How To Make Sure Your Vacation Isn’t a Medical Disaster

Recently while traveling overseas, I found myself in a predicament not often encountered nor taught to health professionals. I was requested to address an emergency at 30,000 feet in the air. This got us thinking: How many patients consider the possibility of a medical emergency in the air?

People with chronic illnesses and the older population (who find themselves retiring and having more time to travel) need to be prepared so their vacation isn’t ruined by a health crisis.

Below are a few tips to stay safe while traveling:

If you have serious medical conditions, be sure your travel companion is prepared to help in case of an emergency. In the event you lose consciousness you need someone to convey information to those on board trained to help you, primarily the flight attendants, or, if you are lucky enough, a medic, emergency medical technicians (EMT), nurse, nurse practitioner (NP), physician assistant (PA) or physician.

This cannot be overstated enough — pack ANY medications you might need in an emergency in a carry-on bag. This includes an epi-pen, albuterol, aspirin, nitroglycerin, antihypertensives, non-steroidal anti-inflammatory medications, insulin, glucose supplement, anti-emetics, oxygen, etc. If you’re not sure if you should carry certain medications on board, discuss it with your primary care physician prior to traveling. TSA states, “Medications in pill or other solid forms must undergo security screening. It is recommended that medication be clearly labeled to facilitate the screening process. Check with state laws regarding prescription medication labels.” Make sure to have plenty of medication for your trip, plan to have your primary care physician call these into the pharmacy at least one week prior to travel. Be prepared for anything. Most airlines only carry a basic first-aid kit, oxygen and a defibrillator.

If you have medical conditions, see if your primary care physician prior to take off for a travel clearance. If your physician detects early warning signs of illness then the risks of travel may far outweigh the benefit.

If you have serious food or environmental allergies (e.g., anaphylaxis — a multi-organ, life-threatening allergic reaction) alert the flight attendants as you board (and have your EpiPen!). Though awareness of serious allergies to peanuts has increased they are still served on some flights. Other commonly served food products include soy and wheat.

Know the health care system of the destination you are traveling to. Have your health insurance information with you and consider additional travel insurance if you are traveling out of the country or to remote destinations. In the event you are too ill to travel in a general economy through an airport, there are medical evacuation services (e.g., helicopters, fixed-wing aircraft) but they can be extremely pricey if paying out of pocket and usually are not covered by generic health insurance. Some plans, certain credit cards and airlines provide travel insurance as a perk BUT be sure you know before you go.

If you ever find yourself aboard a flight with a medical emergency, here are some helpful tips and lessons learned:

• Stay calm! Panic is contagious (especially in the air). Make sure to speak calmly and with a purpose.
• Do not move the patient further than to the aisle if space is needed. Moving a person who is critically ill can be challenging, can worsen medical conditions or delay care. In the event the seats in the row are occupied next to the individual experiencing the emergency have the healthy occupants relocate, as it is far easier to move a healthy individual.
• Just like any land emergency utilize the ABCs to evaluate the patient. Make sure the patient’s airway is open, check if they are breathing and check for a pulse. If you are trained to provide treatment beyond this (oxygen, rescue breathing, chest compressions, airway modifications) then do!
• Identify yourself and your training (credentials — EMT, RN, PA, DO, MD or good samaritan), if any, to travel companions of the patient and to the flight crew so they can assess who is the most qualified to manage the situation.
• Have the flight crew communicate with the captain as needed.
• Lastly and most easily forgotten, have someone record what happened during the event (including times — e.g., how long they were they unconscious, how long did they receive chest compressions) and what interventions were administered — this will be extremely helpful to the medics waiting on the tarmac!

The U.S. Surgeon General Jerome Adams recently helped a patient aboard a flight. You never know when emergencies will occur, so it’s best to be prepared!

Lastly, a huge kudos to the staff of Alaskan Airlines for their calm collected flight attendants and immediate attention to the requests I had while assessing the patient and the needs of the patient!

Ryan Horton is an emergency physician who blogs at the Smart Hospital Patient.




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