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The After Treatment Medical Travel Guide you Always Wanted


Getting back to work soon after medical treatment abroad is important. Medical tourists generally find flying, a safe and convenient way to travel. However, patients must pay attention to certain conditions relating to air pressure and body posture on an airplane, which can aggravate the patient’s existing medical condition.
 

In an aeroplane, as the flying altitude increases there is a decrease in the atmospheric pressure. Also, there is a reduction in the amount of oxygen in the cabin.


Sometimes during flight, oxygen saturation levels can fall to around 90% from a required of 92% or greater, making it difficult for the patient to breathe. Though a healthy individual can withstand this fluctuation, a patient who has recently undergone medical treatment, like a cardiac or a respiratory surgery might face some problems like hypoxia. Hypoxia is a condition where the amount of oxygen reaching the tissues reduces which can lead to temporary memory loss, inability to move body or think. The severe symptoms can include coma, brain death,seizure, etc.
 

When patients travel back after a surgery, their body is under a lot of stress due to low immunity. Any additional exposure to bacteria and viruses during the travel can prove to be eminently dangerous.


Two other significant problems that passengers can face, while travelling after a recent surgery are Blood clot formation and Gas volume expansion.


1. BLOOD CLOT FORMATION

Half of those diagnosed with DVT end up having long term complications such as swelling, pain and discoloration.

 

Deep Vein Thrombosis (DVT) is a condition where a blood clot is formed in the leg or thigh. It usually happens due to coagulation as a wound heals and poor circulation of blood. DVT can cause damage to the valves in the veins around it, resulting in impaired blood flow. It can prove to be deadly when the blood clots breaks off and are free to travel. These blood clots can travel to the lungs and create a deadly blockage known as Pulmonary embolism.
 

Causes of DVT During Air Travel

 

  • Blood clots can be linked to immobility since circulation of blood slows down. Patients recovering from surgeries are always put on rest, however, sitting for longer durations in the same posture in a flight can increase the chances of clot formation for passengers who have had a recent surgery.
     
  • Dehydration also leads to clot formation as it causes blood vessels to narrow and blood to thicken. The low amount of humidity in the cabin can further contribute to dehydration.
     
  • Surgeries require the patient’s blood to be thick so as to avoid too much of bleeding during the process. This thickening of blood in the leg and thigh region can lead to the formation of blood clots.
     

Passengers at Risk
 

Some medical conditions that put the patient at risk of developing DVT are-
 

  • Surgery anywhere below abdomen

  • Cancer treatment

  • Heart or blood circulation related conditions

  • Any illness or surgery which has led to a long period of immobilization

 

2. GAS VOLUME EXPANSION

 

Pain, discomfort and possible damage to the tissues can be caused due to the trapped gas in the body while travelling in an aeroplane. This condition is known as gas volume expansion and it can lead to severe complications during the recovery of the patient.

 

Causes of Gas Volume Expansion

 

  • According to the Boyle’s law, pressure and volume of gas are inversely proportional to each other. Due to the decreased pressure in the plane while flying, the gas volume can increase.
     
  • There are several places in human body, like the middle ear, gastrointestinal tract and the lungs, where gas can accumulate and get trapped. During flying, the volume of the trapped gas increases, causing pain, discomfort and possible destruction of the surrounding tissues.
     

Passengers at Risk
 

Some medical conditions that put the patient at risk of gas volume expansion are-
 

  • Colonoscopy or any other medical process involving introduction of large amount of gas into the colon or intestines.
     
  • Neurosurgery; travel within 7 days can lead to a possibility of gas being trapped in the skull.
     
  • Retinal detachment, undertaking air travel without the recommendation of the doctor, as the surgery involves introduction of gas, so air travel can cause an increase in intraocular pressure which can even lead to permanent vision loss.
     
  • Abdominal surgery; travel is only recommended after 10 days as the gastrointestinal tract is prone to effects of gas volume expansion, which includes damage to the tissues already affected by surgery.


