flight nurse services of Sky Nurses to get their father home. Our team arranged for stretcher services using a commercial airline to get Mushir from the U.S. to Tel Aviv, Israel and then over the boarder to his home in Palestine. Not only did the family benefit from the extensive medical care required during travel, but they also benefited from the extensive international travel experience of the medical escorts when going through security, customs and international boarders.
This is Mushir’s story…
When brothers Ahmad and Kaamil learned that their father, Mushir, had suffered a stroke and cardiac arrest in his hotel room while on a business trip to the United States, they feared he might need an air ambulance to return home to his family in Palestine. It all began when Ahmad, Mushir’s son and emergency contact, received a devastating call one evening informing him that his father had been admitted to a Chicago hospital in late February of 2017.
Medical events such as cardiac arrest or stroke can come on unexpectedly. For this reason, it’s important to always have an emergency contact first responders can call so your loved ones are notified when something goes wrong.
When two weeks passed and their father’s condition didn’t improve, the brothers knew their next step was to investigate their medical escort options. Ahmad and Kaamil knew from the start that returning their father to Palestine wouldn’t be easy.
Travel advisories for Palestine led to limited options for companies departing from the United States.
The logistics of returning their father home grew even more complex as they learned more about Mushir’s condition from the hospital, such as the fact that their father now needed a ventilator and a portable oxygen concentrator to breathe, and routine IV fluids and suctioning to survive. How could their father travel internationally with all that equipment?
The brothers’ first logical step was to explore the option of getting their father home by air ambulance service, which usually have access to machines such as suction machines, ventilators, and portable oxygen concentrators. However, with the distance they would need to cover from Chicago to Ramallah being so great, the cost of an air ambulance transfer quickly put the trip too far out of their budget. To find an alternative, they next looked into hiring a commercial flight nurse or a flight nursing team to travel with their father on a commercial aircraft, but how would the equipment Mushir now needed factor in?
Fortunately, a quick internet search led Ahmad’s brother Kaamil to Sky Nurses. After discussing the details with one of Sky Nurses’ case managers, Kaamil learned that the equipment his father needed would not be an issue.
Stretcher services come complete with portable oxygen concentrators, suction machines, ventilators and other necessary equipment.
Many of the medical escorts at Sky Nurses have access to portable oxygen concentrators and suction machines and ventilators could easily be rented in the right areas, so it would just be a matter of choosing the right flight nurse. As luck would have it, Sky Nurses had a flight nurse with a portable oxygen concentrator in Chicago, right where Mushir was located!
Further discussion of Mushir’s condition revealed that he could travel on a commercial airline, but the flight would need to feature a stretcher service, as Mushir was still too weak to sit up during take-off and landing. A stretcher service is made possible by taking out the last row of 5-7 Economy Class seats to allow room for a passenger to lay across on a stretcher throughout the flight. Not only would this service allow Mushir to travel in comfort during these long flights, but it also allowed him to travel on a commercial airline rather than an air ambulance – which would relieve the cost concerns the brothers shared. Because stretcher services are only offered on non-code shared nonstop or one-stop flights, a quick search of flights from Chicago to Tel Aviv (the nearest major airport to Ramallah) revealed an overnight flight on Turkish Airlines to be the best option.
Booking a flight with a stretcher service can be tricky.
In addition to the rules surrounding which flights offer the service, there are additional rules surrounding how tickets can be booked. Instead of booking online, usually the airline must be contacted directly to check for availability and to submit medical documents before anything can be confirmed. Additionally, because most passengers traveling on a stretcher board the plane directly with the help of a lift rather than passing through the airport, ground transportation to and from the airport with tarmac access must be coordinated with the airports involved.
Medical clearance can be difficult to obtain for a passenger utilizing a stretcher service, so it’s recommended that you have a certified travel agent familiar with the logistics of a stretcher flight assist you with making the arrangements. With the assistance of the travel team at Sky Nurses, Ahmad and Kaamil managed to book all the flights themselves and arrange for an ambulance with tarmac access in both Chicago and Tel Aviv.
To provide Mushir with round-the-clock care during his travels, Sky Nurses assigned George, an experienced commercial flight nurse and Caroline, a respiratory therapist to this case. In addition to working as a commercial flight nurse, George also had extensive experience as both a critical care transport nurse and an Emergency Medical Technician with the fire department in Indiana. In his role as a critical care transport nurse, George often worked with ventilators, which would come in handy during Mushir’s trip.
