Hospital Facilities and Evacuating Critical Patients Internationally

Jivo's international team manages the entire process end to end, from the visa process to ambulance transfer at the airport, and makes sure family members travelling with the patient are comfortable too. They first take the patient's details and advise on the right course of action, so the point of contact should be the international team, who will coordinate directly with BLK-Max.

Access is gained through either the radial artery in the wrist or the femoral artery in the groin. An angiography is first done through a catheter placed in that artery to locate the blockages, and a treatment plan is formed. A wire is then passed across the blockage, a balloon is used to open it, and a stent is placed. If there are multiple complex blockages that would need too many stents, coronary artery bypass surgery is recommended instead, decided by a heart-team approach. In an acute heart attack, PCI directly clears the thrombus, places a stent, and restores flow.

The need for heart transplantation has dropped drastically because of the medical and interventional therapies now available. Donor availability and financing also remain real constraints. In practice, the centre performs about two to three transplants a year, though the facility is available for extreme cases when a donor is available.

Sublingual nitrate (sorbitrate) is the treatment of choice since it acts quickly and is widely available, except in patients with inferior wall STEMI, where nitrates should be used cautiously. If sublingual nitrate doesn't relieve pain, intravenous nitroglycerin can be given alongside opioids for severe pain. On nutrition, the acute-phase approach is largely about hydration status: patients presenting late with severe breathlessness should be given a low-salt diet and IV fluids should be limited to avoid overhydration. For long-term management after an ACS event, high-fat and deep-fried foods should be avoided to keep cholesterol levels down.

Smoking in young patients, diabetes, hypertension, a family history of cardiac disease, a sedentary lifestyle, and lack of sleep are the major risk factors. Pollution and extremes of temperature can also precipitate an event.

A heart-team approach covering complex coronary PCI, structural interventions, electrophysiology, total arterial bypass, cardiac transplantation, and left ventricular assist devices, among others.

Jivo's international team manages the entire process, from the visa process to airport ambulance transfer, coordinating directly with the hospital and supporting travelling family members.