 

PREVENTIVE MEASURES

 

Patient should consult their doctor before planning their journey back to the home country. The increase in medical tourism has led to the emergence of new control systems and regulations to ensure the safety of patients during travel.


Airlines in some countries require a medical certificate confirming that a patient is currently stable and fit to fly. The British Medical Association (BMA) advises doctors to ‘word statements on a person's fitness to fly carefully, indicating the information on which the advice is based, rather than positively certifying a person's fitness'. This implies that the doctors should focus more on providing reasons for certifying that a person is fit enough to fly, to enable easy understanding of the patient's medical condition.

 

Some preventive measures that can be taken by patients to avoid complications during flight are given below.

 

  • It is advisable to walk and stretch as much as possible during the travel so as to avoid the formation of blood clot.
  • Patients are advised to wear compression stockings, which are designed to promote blood circulation in legs.
  • It is important to stay hydrated to ensure relaxed blood flow. But one should avoid caffeine, sugary drinks and alcohol as these drinks have a diuretic effect, that is, lead to dehydration.
  • Doctors usually prescribe some blood thinners to reduce the danger of blood clot formation. Patients should be careful about following such prescriptions.
  • Patients should avoid travelling for the maximum possible time after the surgery. If they have to, a thorough consultation with the doctor is a must.


 

FACILITIES ON AN AEROPLANE CATERING TO MEDICAL EMERGENCIES

 While travelling to medical destination, it is crucial to be well informed about possible complications, and the various facilities provided by airlines that can be helpful.
 

Airlines in the modern times are conscious about the needs of a patient and new norms by the aviation regulatory bodies have made travel after treatment a hassle free process.

 

Federal Aviation Administration (FAA) makes it mandatory for all American commercial airlines weighing 7,500 pounds or more to carry an automatic external defibrillator (AED) and an enhanced emergency medical kit. Also, the flight attendants are required to be CPR and AED certified every 2 years.

                   

The standard American commercial airlines kit includes a stethoscope, bag valve masks, syringes and intravenous catheters in a range of sizes, and commonly used medications. Flight attendants are trained to be familiar with the contents of the kit, and its seal is examined during every pre-flight check and restocked after it is used. For minor medical problems, a first aid kit is stocked separately.

 

A large number of Airlines use the services of medical emergency helplines. These 24 hour helplines are run by physicians. For eg - MedAire, The First Call, StatMD etc. If there is a medically trained passenger who is volunteering to attend the emergency, then they coordinate with the cabin crew and emergency helplines.

 

In the case of a medical emergency being out of control, the flight is landed on the nearest airport where the required medical facilities are available. The final decision to make an emergency landing rests with the pilot in command.


AIR AMBULANCE SERVICES


There are also many private Air Ambulance services available which have made it possible for the patient to have a surgery in the morning in some other country and sleep in their home in the night.  The patients can travel secure in the knowledge that they are receiving the same level of care as they would receive in any hospital.

 

These offer the benefit of convenience, safety, confidentiality and continuous care that cannot be obtained from commercial travel. Also allowing the patients to return home almost immediately after a procedure, enabling recovery and recuperation among family and friends, rather than in a strange and unfamiliar city.

 

It is advisable for the patients to select an air ambulance which is medically licensed and accredited. CAMTS (Commission on Accreditation of Medical Transport Systems) is the primary means of air ambulance accreditation in the United States. There are total 154 Air Ambulance services that meet the standards of CAMTS accreditation.

 

Licensed and accredited air ambulance in-flight medical teams have the education, training and experience to safely care for patients, no matter the condition, and to react to unforeseen circumstances or medical issues. These air ambulances include ventilators, monitors, cardiac equipment, medications and other supplies to ensure transportation is safe and comfortable.

 

There are cases where the patients cannot travel in commercial airlines and it becomes mandatory for them to use private air service for example medical conditions like Leukemia, lymphoma, congenital immunodeficiency or treatments, such as radiation and chemotherapy. Also, patients being treated for communicable diseases such as tuberculosis cannot travel in commercial airlines as there is a danger of other passengers being exposed to communicable diseases.
 

 

Published inMedical Tourism
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