The Ticadoc Journey Management Toolkit is designed to provide you information resources on what you will need to consider in preparing for your overseas (or local) journey.
It may assist you in the following phases of your planning and travel:
- Phase 1: Research & Preparation. Clinic/Doctor/Hotel/Airline
- Phase 2: Transit & Travel. Home to Location
- Phase 3: Treatment. Hospital or Clinic
- Phase 4: Rest & Recovery. Hotel
- Phase 5: Transit & Travel. Location to Home
Inflight Travel Risks
For either an Existing Medical Condition or Post Surgery-Treatment
Airline travel has some unique features that must be considered by Medi-Travelers – either travelers with an existing medical condition or travelers that have received surgery or treatment overseas.
Always discuss these issues with a medical professional to ensure that the risk to your health is minimized when travelling by air. Airlines also have certain timeframe restrictions that may apply according to the state of your physical condition.
Key issues that must be considered include:
- Reducing the amount of oxygen in flight
The cabin oxygen content in flight is 25~30% lower than on the ground. If you have heart/lung disease or anemia, supplemental oxygen may be required during your flight. A passenger travelling within the first 2 weeks of having a stroke or having a Hemoglobin level (that is less then 9.5g/dl) should make sure that they receive supplementary oxygen in flight.
- Reduced atmospheric pressure in flight
Cabin air pressure changes greatly during take-off and landing and gas expansion and contraction can cause pain and pressure effects. Allow at least 10 days after major abdominal surgery and 7 days after full inflation of a collapsed lung (14 days after inflation for partial lung collapse).
- Turbulence in flight
Spinal disease may be worsened by sudden turbulence and from the impact of landing. If a patient cannot sit in a normal seat for more than 2 consecutive hours but can sit upright during take-off and landing, please use prestige/business class. If you cannot sit upright at all you will need to find an airline that can provide a stretcher for your travel.
- Absence of advanced medical care in flight
Cabin attendants are generally not allowed to provide special assistance to specific passengers if that assistance is in any way harmful to, or disregards service to other passengers. Additionally, most Cabin Attendants are trained only in first aid and are not permitted to administer any injection, or to give medication.
- Deep vein thrombosis in flight
A passenger who has a history of cancer and trauma, is elderly or has recently had surgery may be at increased risk of deep vein thrombosis because of sitting immobilized in a cramped seat with low humidity. So, please consider antithrombotic prophylaxis (drugs that act to reduce blood clot formation).
As a Medi-Traveler, ensure that you review the following ‘prompt points’ to assess how prepared you are for all phases of your travel and that you have considered all contingencies.
- Transit Booking Verified: Taxi/Shuttle/Train etc.
- Flight Details Verified: Airline
- Airport Requirements Verified: Parking/Check In/Luggage Assistance
- Accommodation Details Verified: Hotel or Apartment
- Car rental Details Verified: Airport Locations etc.
- Ground Transport: Shuttle, Rail, Taxi & Specifications (disabled?)
- Hotel Booking Verified: Consider Room Type or Facilities
- Medical Facility Booking Verified: Hospital or Clinic
- Disabled/Mobility Restricted Yes/No. If Yes then consider which Wheelchair category-Categories you might fall into:
- WCHR — can climb steps/walk cabin
- WCHS — unable steps/can walk cabin
- WCHC — immobile
- You should advise your airline of your category and complete Clearance Forms, see the Link section for your airline.
- Have you checked Country Safety information such as your governments travel advisory? (Smartraveller/Dept. of State etc.)
- Have you registered your Travel with your Government?
- Passport. You should have at least six months of validity on your passport or travel document if traveling internationally.
- Visas. Ensure that you know the visa requirements for the countries to which you plan to travel. If you need a visa, ensure that you leave plenty of time to apply for and receive your visa. If you previously received a visa for the country to which you will travel, you will need to make sure that it is still valid as most visas have an expiry date as well as a requirement to enter the country within a certain number of days from the issue of visa.
Things You Will Probably Need!
- Foreign Currency (check availability). Are credit cards readily accepted in places like taxis? Can you withdraw cash from ATMs? Do you have enough local currency with you when you land to at least take a taxi and buy a bottle of water?
- Credit Card (Bank notified of travel arrangements for fund clearance). You don’t want to make your first credit card transaction and then have your bank promptly suspend your card for an out-of-the-ordinary foreign transaction!
- Consulate Details. Write down the contact details of your consulate in your country of travel.
