- Email: [email protected]
Care of the patient abroad
INDUSTRY FOCUS
by Karen Bates, RN
Care of the Patient Abroad v e r y year, m i l l i o n s of A m e r i c a n s t r a v e l abroad. T h e y v e n t u r e offto e x p l o r e a n d discover new c u l t u r e s a n d customs. However, w h i l e m o s t t r a v e l e r s h a v e carefully p l a n n e d t h e i r t r i p , t h e y are not p r e p a r e d to d e a l w i t h an unexpected i l l n e s s or injury. They expect m e d i c a l services abroad to be c o m p a r a b l e to those a v a i l a b l e in t h e U.S. However, h e a l t h s t a n d a r d s v a r y g r e a t l y t h r o u g h o u t the world, a n d m a n y p a t i e n t s will benefit m e d i c a l l y a n d psychologically if t h e y receive care in t h e i r accust o m e d s u r r o u n d i n g s . The s u p p o r t a n d care of t h e i r families, friends, a n d p r i v a t e medical doctor can decrease t h e i r a n x i e t y and recove r y time. This type of s i t u a t i o n p r e s e n t s a c h a l l e n g i n g experience for aeromedical r e g i s t e r e d nurses,
respiratory therapists, physicians or mobile i n t e n s i v e care p a r a medics. Besides t h e a c t u a l c a r i n g for t h e p a t i e n t , m a n y d e t a i l s m u s t be a d d r e s s e d to e n s u r e a safe, smooth t r a n s p o r t . The m e d i c a l flight a t t e n d a n t m u s t w o r k closely w i t h t h e flight c o o r d i n a t o r to determ i n e t h e following: 1. F l i g h t d a t e 2. Mode of t r a n s p o r t - p r i v a t e airc r a f t or c o m m e r c i a l a i r l i n e carrier 3. F l i g h t t e a m 4. M e d i c a l e q u i p m e n t 5. C o o r d i n a t i o n of g r o u n d / a i r t r a n s p o r t services A f t e r t h e s e d e t a i l s h a v e b e e n discussed, a t h o r o u g h p r e f l i g h t s c r e e n i n g m u s t be done to minimize p r o b l e m s in a n o t h e r c o u n t r y t h a t could a b o r t t h e flight. Travel d o c u m e n t s such as p a s s p o r t s , visas a n d i m m u n i z a t i o n records m u s t be o b t a i n e d a n d in order. The m e d i c a l flight a t t e n d a n t should also a s k all traveling companions about any
E
Karen N. Bates, R N is Director of Nursing at Air Ambulance, Hayward, Calif.
"NEW TRENDS IN AEROMEDICAL CARE" PROGRAM TOPICS: • Modificationsof carefor long-rangetransports • Pulmonaryconsiderationsof highaltitudeexposure • Methodologiesfor measuringthe impactof care • Pediatricbonemarrowinfusion(Lab) • Safetystandardsfacts& fallacies • Aviationtrackingsystems Questions? Contact Rolando Reyes EMT-P (813) 873-1340 Endorsed By: National Flight Paramedics Association National Flight Nurses Association
Conference Sponsored by:
Second Annual Aeromedical Conference March 18-20, 1988 Orlando, Florida Nationallyrecognizedfaculty/exhibits& workshops/Continuingeducationunits [ I
i I
i l l
i
i
liil
i l i l i l i l i l l i l i i l l i
•
Name:
I•
I I I
i i i l i l
Address:
Title [] R.N. City _
_
I
I I I
i i
Ilill
lill
i
IJ
State _
_
Zip Code
~ EM,Z
! ~ M.D.
~ Other
l
I
Home Phone:
REGISTRATIONFEES
l •
Nurses, E,MT., Others $100.00 Physicians $150.00
el
Please charge my VISA/MASTERCARD
i
l i i l
AIR-CARE '88 CONFERENCE REGISTRATION FORM
Late Registration (After March 1, 1988) $130.00 $180.00
CARDNUMBER
l• l i
EXPIRATIONDATE
•
SIGNATURE.
