Adam Mikulski, general director at Medical Air Service, explains what a medical escort is and why commercial flights are sometimes the better option.
Most journeys follow a predictable pattern: departure, arrival, and, at some point, return home. However, what happens if a medical issue intervenes and alters plans? In such situations, the question is not how to get home, but how to get from point A to point B safely.
In some cases, patients assume that if they need to return home after a medical issue while abroad, they will need an air ambulance. This might not always be true.
In fact, many patients who require a medical escort are not in a critical state and can travel by commercial air as long as they are accompanied by a qualified medical professional. A medical escort is a doctor or nurse who travels with the patient on a regular commercial flight, takes care of them, gives them medicine if necessary, and ensures they can get through the entire flight safely from take-off to landing.
Not every case is an emergency
When we hear of medical transport, we often think of emergency situations and critical patients who need immediate medical attention on board a plane. However, not every case is an emergency.
A patient might be discharged from a clinic or hospital after receiving medical treatment, but may not be able to fly on their own. An elderly person might need medical supervision during a long-haul flight. A patient might need to return home after receiving medical treatment abroad and might not need intensive medical supervision during the flight.
In these cases, the status quo is maintained. The patient does not need an intensive care unit in the air, but they do need assistance, supervision and continued care.
This is where commercial flights with medical escorts come in. The aircraft does not change; the method of travel does. A medical professional accompanies the patient, and travel becomes a controlled environment.
There is a tendency to assume that specialised equipment equates to better treatment. In reality, the best option depends on the patient, not the equipment.
One advantage of commercial flights for the patient is that they operate on a set schedule. In practice, however, access to those flights is not always immediate. Airlines require prior approval to transport a patient, which involves submitting detailed medical information for review. This process can take several days, meaning that same-day or next-day departures are rarely possible.
For instance, while a patient in Southeast Asia, Southern Europe, or Latin America may have multiple routing options available, the timing of the journey depends on when medical clearance is granted, not just flight availability.
Even when approval is given in advance, it is not guaranteed until departure. Airlines can revoke clearance on the day of the flight if the patient’s condition presents differently from what was originally documented.
Cost is also an advantage. Air ambulance flights are expensive by design. A commercial flight with a medical escort can be a safe option for the patient without additional financial pressure, especially if they do not require the level of care provided by an air ambulance.
The advantages of commercial flights do not override medical judgment; they apply only when the patient’s condition allows travel.
Managed medical journey
The presence of a medical escort is what turns a flight into a managed medical journey.
The process begins prior to departure. The patient’s condition is assessed in consultation with various physicians. Arrangements are made for the entire journey.
During a flight, the escort provides continuous patient care. This entails pain management, medication administration, and oxygen therapy. It’s not a hospital environment, but it is a structured setting, nonetheless.
The process also provides a point of coordination with the airline crew. This includes any necessary alterations to the environment.
For the patient, it’s not just about being accompanied; it’s about being cared for during a journey that might be difficult or impossible to undertake alone.
For travellers and families, the most difficult part is rarely the flight itself. It is everything around it.
As soon as the patient is cleared to fly, the process begins. It is a complex system involving many parties. It requires the hospital, the airline, ground transportation services, and the receiving medical facilities to work well together.
It begins with an intensive medical review to ensure the patient is cleared for commercial air travel. Then, the process requires assistance from the air carrier. It requires medical clearance, documentation, and approval for the equipment to be brought on the plane. However, not all airlines are the same. Therefore, the route is carefully planned.
Also, the groundwork is being done. It includes discharge planning, assistance at the airports, and ground transportation from the hospital to the plane and from the plane to the final destination.
Not urgency but judgement
One thing remains the same: the medical escort. There may be two people working in shifts for long-haul flights. They will both travel with the patient from start to finish, but one of them is on duty while the other one rests.
It is not a niche solution, but rather one used for a wide variety of travel-related scenarios such as a patient recovering from surgery in Spain and traveling home to the US; a patient traveling in Southeast Asia and transferring to a special clinic in Europe; a patient on a cruise ship disembarking for medical treatment and eventually returning home; or an expatriate moving for medical care.
In each case, the common factor is not the location, but the condition. The patient is stable but unable to travel independently.
It is equally important to understand where this does not apply. Patients requiring continuous intensive care, advanced life support, and/or those at risk of rapid clinical deterioration cannot be transported on a commercial airliner. For these cases, an air ambulance is required.
There are physical limitations as well. The determination is always based on a thorough medical evaluation. The aim is not to make the process easier, but to provide the degree of care commensurate with the actual need.
The reality of medical travel is not defined by urgency but by judgment.
Not all cases need the most complex option, and being able to differentiate between what needs to be done and what should be done defines the result.
Commercial flights with medical escorts are not a compromise but a choice made in consideration of all variables, including the patient’s condition and the realities of flying between nations.
In the end, the question is not how a patient travels, but whether the journey has been planned with the right level of understanding.
