A 36-year-old woman with brain injury is being provided comprehensive rehabilitation and treatment at Hamsa Spine & Brain Rehabilitation Centre, a unit of Kauvery Hospital, Chennai. The patient had recently delivered a baby, and had suffered a cardiac arrest causing anoxic brain injury (injury to the brain from a period of interruption in blood flow and the consequent deprival of oxygen). She currently breathes through a tube introduced through a tracheostomy (a surgical procedure to establish access to the airway, by means of an incision made on the trachea, the windpipe on the front of the neck, for delivery of oxygen), and needs 2 litres oxygen per minute. She is able to recognise faces only, and is unable to speak or move.
A serious brain injury after cardiac arrest can leave a patient severely disabled. After the immediate and initial stabilisation, rehabilitation is an essential and extended phase of care which requires expertise and the infrastructure to meet the specific needs of the person. "The patient and her husband were on student visas and were unable to meet the medical costs in the USA. They researched on rehabilitation centres in Tamil Nadu, and her parents reached out to us for assistance. After detailed discussions with the family, we decided to fly her down to Chennai to arrange the necessary rehabilitation and other management. Arranging the travel, internationally termed as āaero-medical evacuationā, was a huge challenge as the patient was dependent on oxygen support and a bed. This was a joint effort that called for understanding, cooperation and collaboration of the family, healthcare professionals, airlines and the embassy," explains Dr Balamurali, Head of Department of Spine Surgery, Kauvery Hospital & Managing Director of HAMSA Spine & Brain Rehabilitation Centre.
Dr. Ilango, an American Board Certified (BC) physician from Chennai, was requested to fly to the United States to assess the patient, and supervise the transfer to India, with a paramedical team constantly in attendance. "There were several challenges in the organisation of her travel from Dallas to Chennai via Doha. The transfer to the airport, the check-in process, clearance through security and boarding the aircraft were all done with her on the stretcher, while being continuously monitored by the doctor. The break at Doha for more than 4 hours was assisted by the airport medical team. The entire travel time of almost 20 hours, monitoring and supporting her medically and socially, was a huge risk, considering the criticality of the patient. She was received at Chennai International airport by an experienced, fully briefed and equipped team of medics and paramedics from Kauvery Hospital in an ambulance. At the hospital, she was stabilised and assessed post the long journey, and then shifted to HAMSA Spine and Brain Rehabilitation Centre," adds Dr Balamurali.
Dr Aravindan Selvaraj, Co-Founder and Executive Director, Kauvery Hospital said, āHer recovery can be a gradual but steady process that requires a lot of planning, precision, and patience. She will receive strong support, constant encouragement, careful therapy and meticulous overview by a talented team of neurologists, neurosurgeons and physical and medical rehabilitation specialists. Dr Balamurali, the team of therapists and the family are all confident that, with such support, and in such an environment, she would recover over a period of time.ā