[
*Detachand Mai• check •r credit card t•: Medica• & Safety TrainingSerVice•• P••• B•x 32••26• Tampa• FL 33679
I l i l I D U l I | R N N B I I R | N I I I I N N I B I I I R | R I I I I I I I I I R | R B R I N I i
12 JANUARY/FEBRUARY1988 AMJ
li~
I
p a s t m e d i c a l problems, c u r r e n t m e d i c a t i o n s a n d allergies. The poss i b i l i t y a l w a y s exists for a m e d i c a l e m e r g e n c y to a r i s e i n v o l v i n g a family m e m b e r a n d not, necessarily, the patient. The m e d i c a l flight a t t e n d a n t should r e v i e w i n f o r m a t i o n on t h e cultures, customs a n d c l i m a t e in t h e i r d e s t i n a t i o n country. P r o p e r c l o t h i n g should be t a k e n according to t h e t e m p e r a t u r e a n d customs. M a n y f o r e i g n e r s a r e often offended by t h e " c a s u a l A m e r i c a n . " Medical flight a t t e n d a n t s should be a w a r e of t h e s e a t t i t u d e s a n d p r e s e n t t h e m s e l v e s in a polite, p a t i e n t a n d d i p l o m a t i c manner. M o n e t a r y cons i d e r a t i o n s should be u n d e r t a k e n p r i o r to d e p a r t u r e . A l w a y s t a k e more cash t h a n you t h i n k you will need. M a j o r credit c a r d a r e h i g h l y r e c o m m e n d e d . The t r a n s p o r t t e a m should be a w a r e t h a t " t i p p i n g " customs m a y m e a n t h e difference b e t w e e n o b t a i n i n g a s s i s t a n c e or be ing ignored w h e n you l e a s t expect it. Commercial airlines vary with r e g a r d s to r e s t r i c t i o n s a n d accept a n c e s of p a s s e n g e r s . Some a i r l i n e s do not provide a s s i s t a n c e , while others allow p a s s e n g e r s r e q u i r i n g s t r e t c h e r s , oxygen, m o n i t o r i n g , etc. It n o r m a l l y r e q u i r e s t h r e e days to a r r a n g e a s t r e t c h e r on a commercial a i r carrier. S t r e t c h e r s are secured in special b r a c k e t s over t h e seats. The m e d i c a l flight a t t e n d a n t m u s t be a w a r e of t h e s t r e t c h e r locat i o n in order to a r r a n g e for on a n d off l o a d i n g of t h e p a t i e n t . A hanging IV is allowed on c e r t a i n a i r l i n e s a n d p r o h i b i t e d by others. K n o w i n g t h e airline's policies b e f o r e h a n d will help m a k e t h e coord i n a t i o n of t h e flight go smoother. These c o n s i d e r a t i o n s a r e only %he tip of t h e iceberg." I n t e r n a t i o n a l t r a n s p o r t s a r e d e t a i l e d a n d timec o n s u m i n g - b u t r e w a r d i n g - for those involved: flight coordinators, m e d i c a l flight a t t e n d a n t s , r e f e r r i n g a n d r e c e i v i n g hospitals, p a s s e n g e r service r e p r e s e n t a t i v e s , t r a v e l agents, pilots, a n d t h e p a t i e n t ' s family members. In conclusion, careful p l a n n i n g is essential when assessing a patient for a n a e r o m e d i c a l t r a n s p o r t . As t h e n u m b e r of t r a v e l e r s will grow, so will t h e needs for m e d i c a l repatriation.
by Karen Bates, RN
Care of the Patient Abroad v e r y year, m i l l i o n s of A m e r i c a n s t r a v e l abroad. T h e y v e n t u r e offto e x p l o r e a n d discover new c u l t u r e s a n d customs. However, w h i l e m o s t t r a v e l e r s h a v e carefully p l a n n e d t h e i r t r i p , t h e y are not p r e p a r e d to d e a l w i t h an unexpected i l l n e s s or injury. They expect m e d i c a l services abroad to be c o m p a r a b l e to those a v a i l a b l e in t h e U.S. However, h e a l t h s t a n d a r d s v a r y g r e a t l y t h r o u g h o u t the world, a n d m a n y p a t i e n t s will benefit m e d i c a l l y a n d psychologically if t h e y receive care in t h e i r accust o m e d s u r r o u n d i n g s . The s u p p o r t a n d care of t h e i r families, friends, a n d p r i v a t e medical doctor can decrease t h e i r a n x i e t y and recove r y time. This type of s i t u a t i o n p r e s e n t s a c h a l l e n g i n g experience for aeromedical r e g i s t e r e d nurses,
respiratory therapists, physicians or mobile i n t e n s i v e care p a r a medics. Besides t h e a c t u a l c a r i n g for t h e p a t i e n t , m a n y d e t a i l s m u s t be a d d r e s s e d to e n s u r e a safe, smooth t r a n s p o r t . The m e d i c a l flight a t t e n d a n t m u s t w o r k closely w i t h t h e flight c o o r d i n a t o r to determ i n e t h e following: 1. F l i g h t d a t e 2. Mode of t r a n s p o r t - p r i v a t e airc r a f t or c o m m e r c i a l a i r l i n e carrier 3. F l i g h t t e a m 4. M e d i c a l e q u i p m e n t 5. C o o r d i n a t i o n of g r o u n d / a i r t r a n s p o r t services A f t e r t h e s e d e t a i l s h a v e b e e n discussed, a t h o r o u g h p r e f l i g h t s c r e e n i n g m u s t be done to minimize p r o b l e m s in a n o t h e r c o u n t r y t h a t could a b o r t t h e flight. Travel d o c u m e n t s such as p a s s p o r t s , visas a n d i m m u n i z a t i o n records m u s t be o b t a i n e d a n d in order. The m e d i c a l flight a t t e n d a n t should also a s k all traveling companions about any
E
Karen N. Bates, R N is Director of Nursing at Air Ambulance, Hayward, Calif.