- Insurer Details. Make sure that you have insurance that covers your purpose of travel and then write down the details of your policy including phone numbers. Don’t store all this information on your phone because if you are going to lose anything on your trip it’s most likely to be your phone! (so make sure you have a screen lock enabled on your phone)
- Emergency Numbers (both professional and family)
- Medical Referrals (for treatment phase)
- Pharmaceutical Medicines (for recovery phase. Make sure that you carry your prescriptions with you and also a letter from your doctor if you are required to take any liquid medicines in-flight or if you are going to have to carry prescription medicines across international borders.)
- Headphones/Ear Plugs
- Hotspot/portable internet
- Chargers (all items)
- International Adaptors
- Sleep Mask
- Neck Pillow
- Hand sanitizer
Traveling for medical treatment, or with a medical condition is a big thing! Review the following ‘prompt points’ to assess how prepared you are for all phases of your surgery/treatment and recovery phases.
Medical Facility Details
Write down the details of the facility in which you will be treated and provide that information to trusted friends or relatives at home and also to the hotel that you will stay in before or after your treatment.
- Hospital/Clinic Name & Address
- Hospital/Clinic Telephone & Email
As above, make sure that key people at home and in your country of treatment know who is medically looking after you. It is critical that you let your Hotel know these details so that they know who to contact in the event that they need to contact your medical professional in the case of any issues arising.
- Treating Doctor Name
- Treating Doctor Contact (business hours)
- Hospital/Doctor Emergency 24/7 Contact/s
- I.D. Nurses/Aids for your Treatment
- Know names of other key treating and support staff
Of course the ideal situation is for you to view and inspect the facility in which you will receive medical treatment first hand. If you are traveling internationally then this is not always possible – although we always recommend you do so before checking in for your treatment.
If you can’t physically inspect the medical facility then ensure that you make your wishes with regard to the location of your room (no steps if you are in a wheelchair) or the nature of the room (is it a private room or are you sharing with others) very clear to the facility in writing.
It’s also a good idea to give your travel companion a list of things to check once you come out from your treatment – it’s always nice to have someone else dealing with issues and administration on your behalf if you have just come out from a lengthy medical procedure. This is why almost 80% of Medi-Travelers have a companion with them for their journey.
Things that your companion should check:
- Ensure room and location is appropriate (as per your instructions)
- Ensure room is hygienic.
- Ensure all facilities work (Call button/Air con/TV/Bed etc)
- Ensure hand sanitizer and hand washing facilities are available
- Pre Wipe your Room on all ‘high contact’ surfaces (anti-bacterial wipe TV remotes/Table Tops/Bed Sits/Chairs etc) *Special note: 75% of patients rooms are contaminated with bacteria that can cause staph infections.
- That you have clean water for constant hydration (2 x litres per day min)
Master Medication List
Ensure that a full list of medications is available for all stages in your recovery phase including the following:
- Drug Name
- Prescribing Physician
- Dosage at each stage
- Reason for Consumption
- Details able to be translated?
- Knowledge of your medication schedule
- Ensure your details are checked by staff prior to any medication (via your hospital/clinic in room chart or hospital wrist bracelet)
- Your hospital bracelet should be checked each time you are given any medication.
- Ensure the ‘5 Rights’ are followed:
- Right schedule (time),
- Right medication/drug
- Right dosage
- Right route (IV/oral/injection/topical)
- Right Patient
- Ensure medications are prepared/monitored post discharge
- Ensure generic medication names are understood (potentially different from your country of origin), examples are as follows:
- Advil/Motrin = ibuprofen
- Aleve = naproxen
- Antacids = calcium carbonate, aluminum hydroxide or magnesium hydroxide
- Bayer, others = aspirin
- Benadryl = diphenhydramine
- Bonine = meclizine
- Dramamine = dimenhydrinate– Pepto-Bismol = bismuth subsalicylate
- Imodium = loperamide
- Tylenol/Excedrin = acetaminophen
Perhaps you have some religious or spiritual requirements that you need to have catered for during your stay in hospital? If so, find out at the time of booking if your chosen facility provides visitations options from faith based support personnel (Priest/Imam etc.) or prayer or meditation rooms. Is the there a Counsellor or counselling service available?
Ensure that the facility is going to take a daily journal of all of your treatments and condition/s and that this record will be available to you upon leaving the facility. You may require this for follow up medical visits upon your return to your home country or for future medical treatment.
Make sure that the records include a record of dates/times invasive devices removed (catheters etc.)
