djibouti BS: Medevac

Last Monday i was starting to take off my shirt so i could change clothes to go for a run. i was walking out towards the front desk to make sure nothing was going on so i could leave the clinic. sure enough an ambulance call comes over the radio but i didn't hear any specifics. just out of curiosity i asked "what was that call?" "a heart attack" he replied. i just thought he had seen me standing there and was teasing me, so i said "no, really, what was it?" "a heart attack" he replied. "great" i thought "just another routine chest pain evaluation" I was not on call so i considered just going running anyway since anyone could work up chest pain and then find me if they were concerned. but i decided i would at least stay and at least see the patient with my own eyes. i am glad i did for the second i saw his face I knew this was a real MI (myocardial infarction). I confirmed this with his ECG. I needed to get him thrombolytics to break up the blood clot in his heart artery so the heart muscle can get blood flow again. this is the only way to treat this since the nearest interventional cardiac cath lab is in Dubai about 1,200 miles away. he received the thrombolytics about 30 minutes after the onset of his pain and was pain free about 10, maybe 15 minutes he was given the medicine. the ECG also resolved nicely. the medicine was clinically successful. Now he survived the initial part and the treatment, now i needed to get him through the next several days. there is a period after a heart attack where a lot of other bad things can happen. that is why we keep these patients in an ICU setting for 24 - 48 hours and then watch them on the telemetry ward for another 3 days. Djibouti was no place for this man to be. The issue is that he is not active duty military. he is not one of the contractors that work on our base but he was a member of a group of volunteers from a town in California who get together and buy steaks, fly themselves and the steaks out to our deployed military outposts and them cook them for us on holidays. they were here for the 4th of july and he was loading luggage to go home when he had his heart attack. by the way the steaks they made were a million times better than the "steaks" they serve every Saturday on steak night.

anyway so we arranged for him to be transferred to Landstuhl, Germany. guess who needed to go with him as an escort?

They sent a C-17 with the regular medical transport crew as well as a critical care team.

So

counting myself this single patient was transported with 2 doctors (cardiologist and air force ER Dr), 3 nurses, a respiratory tech, and 4 med techs.

These are the racks for patients. they are used for storage now but this plane can handle approximately 30 stretcher patients for a flight. my patient is in the back there in the white blanket. i don't want to show any pictures of him just for privacy sake.