Handling Medical Emergencies Abroad
It was a beautiful sunny day in Cancun, Mexico, last November when Cajya Darling awoke in her hotel room with a strange tightness in her chest, making it hard to breathe. The New Jersey native roused her husband, who went for help. “The doctor at the hotel gave me a nebulizer, but it didn’t work,” she recalls, “so I was taken to the hospital. After they did some tests they discovered that my right lung had collapsed.”
What happened from there was a nightmare. She was placed in the intensive-care unit, where she remained for nine days. “It was really scary,” she says. “No one spoke English. There was no TV, no clock, no windows. It was horrible.” Darling got to a Houston hospital thanks to Angel MedFlight, a medical flight company, and after a few days was able to return home—though got stuck paying tens of thousands of dollars in medical bills.
Unexpected illness is one thing. Avoiding serious injury is much more in a traveler’s control, says says Jeff Wise, Travel + Leisure contributing editor and author of the new book Extreme Fear: The Science of Your Mind in Danger. “Think about the kind of situation you’re going to be in, what the worst-case scenarios might be, and how you’d be able to respond if they occur,” he says. “It’s astonishing how many times you read cases about people surviving near-catastrophe in the wilderness, and its clear that they hadn’t given any thought to what they were doing, and how it might get them into trouble.”
Fortunately, there are plenty of steps travelers can take in advance of and during their travels to minimize the financial costs and emotional trauma that often accompany serious and unexpected illness or injury in foreign countries.
Some of these steps are incredibly simple, yet can save essential minutes if an emergency occurs. For example, how do you dial 911 in Mexico? What about Thailand? Also, always travel with your health information, so doctors can easily find your blood type, allergies, and any medications you’re taking.
Others options, like arranging for Medevac flights, are more complicated—and expensive. Read your health insurance policy carefully. “People often think they don’t have medical flight coverage in their insurance policy, but a lot of times they do and just don’t know it,” says Jeremy Freer, ceo of Angel MedFlight, based in Scottsdale, Arizona. “Read the Emergency Medical Services section of your policy.”
Like the Boy Scouts say, be prepared. And it doesn’t hurt to have a good insurance policy.
See your doctor before you go.
Make sure you are in sound shape for the kind of trip you’re planning. If you haven’t had a recent medical check-up, get one. If you plan any unusual or strenuous physical activities, tell your doctor. Are there any required or recommended vaccinations for your destination? Don’t wait until the last minute. According to the International Association for Medical Assistance to Travelers, you should receive any necessary vaccinations six to eight weeks before your departure.
Check your medical insurance.
Find out whether your policy provides sufficient coverage for medical bills and transportation while traveling. If it does not, buy a supplemental policy from an independent insurer. Also check with your credit card company; some offer referral services and even reimburse medical and emergency evacuation expenses.
Know when to seek medical care.
Learn about the quality of medical care in your destination before you go so you can make sound judgments about what kind of treatment the local medical community is capable of. Chances are good you wouldn’t want a blood transfusion in a Third World country except in a life-or-death situation. Get details in the Country Specific Information section of the State Department’s travel site.
Register your trip with the State Department.
Registration (do it online here) enables the nearest American Embassy to relay an urgent message from home or tell you about looming crises in your destination. If you contact the embassy in an emergency, the staff can get in touch with your friends and family back home as well as anyone traveling with you. They can provide you with a list of doctors, specialists, and hospitals in your destination. They may even be able to help with a transfer of funds from your account in the United States to pay medical bills.
Join a personalized international medical service.
International medical membership organizations will arrange for emergency case coordination, insurance claims assistance, legal help, and referrals to fully licensed English-speaking physicians overseas who will even make house calls to your hotel at reasonable fees. Get details from the International Association for Medical Assistance to Travelers, International SOS, and Travelers Emergency Network.
Know how to call for emergency service.
Carry your health information with you.
Sure, you know your blood type and that you’re allergic to bee stings. But what about medications you’re taking, previous surgeries, ongoing health issues, and other background information that might be crucial to a doctor giving you emergency treatment? It’s easy enough to forget these things at the best of times, even more likely if you’re agitated or incapacitated. Either write it down and carry with you (for an easy form you can fill out and print, go to www.cdihp.org), get a medical emergency bracelet, or store your information online at sites such as google.com/health or healthvault.com. Your data can now be accessed quickly by health-care providers.
Know your outfitter’s limitations.
“Backcountry outfitters are not health-care providers,” says Jeff Wise, Travel + Leisure contributing editor and author of Extreme Fear: The Science of Your Mind in Danger. Nor are safari Jeep drivers, tour guides, or other trip organizers, so don’t expect what they can’t offer. “Nevertheless,” says Wise, “let them know about any medical issues you might have, and make sure they know where your medicine is. Could save a lot of time when you drop in your tracks and turn blue.”
Request a medical escort.
When you’re not sick enough for medical evacuation but you’re too ill or injured to travel home alone, book a medical escort, usually a licensed nurse or paramedic. Escorts make all travel arrangements, monitor the patient’s vital signs in flight, and administer medications, I.V. fluids, and/or oxygen, as required. If your insurance doesn’t cover this service, expect to pay from $10,000 to $20,000.
Book an air ambulance.
Medevac flights by helicopter or air-ambulance flights by fixed-wing aircraft come at considerable cost—$20,000 and more within the United States, and as much as $100,000 or more from a foreign country. Read your health insurance policy carefully, and before you travel, look into a few evacuation services and have a number handy on your trip. After all, no one ever expects to need emergency evacuation, but it pays to know the number to call if you do.