Prior to arriving at the medical facility for treatment, there are a number of things that you need to pre-plan with regard to your eventual discharge. Make sure that you have planned or discussed the following items:
- Discharge planning identified. What exactly will discharge involve? (other than a large amount of paperwork that will take longer to complete than you think)
- Execution of health care proxies/advance directives prepared
- Transport to Rest/Recovery Hotel pre-booked (ensure this is suitable for your condition i.e. not a taxi if you have a knee brace fitted)
- Rest/Recovery Hotel notified of arrival time/details
- Mobility restricted room & facility options prepared for/considered
- Correct Medical Clearance for airline travel prepared by treating Doctor
- Medical clearance for airport security (if required)
Ticadoc has prepared a number of global airport profiles that are available for review in our directory (search here). These airport profiles have been specifically designed to provide the following types of passengers with a range of detailed facility, contact and service options:
- Passengers with any (restrictive) pre existing conditions,
- Passengers with any (restrictive) post operative conditions,
- Disabilities or
- Mobility Restrictions
Ticadoc have researched fifty (50) separate information categories to assist Medi-Travelers prepare for entry and exit through these airports. These categories include:
- Airport Disability & Mobility Restriction Access
- Airport Location & Contact Details
- Airport Provider Responsibilities (their duties)
- What to do Prior to Your Arrival
- Accessible Parking Details- Availability & Disabled Options
- Details on Assistance to Disabled or Mobility Restricted Persons
- Mobility-Impaired: Precinct Security Restrictions you must Follow
- Transport Options [to & from] inc Disabled & Mobility impaired
- Assistance for Terminal Transfers
- Security Process for Disabled or Mobility Impaired
- Before you Arrive at a Security Screening Point (Preparations)
- What Happens once you Arrive at a Security Screening Point?
- Special Assistance Security Screening Practices
- Medical implants (Procedures if you Have One)
- Artificial limbs / Prosthesis
- Walking Aids
- Vision Impairment
- Carrying Medicines and Medical Tools-Requirements
- Carrying Biological (Medical) Materials-Procedures
- The Security Screening Process
- The X-Ray Machine
- Walk-through metal detector
- Body scanner
- Secondary Screening
- Pat down inspection
- Explosive Trace Detection
- Visually Impaired-Airport Terminals Options
- ATM’s & Banking Options (inc Visually Impaired)
- Visually Impaired Guide Dogs-Procedures
- Access to/from Aircraft-Overview
- Automatic Doors and Lifts-Options
- Chemist / Pharmacy Dispensaries-Availability
- Directory Boards-Availability
- Drinking Fountains-Disabled Options
- Emergency Response-Overview
- Flight Information Displays-Availability& Disabled Options
- International Flights and Border Security Areas
- Language Badges-Staff Use
- Medical Assistance-Availability & Options
- Meeting Point-Options
- Public Telephones-Availability & Disabled Options
- Ramp Ways-Options
- Retail & Food Outlet Facilities-Overview
- Toilet Facilities- Availability & Disabled Options
- Direct Assistance for Disabled or Mobility Impaired
- Airline Responsibilities
- People Movers- Availability & Disabled Options
Airline Discharge-Clearance Forms
Airlines provide these forms for travellers who have a medical, disability or mobility restricted condition for a number of reasons. These include to better provide you facilitation of your journey, to make it clear what information has to be exposed to them to manage you, and/or to meet local, international or industry regulations. It also ensures legal and risk management issues are met.
If you fit into one of these categories (for example you have received surgery or treatment overseas), you will be required to complete this documentation and return it to the airline (or relay this to your travel agent).
See Ticadoc’s following selection of Airline Discharge-Clearance Forms:
Austrian Airlines: https://www.austrian.com/~/media/01FF98933DFB4F6D85EB0A7952558A16.ashx
Caribbean Airlines: https://www.caribbean-airlines.com/assets/documents/MEDA_Form.pdf
Ethiopian Airlines: https://www.ethiopianairlines.com/AA/EN/book/specials/medical-travel-package
REX [Regional Express]: http://rex.com.au/FlightInfo/pdf/MEDICAL_CERT_FITNESS_TO_FLY.pdf
South African Airlines: https://www.flysaa.com/documents/…/7dfb4b29-c2ab-4944-a4e6-2e36dbf54fc2
SriLankan Airways: www.srilankan.com/a/plan-and-book/medical-information-form
Xiamen Airlines: https://www.xiamenair.com/en-us/passengerService/service3_1.html