Case Study — Medical Assistance 2024
Navigating the Complexities of Neurodiversity: Crisis24’s End-To-End Personal Care Ensures the Tranquillity and Safety of a Patient with Asperger’s
Situational Awareness
A 50-year-old man from the United Kingdom with Asperger’s Syndrome, a form of Autistic Spectrum Disorder (ASD), had made multiple solo overseas trips to Disney World in Orlando. However, on this occasion, he developed a chest infection and was admitted to hospital. The patient’s underlying condition caused social interaction and communication difficulties, which were exacerbated by his illness, necessitating careful consideration to ensure his safe return to his home country.
Crisis24 in Action: Providing End-to-End Medical Case Management
Overcoming Barriers to Communication
Crisis24's medical assistance team promptly responded to the patient's condition, closely monitoring his progress in collaboration with the treating doctor. With the administration of antibiotics, the patient's health improved, leading to his discharge after several days, and the necessity for repatriation to his home country arose. In adherence to protocol, Crisis24's nurse conducted a pre-flight assessment with the patient. However, due to the unique circumstances, communication proved exceedingly challenging for the dedicated nurse during the assessment. Despite efforts, the patient could not provide satisfactory responses, even with the presence of a familiar person on the call, complicating the determination of the patient's repatriation needs.
Repatriation Plans
It was decided that the safest option was to repatriate the patient with a nurse escort and precautionary oxygen. The nurse flew to Orlando and assessed the patient in his hotel room to ensure that he was fit to fly. After a long and detailed explanation of the whole repatriation process, a written timetable was also provided to the patient for reference. The nurse arrived at the hotel the following day at the exact time, and the patient was packed and ready to go as planned. Planning is critical in managing such cases as the patient will expect the schedule to be followed to the letter, and any deviations can result in distress and risk the mission’s success. The nurse then accompanied the patient to the airport. As part of our rigorous planning to obtain medical clearance, we work closely with the airline to ensure that they are fully aware and that there is a smooth transition. On arrival, the airline duty manager met the nurse and patient and assisted with check-in. The staff were supportive and understanding, resulting in a smooth process of accessing the quiet area of the lounge.
Overcoming an Unexpected Situation
Despite meticulous planning, the patient became restless, agitated, and fidgety and could not express what was of concern—the nurse knew that something was fundamentally not right. He then started to investigate by doing a basic but essential set of vitals upon which he found that the patient’s heart rate had become rapid and irregular. This resulted in a decision not to proceed with the flight due to the level of risk involved in taking a 9-hour flight with undiagnosed medical symptoms.
The nurse promptly coordinated with the lounge staff to summon an ambulance and emergency paramedics to the scene. With clarity and sensitivity, he communicated the next steps to the patient, ensuring he felt prepared and minimizing any potential distress. Throughout the journey, the nurse remained by the patient's side, providing continuous support and reassurance. Upon arrival at the local Emergency Department, the nurse accompanied the patient, facilitating his admission to the cardiology unit. Importantly, the nurse ensured that hospital staff were informed about the patient's Asperger's condition and took measures to ensure his comfort and well-being before departing the hospital.
Results
The condition was an arrhythmia (fast AF – atrial fibrillation) that had been previously undiagnosed. Crisis24’s medical team monitored the patient’s progress following this admission. The treating doctor found the patient to be stable, and he was discharged on medication that stabilizes the arrhythmia and again deemed fit to fly. A doctor escort flew out to accompany the patient home, following the same rigorous planning process as before, and this time, there were no complications. The patient was safely handed over to his official carer where he resumed his day-to-day activities as usual.
