Air ambulance, gastroenterology: obstruction in a patient’s small bowel while on a cruise on the Mediterranean Sea

Air AmbulancePatrick and his wife Karen from Nebraska planned to celebrate their 28th wedding anniversary by taking a dream cruise that started in Rome and continued on to Mediterranean ports of call, destinations mentioned in travel brochures as the perfect spot for a second honeymoon.
Initial indications on the boat told them that there had been an outbreak of Norovirus.

Noroviruses are a genetically diverse group of single-stranded RNA, non enveloped viruses in the Caliciviridae family. The viruses are transmitted by fecally contaminated food or water, by person-to-person contact, and via aerosolization of the virus and subsequent contamination of surfaces. Noroviruses are the most common cause of viral gastroenteritis in humans. Norovirus affects people of all ages.

After infection, immunity to norovirus is usually incomplete and temporary. Outbreaks of norovirus infection often occur in closed or semiclosed communities, such as cruise ships, where the infection spreads very rapidly either by person-to-person transmission or through contaminated food.

Two days into the trip, while approaching Alexandria, Egypt, the dream became a nightmare when  Pat contracted the virus, which caused an obstruction in his small bowel. The medical team on the ship transferred him to a hospital in Alexandria.

Karen had immediate concerns the hospital in Alexandria was not able to provide Patrick the medical care he needed.  When it became clear Patrick  would need surgery to address the small bowel obstruction, Karen decided to evacuate her husband to a medical center qualified to provide him the medical care he needed and immediately explored her options. Karen knew that Patrick needed to be evacuated immediately, and that he needed a specialized medical team to address his rapidly failing condition. Karen decided to evacuate Pat to the “Hadassah Ein Kerem” Medical center in Jerusalem.

Professor, Director of the Intensive Care Unit at Hadassah and one of the founders of the iMER company, took Karen’s call and organized the team needed to assure Pat would be immediately and safely evacuated from Alexandria, even allowing for the performance of emergency surgery in the air ambulance if that proved necessary. The evacuation team included Dr. Bala Miklosh, a general surgeon from Hadassah, and Dr. Dafna Givati.  The evacuation team flew from Israel to Alexandria, Egypt and brought P. and K. to Jerusalem for immediate surgery at Hadassah.

Following the operation and a recuperation period in the surgical ward of the recently opened Sara Davidson Tower at Hadassah, Patrick and Karen are happily packing their bags and preparing for their return trip home to Nebraska

who is also a pilot.da
After learning about the case on the telephone, Prof. Linton, along with the medical backup of General Surgeon Miklosh Bala, flew to Egypt on Friday night, where Mr. Griffin had been hospitalized. They were back at Hadassah before Saturday morning. Dr. Bala operated on Saturday morning, and by Saturday night, Mr. Griffin was in his room in the new Sarah Wetsman Davidson Hospital Tower, resting comfortably.

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Patients’ Stories

As told by Maria, iMER coordinator: This was one of my first big neurosurgical cases, concerning a surgery for a brain tumor, and I remember everything as clearly as if it happened just a few days ago. There are some medical cases that seem ordinary, but they are not: the illusion that everything is happening on its own is created by accurate and well-timed decisions of many people, decisions that allow the patient to receive life-saving treatment…. V. was a young woman, a college student,
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