When terminal patients are wheeled off an airplane

Written by Julia Muston, CNN

To accommodate one terminal patient, the seven-hour flight with air ambulance service AirMed is coordinated with a team of doctors.

“If they need somebody to be by their side, we can do that,” says Project Care Consultant Sefni Mekelman, in the airport departure lounge. “We’ll have support staff who will remain with him or her and people who will be at the control point for those who come from places where local hospitals are not able to help.”

The specially equipped plane has 8.3 seater seats and is designed to help visitors keep an eye on the passenger.

AirMed provides life-saving flights for accident and emergency cases in 21 countries around the world. As of 2017, they were covering an average of 14% of the world’s population — 3.8 million passengers and 3.3 million crew per year.

To study their first operation , CNN followed the team as they took on a terminally ill man from the town of Maastricht. This is the first of two stories in a series on terminal patients and medical transport.

One by one, the team makes their way to a standard Airbus A319. Inside, the planks of wood lining the walls are mostly replaced with oversized furniture or a bed for the patient. Throughout the plane, maps of various areas are displayed in aluminum panels, meaning the observer will always know what’s going on.

The patients are being delivered to one of two lifts, where an emergency medical team will be ready to guide the patient from his or her seat to the floor. The recovery process is slow, as attendants wait for the team to catch up on paperwork and coordinate flights to other hospitals.

They pause to get used to each other, play guitar and sing happy birthday to one of the other members of the team.

The pilot will follow the route to take the patient to the terminal and then a routine passport check, followed by the flight to the airport. After the work has been done, it’s time to change.

Another team member, physician Dr. Bert van Dongen, assesses the patient’s body temperature. The temperature is as one would see it in a stable state. “So we are not getting off here and 20 minutes later you’ll be, ‘oh my God I’m sick.’ “

When the plane’s wheels touch the ground, AirMed will call the patient’s family and say that he or she should undergo an immediate terminal test. The team can identify when the patient is losing his or her oxygen supply or feels faint. Then they’ll send in a doctor or a family member.

Either way, they have brought the patient into a sterile environment, where they can live safely for the remainder of their life. The next stage is the ER.

Virtually, terminal patients who are admitted to an appropriate hospital can expect to have to undergo potentially difficult medical treatments. The team at AirMed looks for ways to help their patients deal with these. Sometimes, that involves providing a bed, but in other cases it involves referrals. In some cases, there’s the opportunity to simply offer a sense of security and comfort.

AirMed’s van is then taken to the patient’s landing site and unloaded. A bed is placed in the plane for the patient to sleep on.

The team then delivers the patient to a terminal room. This will be the first time the patient will leave the plane. This place is often adorned with posters, so there’s a chance that the patient’s look is something a bit whimsical. There are small paper flowers attached to the wall. There’s a present on the table from a friend or family member.

After that, there’s no place to go.

In the United States, terminal patients are usually transported back to their own hospital, where, according to the American Hospital Association , “the patient’s family usually meets the patient. Staff provide comfort at the front desk and follow up with the patient when they return home.”

“To go back to a familiar environment is very important,” says Dr. Jeannette De Negri, the director of the research department at AHA. “It can make the person feel better, because they have a family and we haven’t been there with them. It also helps in the medical interventions.”

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