The good news

After the telephone conversation between the father and the Rega flight coordinator, the medical consultant at Rega contacts his Greek colleagues, informs himself about the current situation and then studies the diagnostic documents. He is thus able to obtain remotely an as accurate a picture as possible of Remo’s state of health, as well as of his medical care on location. Based on this information, he assesses, among other things, whether Remo Lack is fit to be transported in the first place.

From his office at the Operations Centre at Zurich Airport, the medical consultant calls the 23-year-old and explains the diagnosis: fracture of a lumbar vertebra. It is important to move as little as possible, so that the bone can grow back together. If, however, the vertebrae were to shift, an operation might become necessary and in the worst case there would be a risk of further damage.

Finally Remo Lack can put what has happened into context and communicate with someone in his mother tongue. He is also told that he will be flown home in a Rega ambulance jet. “That was a great feeling – knowing that Rega is coming and that I’ll soon be back in Switzerland,” says Remo Lack. That knowledge alleviates some of the worry.

Thinking in terms of different scenarios

At the same time, intensive care nurse Karine Lang and flight physician Julia Janssen inform themselves about their patient’s condition and about their mission the following day. They read the medical consultant’s report and discuss it with each other. Every Rega mission is preceded by careful preparation. The two medical specialists prepare themselves for different scenarios. For instance, that Remo Lack’s state of health could have changed by the time they arrive. They therefore ask themselves questions such as: what can we do on location if Remo Lack’s condition has deteriorated in the meantime or even suddenly worsens during the flight?
 

Administering painkillers

Twenty-four hours after the first contact is made, the Rega jet lands at Chania Airport on Crete. For once, the Rega medical crew do not drive to the hospital to collect their patient; Remo Lack is taken by ambulance directly to the ambulance jet on the airfield. This procedure is also due to the Covid-related access restrictions at the hospital.

The doors of the ambulance are opened and Karine Lang and Julia Janssen climb into the vehicle. After greeting Remo Lack, they first ask him a few simple but specific questions about his state of health and his pain. “The first impression is extremely important for us. We can quickly assess how the patient is doing and what he needs for the transport. Remo Lack was in a lot of pain,” says Julia Janssen. “For this reason, Karine Lang and I discussed the pain therapy already in the ambulance.” The objective is clear: the young man should be in as little pain as possible when he is taken on board the jet and during the flight. To ensure that Remo Lack remains responsive, the dosage of the strong painkillers has to be very precise.
 

Under observation in the cockpit

The pilots also help to carefully push the patient, lying on the stretcher, up the ramp and into the cabin. Today, there are three pilots lending a hand. On flights within Europe, Rega’s cockpit crew generally comprises a captain and a co-pilot. On this mission, besides captain Benedikt Steiner and co-pilot Adrian Megert, Raphael Jenni is also on board as a socalled check pilot (see box on the left). Great care is required when transferring the patient onto the Rega bed in the jet, as the fractured vertebra must not be allowed to shift under any circumstances. After he has been moved off the stretcher, the Rega flight physician and the intensive care nurse prepare him for takeoff with practised hand movements: they secure him with straps, carefully pull them tight, and attach the sensors that transmit vital parameters such as heart rate and oxygen saturation to the monitoring machine. Now Remo Lack is ready for takeoff. From the Greek island, the journey continues to Tirana in Albania, where a second patient is waiting for Rega.

Slipped over in a public car park

His name is Gazmend Omeri and he comes from Frauenfeld. His vacation has also taken an unfortunate turn; with him, too, a fall has upset his plans. He slipped on the we floor of a multi-storey car park and hit his leg against a concrete pillar. The diagnosis: a fractured kneecap. For his repatriation, an ambulance jet is not absolutely necessary from a medical point of view. But wherever possible, Rega’s Operations Centre tries to repatriate several patients on one mission. These so-called combination flights allow the available resources to be used economically and ecologically. In approximately one in three jet missions, the Rega crews fly two or more patients home at the same time.

On the return journey from Crete, the ambulance jet lands in Tirana to pick up Gazmend Omeri. Shortly afterwards, the 43-year-old is lying next to Remo Lack in the cabin of the jet with his leg in a plaster cast. After landing in Zurich, the two patients go their separate ways and are taken by ambulance to hospitals near their homes and their loved ones.

Back home

Back in Switzerland, Remo Lack is thoroughly examined again, and then it becomes clear: he needs to wear a corset, take it easy, and lie down as much as possible. And hope that an operation will not be necessary.

The photo of the beautiful beach scene in the early morning on Crete will always remind him of the abrupt end to his holiday – and of his return home in the Rega jet.