You are a doctor in Sydney

You are a doctor in a hospital in Sydney, and your task for today is to assess whether your patient is fit for repatriation to the Czech Republic. The patient is a 26-year-old man, previously healthy, who fell from a rocky cliff while hiking. As a result of the accident, he sustained a fracture of the C4/C5 vertebrae with dislocation and spinal cord injury, leading to ischemic brain damage caused by hypotension during spinal shock. On the 60th day after the injury, the patient is conscious, able to communicate, on supportive ventilation with a tracheostomy, and has undergone stabilizing surgeries.

Is this patient suitable for transport?

Help

Yes, we try to transport the patient as soon as possible, even at the cost of possible complications.

If the patient's condition requires mechanical ventilation it is not appropriate to airlift the patient.

The decision to transport is not the responsibility of the attending physician; his or her role is to provide information about the patient to the repatriation team and to make recommendations if necessary.

Yes, as the attending physician we know the patient's documentation, his current condition and I can recommend transport because his condition is now stable.

years

185

man

14 /min

75 /min

SpO2

97 %

118/82 (94) mmHg

temperature

36 °C

GCS

EKG

rythm: sinus

Examination

A: Tracheostomy tube size 8.5, no obstruction
B: On mechanical ventilation, SpO₂ 97% with FiO₂ 0.3, symmetrical alveolar breath sounds, ventilation parameters within normal limits
C: BP 118/80 mmHg, HR 75/min, sinus rhythm, capillary refill < 2 s, good perfusion
D: GCS 15, pupils equal and reactive to light, quadriparesis
E: Temperature 36.8 °C, skin intact without pressure sores, adequate urine output 1 ml/kg/h, no bleeding or edema

Glycaemia

Take a sample

Arterial blood gas

Take a sample

Complete blood count

Take a sample

Biochemical analysis

Take a sample