When the daughter of an expatriate employee sustained a significant electrical injury in a remote location, our demonstration of efficient decision making and focused case management meant that flight restrictions would not impact the outcome of the case.
The whole story: A French, expatriate, teenage girl was holidaying with her family in a remote National Park in Kenya. She pulled herself up on what she thought was a rope to help her climb a pole but the ‘rope’ was actually a live power cable and when she made contact with that and the pole she sustained a significant electrical injury. She was thrown (unwitnessed) several feet and appeared to have landed on her face.
- The family were 2 hours by road to the nearest city and a flight away from a full hospital with a burns unit. We were concerned that she had potential facial/cranial fractures, significant entry and exit burns and we were alarmed that her cardiac function had not been assessed where she was.
- The National Park staff took her by jeep to the local cottage hospital. They assessed the burns while we made arrangements to get an Air Ambulance plane to move her to the Tertiary facility with a Burns Unit in the city accompanied by one of her parents.
- As the flight plan was lodged, the fog started to roll in making a safe landing impossible. The decision was made to transfer the patient by ICU road ambulance, to the Regional Hospital in the nearest town whilst we waited for the fog to clear.
- The road ambulance took some time due to the poor road conditions and fog; however it did mean that she was able to be assessed and cared for to a much higher level for the night, The hospital was able to perform a scan of her head confirming a significant jaw fracture and other more minor fractures. It also meant that she could have an ECG and continuous cardiac monitoring to ensure rhythm stability, which can be a significant risk with electric shocks.
- Despite no burns unit, we put the Tertiary Hospital Burns Specialist in contact with the Regional Hospital ICU so they were able to ensure the best available burns care was administered. This meant the patient had access to the best available care until her fight the following afternoon, once the fog lifted.
She has required ongoing plastic surgery for the burns but has otherwise made a remarkable recovery.