"NEW TRENDS IN AEROMEDICAL CARE" PROGRAM TOPICS: • Modificationsof carefor long-rangetransports • Pulmonaryconsiderationsof highaltitudeexposure • Methodologiesfor measuringthe impactof care • Pediatricbonemarrowinfusion(Lab) • Safetystandardsfacts& fallacies • Aviationtrackingsystems Questions? Contact Rolando Reyes EMT-P (813) 873-1340 Endorsed By: National Flight Paramedics Association National Flight Nurses Association
Conference Sponsored by:
Second Annual Aeromedical Conference March 18-20, 1988 Orlando, Florida Nationallyrecognizedfaculty/exhibits& workshops/Continuingeducationunits [ I
i I
i l l
i
i
liil
i l i l i l i l i l l i l i i l l i
•
Name:
I•
I I I
i i i l i l
Address:
Title [] R.N. City _
_
I
I I I
i i
Ilill
lill
i
IJ
State _
_
Zip Code
~ EM,Z
! ~ M.D.
~ Other
l
I
Home Phone:
REGISTRATIONFEES
l •
Nurses, E,MT., Others $100.00 Physicians $150.00
el
Please charge my VISA/MASTERCARD
i
l i i l
AIR-CARE '88 CONFERENCE REGISTRATION FORM
Late Registration (After March 1, 1988) $130.00 $180.00
CARDNUMBER
l• l i
EXPIRATIONDATE
•
SIGNATURE.
[
*Detachand Mai• check •r credit card t•: Medica• & Safety TrainingSerVice•• P••• B•x 32••26• Tampa• FL 33679
I l i l I D U l I | R N N B I I R | N I I I I N N I B I I I R | R I I I I I I I I I R | R B R I N I i
12 JANUARY/FEBRUARY1988 AMJ
li~
I
p a s t m e d i c a l problems, c u r r e n t m e d i c a t i o n s a n d allergies. The poss i b i l i t y a l w a y s exists for a m e d i c a l e m e r g e n c y to a r i s e i n v o l v i n g a family m e m b e r a n d not, necessarily, the patient. The m e d i c a l flight a t t e n d a n t should r e v i e w i n f o r m a t i o n on t h e cultures, customs a n d c l i m a t e in t h e i r d e s t i n a t i o n country. P r o p e r c l o t h i n g should be t a k e n according to t h e t e m p e r a t u r e a n d customs. M a n y f o r e i g n e r s a r e often offended by t h e " c a s u a l A m e r i c a n . " Medical flight a t t e n d a n t s should be a w a r e of t h e s e a t t i t u d e s a n d p r e s e n t t h e m s e l v e s in a polite, p a t i e n t a n d d i p l o m a t i c manner. M o n e t a r y cons i d e r a t i o n s should be u n d e r t a k e n p r i o r to d e p a r t u r e . A l w a y s t a k e more cash t h a n you t h i n k you will need. M a j o r credit c a r d a r e h i g h l y r e c o m m e n d e d . The t r a n s p o r t t e a m should be a w a r e t h a t " t i p p i n g " customs m a y m e a n t h e difference b e t w e e n o b t a i n i n g a s s i s t a n c e or be ing ignored w h e n you l e a s t expect it. Commercial airlines vary with r e g a r d s to r e s t r i c t i o n s a n d accept a n c e s of p a s s e n g e r s . Some a i r l i n e s do not provide a s s i s t a n c e , while others allow p a s s e n g e r s r e q u i r i n g s t r e t c h e r s , oxygen, m o n i t o r i n g , etc. It n o r m a l l y r e q u i r e s t h r e e days to a r r a n g e a s t r e t c h e r on a commercial a i r carrier. S t r e t c h e r s are secured in special b r a c k e t s over t h e seats. The m e d i c a l flight a t t e n d a n t m u s t be a w a r e of t h e s t r e t c h e r locat i o n in order to a r r a n g e for on a n d off l o a d i n g of t h e p a t i e n t . A hanging IV is allowed on c e r t a i n a i r l i n e s a n d p r o h i b i t e d by others. K n o w i n g t h e airline's policies b e f o r e h a n d will help m a k e t h e coord i n a t i o n of t h e flight go smoother. These c o n s i d e r a t i o n s a r e only %he tip of t h e iceberg." I n t e r n a t i o n a l t r a n s p o r t s a r e d e t a i l e d a n d timec o n s u m i n g - b u t r e w a r d i n g - for those involved: flight coordinators, m e d i c a l flight a t t e n d a n t s , r e f e r r i n g a n d r e c e i v i n g hospitals, p a s s e n g e r service r e p r e s e n t a t i v e s , t r a v e l agents, pilots, a n d t h e p a t i e n t ' s family members. In conclusion, careful p l a n n i n g is essential when assessing a patient for a n a e r o m e d i c a l t r a n s p o r t . As t h e n u m b e r of t r a v e l e r s will grow, so will t h e needs for m e d i c a l repatriation.