Travel Emergencies: Be Prepared Before You Go by Elif E. Oker, M.D.
Believe it or not despite the current frigid temperatures the spring and summer travel seasons are upon us. There is no better way to ruin a wonderful vacation than to be ill prepared for an emergency while away from home. As with most things in life a bit of advanced preparation is the key to weathering this storm and its impact on your well deserved break.
Before You Go:
Step 1: Research your destination and locate the medical services available to you. If you have special needs such as dialysis enlist your doctor’s help to make these arrangements in advance.
Step 2: Get a check up and up date your immunizations.
• Most experts suggest a check-up with your health care provider about 2 months prior to your trip.
• I recommend calling your doctor’s office before making this appoint. Ask them if you would be best served by their office or a travel clinic.
• In some cases, depending on your health and medical problems you may need to schedule a visit with both.
• Depending on your destination a travel clinic is more likely to stock certain vaccinations like yellow fever, typhoid to name a few. A travel clinic may be more versed in unusual travel destinations and better able to advise you on precautions in certain areas of the world.
Step 3: Put together a Personal Medical History. This document should include:
• Name and address
• Emergency contact
• Doctor(s) contact
• List of medical conditions and surgeries
• List of medications (OTC and prescription) and their doses
• List of vaccinations
• A copy of a recent ECG or last catheterization report
• A letter or card describing any implantable device like a pacemaker or joint replacement.
Step 4: Get your medications in order.
• Be sure to have copies of your prescriptions and enough medications to last your trip.
• If you are in the US, ask your pharmacy about locations near your destination. You may be able to obtain re-fills at these locations.
• International travelers should note that not all medications in the US are available overseas.
• If you are traveling for a prolonged period, discuss ordering extra medications with your pharmacist. Allow sufficient time for the pharmacy to fill your order, since the amounts needed may not be in stock.
Step 5: Assemble a Travel Health Kit. In addition to your meds this could include:
• Anti diarrhea medication
• Antibiotics for diarrhea
• Allergy medications like antihistamines or an Epi Pen
• Motion sickness medications
• Cough/cold medications
• Pain medications
• Insect repellent
• Band aids and antibiotic and antifungal creams
• Digital thermometer
• Hand sanitizer or wipes
Step 6: Check your Insurance
• Check with your health insurance provider regarding coverage while traveling.
• Be sure to understand what your policy will and will not cover.
• Some issues to ask about include:
o Medications and doctor visits out of plan and internationally
o Hospitalization out of plan and internationally
o Transportation costs to return home.
o Options to purchase additional coverage to cover these incidentals.
• Note: Seniors: Medicare does not cover healthcare costs outside the US. There are options to purchase insurance to fill in this void.
• Foreign providers may not bill your insurance.
o Be prepared to pay in cash or with credit card for services overseas.
o Get detailed, itemized copies of your bills to submit to your insurance provider upon your return.
o Do not assume these documents will be in English.
o You may need to get these documents translated prior to submission to your insurer.
o Your provider may have time requirements for pre-authorization and reimbursement requests for services.
o These may be difficult to meet if overseas
• Consider travel insurance.
o Travel insurance, depending on the policy, may provide emergency payments, evacuation assistance, translation services, emergency medical transport, accident, death, trip cancellation.
o Costs vary and depend on your individual situation.
Step 7: Special Precautions for Children.
o Child safety seats/CARES
Step 8: Special Precautions for International Travel.
o Check out the US Embassy or local consulate. Be sure to register. Often the website will have list of local physicians and hospitals available to assist English speakers.
o Consider an evacuation plan in the event of a medical emergency. Examples: Air ambulance services, etc…
On the Road:
Staying safe and healthy while en route to your vacation is as important as advanced preparation. The main stay of good health is general common sense. Some tips to make the trip include:
• Step 1: Stay active
o Long trips, particularly those over two hours, can result in blood clots in the legs. DVTs or deep venous thromboses are dangerous because they can dislodge and travel to the lungs, causing difficulty breathing and death. The key to prevention is activity.
o Get up every couple of hours and walk about the plane or train. If driving, stop for a break and take a brisk walk. If you cannot get up, stretch your legs by curling your toes several times for several minutes. Compression stockings and loose fitting clothing may also help.
• Step 2: Eat well and stay hydrated.
o Traveling can take a lot out of you, even if you are just sitting on an airplane or train. Be sure to drink plenty of water and avoid excessive alcohol and caffeine.
o Eat frequent light meals and snacks.
• Step 3: Avoid Motion Sickness.
o Nothing takes the fun out of travel than an upset stomach. If you experience motion sickness some steps to minimize your discomfort include:
ï‚§ Choose your seats carefully
• Plane: over the wing
• Train: by the window
• Ship: cabin in the forward or middle of the ship, upper deck
• Auto: drive, front seat
ï‚§ Don’t read. Look at the horizon or at a distance.
ï‚§ Rest your head against the seat back
ï‚§ Avoid overeating, challenging foods, alcohol.
ï‚§ Try Ginger ale, water, crackers, ginger snaps to settle your stomach.
o If all else fails there are medications that can help. The chief side effect of these drugs is excessive sleepiness. Be sure to check with your doctor to see what medications are right for you.
While You Are There:
Enjoying your vacation means taking care to avoid certain potential hazards that may lead to illness.
• Step 1: Avoid the water
o Local water supplies may not be safe to drink. Therefore depending on the area, drink only bottled water. Don’t forget to use bottled water for brushing your teeth.
o Remember to avoid ice, fountain drinks, street food, raw fruits and veggies, unpasteurized milk and dairy products (ice cream).
• Step 2: Avoid insect borne diseases:
o Mosquitoes can transmit diseases so be sure to use insect repellent containing DEET
o Protective clothing and netting may reduce exposure as well.
o Step 3: Avoid excess alcohol. Excess alcohol hampers judgment increasing the risk of injury and may get you in trouble with local authorities.
Centers for Disease Control www.cdc.org
American College of Emergency Physicians www.acep.org
Travel Medicine Inc. www.travmed.com
United States Department of State www.state.gov
International Association for Medical Assistance to Travelers www.iamat.org