Love to Travel?.

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Presentation transcript:

Love to Travel?

Issues… What type of travel? Fitness to Fly How do you help prevent illness? What if you do get ill? What if you’re called to help?

Think about insurance… EHIC http://www.ehic.org.uk/ Check cover depending on trip

Fit to fly?

Getting ill on board a flight…. Anyone been there???

Why are there restrictions on people flying?

Can I fly? I had my appendix out 6 days ago? My husband had a heart attack when he was on a business trip. When can he fly home? Dad’s got COPD, we’d like to take him on holiday to get some sun as he’s getting down. Is it ok? My son has got epilepsy: is it ok to go on holiday?

Can I fly? My 3 year old’s got a rash, we’re going on holiday to Lanzarote in 2 days. It’s chicken pox. I’ve got anaemia from MDS, it’s not going to get better. I really want to go and see my sister in America as she’s dying. It might be the last time.

Can I fly? I broke my arm snowboarding I’ve got diabetes, what do I do with my insulin? My son is allergic to peanuts, he should be ok shouldn’t he? I’m pregnant Last time I flew I had a real problem with my ears…

Can I fly? I’m on holiday here, I’ve just had a DVT… I feel ok when can I fly home? I had a dvt after my pregnancy last year: do I need any special precautions? I’ve got a colostomy I’ve got an implanted defibrillator: is there a problem with the security machines?

Things to consider to take with you

Things to consider to take with you Normal meds, General analgesics Bite avoidance ?antimalarials ?Sterilising tabs ?antibiotics ?anti diarrhoeals contraception : think STD/HIV ?IV kit

Immunisations/Malaria Changing recommendations: always look at current http://www.fitfortravel.scot.nhs.uk Pulse charts

High Altitude -High Altitude: 1500 - 3500 m (5000 - 11500 ft) -Very High Altitude: 3500 - 5500 m (11500 - 18000 ft) -Extreme Altitude: above 5500 m Unlikely to be a problem <2,500m (8,000ft)

Normal changes at altitude

Normal changes at altitude Hyperventilation (breathing faster, deeper, or both) Shortness of breath during exertion Changed breathing pattern at night Awakening frequently at night Increased urination (Periodic breathing)

AMS Headache + 1 or more of Loss of appetite, nausea, or vomiting Fatigue or weakness Dizziness or light-headedness Difficulty sleeping

HA Cerebral Oedema confusion, changes in behavior, or lethargy. Ataxia Happens when ascend with preexisting AMS. Severe, life-threatening hours or 1-2days

HA Pulmonary Oedema Extreme fatigue Breathlessness at rest-Fast, shallow breathing Cough, possibly frothy or pink sputum Gurgling or rattling breaths Chest tightness, fullness, or congestion Blue or gray lips or fingernails Drowsiness

Prevention If possible, you should spend at least one night at an intermediate elevation < 3000m above 3000 m (10,000 ft), sleeping elevation should not increase > 300-500m m (1000-1500 ft) per night. Every 1000 m (3000 ft) spend a second night at the same elevation. "climb high, sleep low".

Medication/Prophylaxis for persons on forced rapid ascents (e.g. flying into Lhasa, Tibet, or La Paz, Bolivia), for climbers who cannot avoid a big altitude gain due to terrain considerations, for rescue personnel on a rapid ascent for persons who have repeatedly had AMS in the past

Acetazolamide (Diamox®) 125-250 mg (depending on body weight; persons over 100 kg (220 lbs) should take the higher dose) BD starting 24 hours before ascent, and discontinuing after the second or third night at the maximum altitude

Treatment Mild: simple analgesia Don’t go higher (acclimatisation 24-48h) Acetazolamide hastens acclimatisation (250mg bd) Dexametasone 4mg x 2 6h apart (symptoms helped rapidly but doesn’t speed aclimatization) (12-20mg if HACE/PE) O2 (if available: usu for severe)

Treatment GOLDEN RULE I: If you feel unwell at altitude it is altitude illness until proven otherwise. GOLDEN RULE II: Never ascend with symptoms of AMS. GOLDEN RULE IIIIf you are getting worse (or have HACE or HAPE), go down at once.