"The medical information received prior to arrival can be incorrect, incomplete or, as in the case described below, the situation of the patient can deteriorate,” Dr Kerry Hunter, Senior Flight Doctor of Capital Air Ambulance in the UK, reports in the latest edition of Air Ambulance Review.

“As our Learjet 45 touched down on a sunny and calm landing strip in Morocco, we transferred ourselves and our intensive care kit into an ambulance and drove to a small district general governmental hospital. Th e information that we had received described a young man who had fallen from a three-storey building four days earlier and sustained a large extradural bleed. This had been drained in theatre and the CT report at that time stated that there were no further spinal injuries and a fracture of the ischium.

“Waiting outside the intensive care department we were met by some concerned family members and the grave face of the resident ICU doctor. Apparently run ragged as the sole doctor covering a busy 10-bed ICU department, he was trying his best to keep control of his patients and had clearly been up all night. He had minimal nursing support and resources were scarce.

“He informed us that the patient had deteriorated overnight. He had become septic, spiking temperatures of 38.5oC and a lumbar puncture had returned positive for bacteria, indicating a meningitis – an infection inside the brain cavity as a result of either the previous brain surgery or frontal skull fractures allowing the entry of bacteria. He was already on appropriate broad-spectrum antibiotics to cover the meningitis. His routine bloods from that morning had also returned and had showed a massive acute drop in his haemoglobin level from 12 to 6.1g/dL – he was bleeding from somewhere internally and he was critically unwell and unstable…

Read Dr Kerry’s full account on page 40 of the latest edition of Air Ambulance Review: https://issuu.com/voyageurgroup/docs/itij224aar_phase2?e=6288845/72297024