Feature
Medical Emergencies on Vacation
A little planning now might avert a disaster down the road
SOME TIME AGO, when I was about to set off on a month-long family road trip, I suddenly realized I did not have a copy of my current vision prescription. My glasses were expensive, and if they wound up broken or misplaced on our trip, my only extra pair were tinted as sunglasses.
A quick trip to my optician solved this problem, but left me wondering what other, far more serious medical emergencies might occur on vacation — and how many of them could be avoided with a little pre-travel planning.
Just because we are nurses doesn’t mean we’re not as vulnerable to emergencies as anyone else. Like most people, I prefer to avoid thinking about potential catastrophes, but an ounce of prevention can prevent a truckload of disaster. After all, anything can happen on the road or in the air, from a twisted ankle to a heart attack.
Research Your Destination
For travel abroad, it’s important to be aware of potential health concerns in the specific area. Check with the CDC website and the U.S. embassy or consulate to see if there are any advisories that apply to the region where you’ll be traveling. For instance, in Costa Rica, malaria is endemic in certain low-lying areas, but not in the mountains.
In some cases, you may need to update your vaccinations before traveling. Keep in mind that some inoculations (such as hepatitis A vaccine) must be administered several weeks in advance.
If you or the people you’ll be traveling with have chronic or serious health conditions, consider researching medical facilities in the vicinity of your destination. This may not be practical if you’ll be constantly on the move, but if you will be in a specific area for several days or more, this research may pay off in an emergency. Good modern travel guides often include such information, and embassies and consulates may have recommendations about local healthcare.
If you will be traveling as part of an organized group, such as a bus tour, ask the organizers what provisions they have for medical care and emergencies. Some organizations, like cruise lines, usually have their own medical facilities
Prescriptions & Medical History
Before your trip, be sure you have an adequate supply of any prescription medications you may need. Keep them in their original containers, or you may have some uncomfortable moments with the TSA, customs officials, and local police! Labels should include the generic name of each drug. The same drugs are often sold under different names in different countries.
Make a complete list of your medications, along with the name and contact information of your primary care provider and any vital medical information. Doctors looking after you at a facility far from home will have a much easier time diagnosing and treating you if, for instance, they know that you take a blood thinner, have a history of asthma, or are diabetic.
Some people wear wristbands or dog tags stating that they are allergic to penicillin or codeine, or that they have a rare blood type, a stent, or an artificial heart valve. Such information should also appear on your medical information list.
Although it might be tempting to store this information on your smartphone, you should also print it on a card you can carry in your pocket, wallet, or purse. In an emergency, your phone could be lost or broken, or you might be in no position to access it!
Personal First Aid Kit
Next, put together your own first aid kit. Always carry aspirin or ibuprofen, anti-diarrhea medication, and a small assortment of bandages. Depending on where you’re going, motion sickness pills, aloe for sunburns, and antihistamine for mild allergic reactions might be good investments.
Even if you’re traveling to someplace with plenty of shops, bringing your own supply of over-the-counter medications may save you a lot of discomfort. If you have a bad reaction to something you ate, the last thing you’ll want to do is comb through a foreign shop full of unfamiliar brand names to find relief.
If you don’t speak the language well, get yourself a small dictionary or phrase book. In many parts of the world, doctors often speak at least some English (and may have studied in North America or Europe), but nurses and hospital staff may not speak any English.
Review Your Health Insurance
Going on a trip even within the U.S. is a good time to check the fine print on your health insurance and find out what provisions it offers for care outside your normal area. If your coverage is limited to in-network providers, the answer may be “not much.”
It is often a good idea to buy additional travel health coverage before traveling abroad. A web search can direct you to companies that provide insurance for travel emergencies.
Some travel health plans include air ambulance coverage to medically evacuate a patient. The latter is especially important if you are planning to visit an area where medical care may be limited or inadequate.
Some high-limit credit cards include coverage for out-of-country medical expenses or even transport home in an emergency. Ask your credit card company what travel services they offer.
The Pharmacy Is Your Friend
In many parts of the world, pharmacists routinely provide primary diagnostic care and advice. Going to a pharmacy may save time, money, and hassles for travelers.
Pharmacists in some countries can prescribe drugs on the spot and even administer injections, avoiding the need for a doctor’s appointment. Some can also treat conditions such as respiratory infections, cuts, and skin problems.
On the final day of a trip to Greece, my teenage daughter developed vomiting and diarrhea. Anxious to ensure that she was well enough to travel home, I located a nearby pharmacy. Although the druggist spoke a little English, I mimed my daughter’s symptoms to him and he sold me Lomotil over the counter, as casually as if it were aspirin. It alleviated the symptoms enough for her to make the flight home and see our family doctor.
Finding a Hospital
An ambulance may take a patient to whatever emergency room is closest in a non-life-threatening emergency such as a sprain or a possible fracture. For more serious conditions, it pays to ask locals to recommend a hospital. In many places, hospital quality varies greatly. Some hospitals may be more accustomed to treating tourists — and more likely to have English-speaking staff members.
Remember, just because hospitals are located overseas doesn’t mean they are automatically inferior to U.S. facilities. In this age of medical tourism, some may boast innovations that few stateside hospitals can match.
No one wants to anticipate disaster, especially on what’s supposed to be a fun vacation. How-ever, these simple precautions can help you avoid unnecessary stress in a time of crisis. Travel well, but travel in good health!
“Your Husband Was Taken to the Hospital”
A Medical Nightmare in Portugal
YEARS AGO, ON A TRIP to Lisbon, Portugal, I returned to our hotel after running an errand, only to discover that my husband was no longer in the lobby, where he had been waiting for me. “Oh, by the way,” said the clerk, “your husband was taken to the hospital.”
In an instant, a carefree holiday turned into a real-life nightmare. Since my husband was in good health, his sudden collapse in the hotel lobby was the last thing either of us expected.
I spoke not a word of the language, but, clutching my English-Portuguese phrase book, I made my way through narrow cobblestone alleys to the hospital — a massive, ancient stone structure where anxious, black-clad families wandered through the corridors.
I finally found my husband in the emergency room, where the English-speaking doctors were kind and attentive. Although various blood tests, an electrocardiogram, and a chest X-ray all appeared to be normal, they suspected cardiac problems and kept him overnight before releasing him with two prescriptions. “Go home,” they told us.
AS A NURSE, I WAS DISMAYED by the standard of care my husband received. The X-ray film quality was so poor the doctor could not read it. The needles used were not disposable. Although the doctors assured me they had tested for cardiac enzymes, I began to have my doubts. Also, my husband wasn’t allowed to keep his watch, glasses, or Portuguese phrase book with him overnight, which was quite a drawback, since the nurses didn’t speak English.
Then, there were the prescriptions, which turned out to be completely inappropriate. Not only was my husband’s blood pressure abnormally low, his pulse dropped alarmingly to 46 after taking just one of the prescribed pills. I quickly discarded them once I realized they were actually for hypertension.
WE GOT BACK TO THE STATES the next day. My husband felt tired and occasionally short of breath. Two weeks later, he underwent a quadruple coronary bypass, fortunately with excellent results.
This probably wasn’t a situation that we could have avoided through preparation or planning. My husband’s trip to that hospital was a surprise medical emergency, and while our language barrier didn’t help, even being fluent in Portuguese wouldn’t have prevented the litany of medical errors.
There will always be some disasters you can’t avoid — which is all the more reason to try to mitigate the ones you can.
DIANE BARNET, RN, is a legal nurse consultant and author of What You Need to Know About Hospitals.