With over a decade of experience operating ventilators, suction machines, and administering oxygen as a respiratory therapist, Caroline would be there to assist him in making sure all Mushir’s needs would be met. Together, both medical escorts managed the equipment necessary for the mission.
Caroline and George met with Ahmad and Kaamil in Mushir’s room at the hospital in Chicago at 6:25 pm (local time) on March 14th to perform a pre-flight assessment.
After performing a quick physical, taking Mushir’s latest vital signs, and talking with his physician, George declared that Mushir was fit to fly. While George secured Mushir’s prescriptions for the trip, Caroline prepared Mushir for travel. By 8:00 pm, everyone was en route to Chicago O’Hare International Airport.
Late evening traffic was on their side – the party arrived at the airport in less than thirty minutes! Despite all the medical equipment, passing through security was relatively painless. Security can be enough of a hassle without involving medical equipment such as a portable oxygen concentrator, ventilator, or portable suction machine. However, with the help of seasoned veterans like George and Caroline, delays were easily avoided with a quick explanation and the presentation of paperwork.
Though there were some minor visa issues for Ahmad and Kaamil as they cleared the security checkpoint, they were quickly resolved without much trouble. Once everyone had arrived at the gate, George collaborated with the flight crew and airport staff to confirm and coordinate boarding of Mushir through the back of the plane – easier access for someone in a stretcher.
Thanks to the assistance of flight crew and several local firefighters, Mushir was settled in safely on board by 10:26 pm.
By 5:11 am (local time), Mushir and his family had landed in Istanbul after a smooth, uneventful flight. After a quick layover, they were back on board their next flight at 6:03 am without incident. They arrived in Tel Aviv by 8:03 am, where an ambulance was waiting on the tarmac to take Mushir to the main terminal to clear customs. While George and Caroline escorted Mushir in the ambulance, Ahmad and Kaamil disembarked the usual way with a plan to meet up again on the other side of customs.
The trip was going smoothly so far, but going through customs proved to be not quite as easy. Even though Mushir had a visa to enter Israel, officials did not initially accept it because his passport was Palestinian.
It helps to have the assistance of an experienced traveler like George the international flight nurse during times like these!
By 10:05 am, Mushir, George, and Caroline met up with Ahmad and Kaamil just outside of customs to take Mushir back to the ambulance waiting at the curb. From there, the group made their way to Ramallah in an hour’s ride, with Mushir, George, and Caroline riding in the ambulance and Ahmad and Kumir trailing behind them in a taxi.
Because they would be crossing sensitive borders, arrangements had been made by Kaamil to transfer Mushir from an Israeli ambulance to a Palestinian ambulance at a point near the border along the way. Throughout the ride, Mushir remained stable and comfortable and passing through the border proved easier than expected.
By 11:17, the ambulance arrived at the hospital in Ramallah. While George and Caroline gave report to the charge nurse, Mushir was admitted to the emergency room. At 11:55 am, the brothers’ taxi had arrived and they were reunited with their father at last. After all their family had been through in such a short time, they were finally together again.
Thanks to careful coordination and experience, this trip went off without a hitch.
However, the logistics of coordinating a stretcher service on a commercial airline can be daunting, especially if equipment rental and clearance is required. Fortunately, even though they didn’t book the tickets themselves, the travel team and medical management staff at Sky Nurses was there to help guide the brothers through the process and to submit the necessary paperwork to get Mushir cleared for travel with the airline in no time.
Though tensions ran high during security in Chicago and customs in Tel Aviv, having a seasoned traveler among their ranks helped alleviate the potential for disaster for this family when traveler’s documents came into question. Even if you are an experienced traveler yourself, it never hurts to have someone who can take the wheel when stressful situations arise. Thanks to their efforts, Mushir made it across both borders to come home safely to his family. Mission accomplished!
The above story was compiled from the intake files and stream of constant communications the case managers at Sky Nurses receive from the clinicians and air medical escorts throughout the repatriation trip with our patient. When you travel with a flight nurse from Sky Nurses, you’re travelling with an entire team of medical professionals and travel agents.
We take privacy very seriously. All names have been changed to protect patient and clinician privacy.