Asian dilemma – swift action saves limb amputation

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One of Intana Global’s clients is a Singapore aviation company, deploying staff globally – sometimes in remote regions with inadequate medical facilities. When an employee injured his foot in rural Vietnam, our medical case management and repatriation services were needed to stem a potential disaster.

At first, the injury seemed to be a minor abrasion. But the foot became infected - slowly spreading to the whole foot and by the time he consulted a local doctor the situation was serious. The medical problem was complicated with the patient’s history of heavy smoking. The blood supply to his leg and foot was weaker than it should have been, and was not helping to heal it. Drastic action was required, and we implemented an emergency plan:

• Medical details were quickly obtained and our Medical Director discussed the case with the local doctor by telephone
• Provision was made for immediate evacuation to a well-equipped hospital in Singapore, with a medical escort throughout the journey by two ambulances, and by commercial airline
• Liaison with the airline stressed the need for a smooth and trouble-free transit and in flight experience
• A block of three seats was booked to minimise patient discomfort on the plane
• The hospital was briefed on the medical condition and regularly updated on arrival times

In Singapore the patient had two toes amputated, and it became clear to the medical team that they would have to consider a below the knee amputation. However, a vein by-pass operation was performed in an attempt to improve the blood flow to the infected area. After further surgery and two more amputated, the patient recovered and his leg was saved.

We then managed his comfortable, safe, and trouble free travel home to Europe to continue physiotherapy and rehabilitation treatment.