This document describes a medical evacuation that occurred at sea. It provides details of a patient, a 34-year-old Indian seaman, who developed Fournier's gangrene/necrotizing fasciitis. Due to the imminent fatality risk and the distance to the scheduled port being 4 days away, a decision was made to request emergency evacuation. Two rescue helicopters were dispatched and medical workers were lowered by winch to retrieve the patient. The patient was then transported to Santa Barbara for further treatment.

1. MEDEVAC ON HIGH
SEAS
( INCIDENT REPORT )
Dr. A. C. KULKARNI
3 A SIDDHI VINAYAK CHAMBERS
BANDRA EAST, MUMBAI 400051

2. MEDICAL ADVISE
INFORMATION TO BE TRANSMITTED
BY MAIL OR IN CASE OF EMERGENCY
BY TELEPHONE

3. MEDICAL ADVISE
INFORMATION TO BE TRANSMITTED BY
MAIL OR IN CASE OF EMERGENCY BY
TELEPHONE
INJURY: PART OF THE BODY
OPEN WOUND / CLOSED
BLEEDING CONTROL

4. MEDICAL ADVISE
INFORMATION TO BE TRANSMITTED BY
MAIL OR IN CASE OF EMERGENCY BY
TELEPHONE
INJURY: PART OF THE BODY
OPEN WOUND / CLOSED
BLEEDING CONTROL
LEVEL OF CONSCIOUSNESS

5. MEDICAL ADVISE
INFORMATION TO BE TRANSMITTED BY MAIL OR
IN CASE OF EMERGENCY BY TELEPHONE
INJURY: PART OF THE BODY
OPEN WOUND / CLOSED
BLEEDING CONTROL
LEVEL OF CONSCIOUSNESS
PAIN

6. ETA LONG BEACH,CA. 4 DEC

7. PATIENT, 34 YRS, INDIAN
SEAMAN. NO PAST H/O
DIABETES, HYPERTENSION.
HIV AND Hep B NEGATIVE.

8. SYMPTOMS
• ON 17 NOV COMPLAINED OF PAIN
AND BURNING AROUND ANAL AREA
AFTER PASSING MOTION.
• NO BLEEDING
• NO CONSTIPATION
• TREATED SYMPTOMATICALLY

9. PROGRESSION OF CASE
• PATIENT DEVELOPED MULTIPLE
EXTERNAL PILES.
• FEVERISH FEELING WITH
EXHAUTION
• UNABLE TO WORK
• COMPLAINED OF PAIN IN RIGHT
GLUTEAL REGION
• PRESCRIBED ANTIBIOTICS IN CASE

12. DIAGNOSIS
FOURNIER’S GANGRENE
NECTROTISING FASCITIS

13. DECISION MAKING
•IMMINENT FATALITY

14. DECISION MAKING
•IMMINENT FATALITY
•DISTANCE / TIME TO
SCHEDULED PORT 4 DAYS.

15. DECISION MAKING
• IMMINENT FATALITY
• DISTANCE / TIME TO SCHEDULED
PORT 4 DAYS.
• NO PORT OF REFUGE.

16. DECISION MAKING
• IMMINENT FATALITY
• DISTANCE / TIME TO SCHEDULED
PORT 4 DAYS.
• NO PORT OF REFUGE.
• SOURCE OF EXTERNAL ASSISTANCE

17. DISCUSSION WITH RCC
ALAMEDA

18. RICE
• R- REST
• I – IMMOBILISATION
• C- COLD COMPRESS
• E- ELEVATION
DISTANCE TO SANTA BARBARA 478 NM

19. SEQUENCE OF EVENTS
1228 AIRCRAFT RESCUE 07 CALLED VESSEL ON
VHF CH 16 FOR SAFETY BRIEFING.
1230 COMMENCED SAFETY BRIEFING ON VHF
CH 16
1242 COMPLETED SAFETY BRIEFING
1250 HELICOPTER LANDING CHECKLIST
COMPLETED.
1255 AIRCRAFT RESCUE 07 INFORMED
APPROACHING TOWARDS VESSEL AND MAKING
ROUND ABOVE THE VESSEL.


20. 1300 AIRCRAFT RESCUE 07 ADVISED TO
ALTER COURSE 270 AND 10 SPEED
KNOTS, AS TWO HELICOPTERS RESCUE
09 & RESCUE 02 COMING SHORTLY TO
EVACUATE THE PATIENT.
1315 BOTH HELICOPTER STARTED
MAKING ROUND AROUND THE VESSEL.
1318 HELO RESCUE 09 CAME OVER
LANDING AREA AND TWO PARAMEDICS
WINCHED DOWN.
1320 RESCUE 02 WINCHED DOWN TWO

21. 1320 RESCUE 02 WINCHED DOWN TWO
PARAMEDICS ALONG WITH STRETCHER.
1345 PATIENT ON DECK IN STRETCHER
1356 PATIENT PICKED UP BY HELO
RESCUE 02 BY WINCHING ALONG WITH
TWO PARAMEDICS.
1400 HELO RESCUE 09 PICKED UP TWO
PARAMEDICS BY WINCHING
1730 HELO 02 LANDED AT SANTA
BARBARA AND PATIENT TRANSFERRED

22. BLACK HAWK HELICOPTER

29. THANK YOU