When you get sick abroad, medical escorts come to the rescue

January 17, 2013

Exotic travel. Suspense and drama. Helping humankind. Happy endings. These are the hallmarks of a James Bond ad­ven­ture — and a medical escort’s job.

These trained professionals move around the world as if it were a hospital without walls, tending to American patients in foreign cities, in cruise ports, in jungles and in deserts. When a traveler falls ill, the escort will fly to that person’s side and assist with care and with transport home. “We call it curbside to bedside,” said Amanda Smrcka, a part-time flight nurse with the Florida-based Commercial Medical Escorts.

Most escorts are certified nurses, paramedics or physicians who work for an air ambulance or emergency medical transport service, which an insurance company will hire to repatriate an injured or ailing client. Because of the unpredictable nature of the job, which can include flying commercial planes with a debilitated patient, they have at least three years’ experience in emergency medicine, intensive care and/or critical care transport, preferably by air. Like military medics, they must be prepared for unexpected jolts or surprises. “The patient might have to be taken off the flight and go back to the emergency room,” Smrcka said.

First and foremost, the escort is the traveler’s main caregiver throughout the journey. But he or she will also play additional roles, as travel agent, bodyguard, luggage porter, airplane companion/chatty seatmate and, if time permits, tourist — even if this entails just a quick trip to an art museum or a local restaurant.

We contacted several medical escorts for an insider’s peek into their Bond-in-nurse-whites world. Here are edited excerpts of our conversations:


(The Washington Post)
Gabrielle Bartusiak

President and CEO, Rescue Nurse International, Colorado

What are your responsibilities?

We’re responsible for bedside-to-bedside care of the patient. Once initial contact is made, we finalize each detail of the medical care throughout the transport: medication schedules, wound care, mobility challenges, dietary needs and everything in between. We’re 100 percent responsible for every aspect of the patient’s care from the moment they leave the hospital until we readmit them to a home hospital, rehab or personal residence.

Are most of the cases international or domestic, or a mix?

Seventy-five percent of our cases are international. I’ve traveled to 82 foreign countries and 50 U.S. states. I’ve traveled as far as India, China, Australia and Kenya, and have transported patients as close as my home town [in Colorado].

Can you provide an example of your work?

I landed in Chile and went straight to the hospital where my patient was recovering from cardiac arrest.The patient was scheduled for discharge the following evening. His wife and I decided to dine together that night. The conversation was lively and filled with laughter. On the flight home [to Virginia Beach], the patient and I chatted the entire time. We stayed in contact, and years later, I was invited to celebrate their 50th wedding anniversary at a dude ranch in Colorado.

Do you ever have time to experience the destination?

In India, my driver was a delightful man who was very protective of me while we went from hospital to pharmacy to my hotel and around the city. After a day of patient care and sightseeing, he invited me to meet his family. We had a delicious home-cooked meal in their modest apartment. After dinner, his wife told me that it was tradition to have their guest try on one of her wedding saris. The photos are a beautiful memory of an amazing chance encounter.

What was the inspiration behind your career choice?

By creating Rescue Nurse International, I was able to join two of the greatest loves of my life: patient care and travel. This setting provides the perfect balance of travel, caretaking and adventure. It really doesn’t get any better than this.

Gary Spence

Medical escort, IMC Meditrans, Florida

Can you describe your caseload?

I fly approximately two to three clients a month. There are times when you have a couple of hours to get your bag packed and get to the airport. My closest destination is the state I live in (Florida); the farthest would be, you name it, India, Australia, China, Saudi Arabia, Vietnam, all over Europe, Africa. There really isn’t a destination we don’t go to. The cases range from fractured bones to post-heart attacks, strokes, respiratory problems, etc. The clients may be in a hospital, hotel, cruise ship or home.

How do you relate to the patients?

When you arrive at your client’s bedside, you wouldn’t believe the reception you get. They will say, “Thank God you’re here. Please get me out of here.” Usually they’re on vacation and it has been interrupted, and all they want is to go home. Some flights are a few hours long; some are 20-plus hours. I recently spent 42 hours with my client due to delays. So you really get to know your client and their family in a short period of time. When I get them to their final destination, you feel like you’re friends. Hugs are exchanged and sometimes Christmas cards are sent, with huge thanks.

Leon Houben

Medical escort, IMC Meditrans, Netherlands

What kind of cases have you been assigned?

I transport clients from war zones (Iraq and Afghanistan) and luxury holiday residences and everything in-between. I transport clients with mental and physical problems, and cardiac, pulmonary, cerebral and gastrointestinal diseases.

Any escort story you wish to share?

I had a client who was involved in an IED blast and lost both legs and his left arm. I was shocked when I saw him. He was 36 years old, a young man from Uganda. He was an incredibly optimistic guy, full of plans for the future. He sent me pictures after six months of rehab. He could walk with his prostheses, had a job and could accept his amputations.

Wendy Slater

Medical services director, National Jets Inc., Florida

What was one of your tougher experiences?

On a Caribbean island, a man there on a mission had taken some of his co-workers to a restaurant. As they were leaving, they were approached by some nasty locals who intended to rob the group. He resisted and was shot in the head. He was taken to a local hospital, where they basically left him alone to die. He didn’t. After about a week, we were called to take him home. I won’t go into the gruesome details, but this man should have expired days before we got there. We got him home, and he passed about an hour after we left. Lesson: Even when we know that an event is not survivable, never give up.

And now for something a bit lighter.

We responded to a call in the Caribbean to pick up a gentleman who had participated in a snorkel excursion with humpback whales during their birthing season. He was with a group of snorkelers when they found a pod of whales with a mother and a calf. As they were observing them, he got caught in a current that sent him speeding toward the calf. He put out his hand and drifted into the calf, touching it. The calf woke up screaming, which woke up the mama, who became very defensive. She picked up her tail and slammed it down on our friend. He was very lucky that she hit his leg and not his head. It was one of those calls where all you can do is shake your head while trying to make the patient as comfortable as possible for the long flight home.

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