Health No. 1 September 2016 Article on AXA Assistance’s Nurse Swan Hwee Boon

In her 20 years in patient care, AXA Assistance Singapore’s Head Flight Nurse, Swan Hwee

Boon has travelled to 6 continents with the exception of Latin America and has handled more

than a thousand overseas medical cases that include major events such as the 2002 Bali

Bombings, last year’s explosion at Bangkok’s famous Irawan Shrine and the Jakarta bombings

that occurred earlier this year.

Hwee Boon joined the International Emergency Medical Assistance Centre in 1997 as a Flight

Nurse and prior to that, she had 10 years of nursing experience, 5 of which were with the ICU.

She attributed the reason for her move to being a flight nurse, as wanting to challenge herself and

also broaden her exposure beyond Singapore and she was inspired to do so, after someone from

the same field shared his flight experience with her.

Her first case in 1997 saw her travelling to Italy to escort a pneumonia patient back to Taiwan

and her most recent case last month, involved her escorting a business woman who suffered

severe chest pains from Dalian, China back to Singapore;

In her current role as Head Flight Nurse for AXA Assistance Singapore; her primary function is

escorting patients back to Singapore and making sure all preparations for each trip are taken care

of. Her working hours may be 8am - 5pm from Monday to Friday but she's always on 24 hrs

standby in case of any emergencies.

When asked about some of her more memorable cases, Hwee Boon pointed to the 2015 Irawan

Shrine Explosion and her trip from Guam to Manila in 2014.

For the explosion at Irawan Shrine in Bangkok on 17 August 2015, two Singaporeans were

admitted to a local hospital in Bangkok for treatment and warded for 2 days. On the 19th, the

team received a call and escorted the mother and son back to Singapore General Hospital safely

for further medical treatment. The standards of the Bangkok hospital were decent but as both

patients required long term treatment so in consideration of their emotional needs, they decided

to go back to Singapore to be reunited with their family while receiving treatment.

Her role in this case was to coordinate the communication and information shared between flight

doctor and local doctor such as deciding whether the patients were suitable for flying, was there

any danger in flying and also preparing all related medical documents (X-Rays) and ultimately

waiting for private plane and required permits for airplane to land at Bangkok Airport.

Nurse Swan further explained the main duty of a flight nurse and flight doctor is to observe and

take care of their patient's conditions; ensuring their safety and making sure they get home "in

one piece."

She also recalled her trip from Guam to Manila in 2014, where a patient suffered from Acute

Respiratory Distress Syndrome (ARDS) and the doctor from Guam suggested that his wife bring

him back to Manila for treatment. Not long after the plane’s departure from the airport, the

patient suddenly collapsed and his pulse and blood pressure dropped drastically. Both the doctor

and her had to perform CPR on the patient while comforting his frantic wife. After performing 2

hours of CPR, they were both exhausted and one of the pilots of the plan had to assist in the CPR

the plane arrived in Manila.

In actuality, the doctor already knew that the patient had already passed away while performing

CPR on the plane but in order not to disappoint his wife and also in the midst of holding out for

miracle to happen, the trio continued to perform CPR till the airplane landed. The patient was

transferred from the plane to the local medical team where the doctor from Manila Hospital

certified the time of death.

But despite failing to save the patient, the patient's wife and family members were sincerely

thankful to the team for their assistance and both Hwee Boon and the doctor were pleased to hear

this as they felt that they have done their best for the patient.

Hwee Boon notes that the difference between a flight medical team and a ground medical team,

is the fact that if there's any cases of medical emergencies that happen on the ground, there will

be more than 5 or 6 people that are able to rush in to assist a given patient but in the air, there's

only the doctor and herself, and if the medical equipment malfunctions or if there is inadequate

medical supplies, they can only be resigned to fate and that is the biggest singular challenge they

Today in her current role as head flight nurse in AXA Assistance Singapore, there are

approximately six to nine cases that happen every month and for each trip both herself and the

doctor are in charge of preparing all the heavy medical equipment to be carried aboard the plane.

Carrying all these heavy item has taken a toll over the years and has caused Hwee Boon to

develop spinal problems, but in spite of this, she still wishes to work towards saving and serving

as many patients as she can till she reaches 62 years old, the age of retirement.

On her trip to Dalian, China last month, Hwee Boon met a fellow colleague who is 67 years old

and she strongly believes that she can follow the example of that colleague and continue to work

till she is of retirement age as long as she is able to perform less complicated cases, though she

would still like to handle some challenging cases from time to time.