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Keen intuition and experience

Rega’s medical consultants are on hand day and night to help patrons who need medical advice when they are abroad. The situations of those seeking help are as diverse as the places they are calling from, as the early shift of medical consultant Kerstin Woernle shows.

Rega Centre, 6.30 am: Shift handover at the Jet Operations Centre. The work colleague from the night shift brings medical consultant Kerstin Woernle up to date: Rega patrons in Thailand, Sri Lanka, Finland, Italy and the Czech Republic are waiting for medical clarifications or advice from Rega. As the time difference in Asia means that it will soon be evening, Kerstin Woernle first calls Phuket in Thailand. “Bangkok Hospital, sawadee ka,” says the voice over the receiver. In English, Kerstin Woernle asks for the doctor who is looking after the Swiss patient. The man is suffering from terminal cancer. He has travelled to Thailand for a special cancer therapy, but it has not had any effect. Now he has unbearable pain, is becoming weaker by the day and can only walk a few steps. “The hospital is very good. Nevertheless, they’re no longer able to alleviate his pain there,” says Kerstin Woernle. “I’d like to know from the doctor in attendance whether he considers the patient fit to fly – that is a prerequisite for us to be able to fly someone home in our ambulance jet.” The Thai doctor is on the end of the line. The patient would be able to fly, but besides the medical care during the flight, he would need strong painkillers. Shortly afterwards, the medical consultant calls the patient. He is feeling very poorly, but he calmly explains that he wants nothing more than to go home as soon as possible. For Kerstin Woernle the situation is clear: the man needs the Rega ambulance jet. She informs the flight coordinator, who immediately starts to organise the mission.

 

Medical consultant Kerstin Woernle informs the flight coordinator that an ambulance jet needs to fly to Thailand.

 

Fall down the stairs in Thailand

7.15 am: Another patient is lying in hospital in Phuket. The elderly lady fell down a flight of stairs while on holiday and has suffered a femoral neck fracture. When she is admitted to hospital, the orthopaedic surgeon in Thailand notices a slightly reduced oxygen saturation in the patient’s blood and arranges for a computered tomography (CT) scan. “That was unusual because the blood values gave no cause for concern,” says Kerstin Woernle. “But it was precisely because of this check that the doctor saved the woman’s life. For the CT showed that she had suffered a pulmonary embolism.” The doctor in Phuket recommended that the patient should have a kind of filter inserted into the vein to prevent the blood clot from travelling any further and causing a heart attack. The Rega medical consultant asks the physician responsible in Thailand for the latest status. It has not yet been possible to insert the filter because the patient’s daughter has concerns. Kerstin Woernle makes a note in the computer system to call back the following day.

Kerstin Woernle discusses with a young woman in Sri Lanka where she can be vaccinated against rabies.

 

Rabies in Sri Lanka

8.00 am: A young Rega patron scraped her knee in Sri Lanka and shortly afterwards a dog licked the wound. Rabies is widespread in Sri Lanka and the woman is afraid that the dog may have infected her with it. “She should now be vaccinated against rabies, and I need specialist advice in order to draw up a vaccination schedule,” explains Kerstin Woernle. The Rabies Centre in Berne is familiar with this vaccination schedule – a kind of timetable for the individual doses of rabies vaccine. Kerstin Woernle obtains the necessary information and calls back the patron in Sri Lanka. She should go to hospital immediately for the first vaccination. For the young woman, this news means the end of her trip and she is very upset. Kerstin Woernle says she is very sorry, but there is no alternative that she could recommend.  

Accidents in the Czech Republic, Italy and Finland

11.00 am: In the Czech Republic, a young man crashed headfirst into a tree after making a jump on his snowboard. He was taken to hospital with suspected traumatic brain injury. A further examination is scheduled for the afternoon. Only after this does it make sense to call the local doctor. Therefore, it is the turn of the next patient: a 24-year-old man in Italy has also suffered a winter sports accident. He is in hospital with a brain haemorrhage and traumatic brain injury. But here, too, it is necessary to wait for further investigations to be carried out. 

12.45 pm: A man has fallen while cross-country skiing in Finland and is thought to have broken a vertebra. Kerstin Woernle calls him in the Finnish hospital and asks for X-rays and laboratory results. After studying them, she tries to reach the doctor in charge – in vain. She or a colleague will have to try again later.

In the hangar, Kerstin Woernle gives intensive care nurse Thomas Burren the last pieces of information for the jet mission.

 

Office instead of operating theatre

2.00 pm: Her shift is coming to an end. Kerstin Woernle finds time for a brief chat. The neuro-surgeon exchanged the operating theatre for the Rega Centre two years ago: “Here, I have all kinds of medical issues on my desk. That makes the work very interesting and varied.” Many of her colleagues are anaesthetists or specialists for internal medicine, while others are intensive care specialists or surgeons like Kerstin Woernle. The diversity of professional expertise is helpful when assessing the individual cases. “We can’t examine the patients ourselves, but depend on information provided by the local doctors, the patients or their relatives,” she explains. “Sometimes there are language barriers or cultural differences that we need to overcome in order to assess a situation correctly. For this, we need a keen sense of intuition and a wealth of experience.” It’s like doing a jigsaw puzzle, says Kerstin Woernle. “We try to create as complete a picture as possible from lots of individual pieces.”

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