Rail Ambuance From Delhi to AIIMS Patna
A 38-year-old male, critically ill and battling Chronic Liver Disease (CLD), was entrusted to our care for a high-risk transfer from Delhi to AIIMS Patna. But this wasn’t just any transfer — this was a race against time, where every system in his body was crashing.
The patient was:
- COVID-19 Positive
- On mechanical ventilation (PEEP: 13 cm H₂O)
- Suffering from Ventilator-Associated Pneumonia (VAP)
- In septic shock, requiring Noradrenaline + Vasopressin
- Undergoing CRRT (Continuous Renal Replacement Therapy) for acute kidney injury
Air evacuation was ruled out — the patient was too unstable to handle even a minute of turbulence. That’s when our Life Savers Rail ICU Ambulance stepped in.
- We converted a train coach into a fully functional mobile ICU:
- Advanced ventilator with lung-protective strategy
- CRRT machine running continuously during the 17-hour journey
- Invasive arterial BP, EtCO₂, CVP, and hourly ABGs
- Triple-channel syringe pumps managing inotropes and sedation
- Defibrillator, suction, humidified oxygen — all in motion
Halfway through the journey, the patient developed a clot in the CRRT filter, leading to rising potassium and impending metabolic acidosis. Inside a moving train, our team calmly changed the circuit, re-established flow, and continued dialysis without interrupting ventilator settings or hemodynamic support.
There were multiple moments of desaturation, borderline bradycardia, and pressure dips — each managed in real-time with clinical precision and unwavering focus.
Upon arrival at AIIMS Patna, the patient was handed over still on CRRT, ventilated, and alive. His MAP was stable, inotropes were optimized, and oxygenation had slightly improved — a small but powerful victory in a near-impossible mission.
This wasn’t just transport. This was an ICU on rails, a testament to critical care in motion, and a reminder that with the right team — every mile can mean survival.
