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Landslide Volcanic Eruptions in Costa Rica

by Lux Joseph 23. March 2015

Costa Rica is normally a hot spot for tourism, with it’s tropical weather and lovely tourist destinations, but if you were thinking of going there on vacation any time soon, you might want to travel with caution. Approximately 43 miles east of San Jose, the capital of Costa Rica, is a slumbering giant, the volcano Turrialba. Or at least it was sleeping. Recently, on Thursday, March 12th, this massive volcano awoke with an eruption of smoke and ash that spewed up to a height of one kilometer (around 3,280 ft) into the air from the top of the volcano.

This latest eruption has been Turrialba’s largest in two decades, with the last eruption having been in 2010. Four explosions were heard as the volcano spit out large plumes of ash. Those living close to the volcano were evacuated, as the main roads and four schools in close proximity where closed. The ash traveled out, reaching as far as San Jose itself, including the Tobias Bolanos airport. The ash made the runways slick and even interfered with visibility, leading to the temporary closing of the airport and over 100 delayed flights. Even the President of Costa Rica, Luis G. Solis was forced to cancel his diplomatic trip to Europe. Thankfully, the airport crew were able to clear out most of the ash next day, allowing the airport to reopen.

Although things seemed to calm down in the following days, the last explosion happening roughly around 8:00pm on March 13th, experts from the the National Seismological Network and the Volcanological and Seismological Observatory of Costa Rica continue to monitor the surrounding area, observing the seismic activity still occurring in the volcano. From their observations they’ve found that seismic activity is still occurring and while it seems that Turrialba may go back into a dormant state, they’re keeping on guard for any sudden changes. Costa Rica is currently in Yellow alert, ready to respond if needed, and tourist are restricted from entering the national park.

CME recently moved two patients out of San Jose, Costa Rica shortly after the explosion on the 13th. In situations like these, our safety and operations team do everything possible to ensure the safety of not only our patients, but our escorts is number one priority. When traveling via commercial airline or any aircraft, there is no telling what mother nature will present to us, but we do our best to be proactice and anticipate situations to the best of our ability.

Meet Patrick

by Lux Joseph 10. February 2015

When you are ready to be transferred back home, Patrick is ready to take you. Based in South Florida, Patrick joined CME with a wealth of knowledge and experience in emergency care for patients. We are fortunate to have him on our clinical team and wanted to give you the chance to know a little more about him today.

What is the most enjoyable part of this job: There is no place like home. When someone is sick or injured far from home the process of healing is compounded. The overwhelming joy these folks experience when they finally get home is the best reward. I've never experienced such sincere, heart felt gratitude as I have from these troubled travelers and their families, it can get pretty emotional.  

Where did you gain your experience and knowledge in the field of nursing: I've been a nurse for over 1/3 of a century. My background is ER and ICU. I've worked in major teaching hospitals like the trauma ER at The University of Pennsylvania and The National Naval Medical Center in Bethesda. I've also worked in small rural hospitals and did international relief work.  I've worked in large for profit facilities as well as local nonprofit and government hospitals. I've also had the good fortune to live and work in Thailand for 5 years, where I met my amazing wife. These varied experiences help me to adapt to most situations. 

What has been your most interesting transport? Why is that: All of my transports are interesting, each one with unique challenges. The most interesting was probably transporting a woman home who took ill while on a family cruise. She was facing a terminal illness and knew her time was short. She became very talkative during our trip and told me about her life, a very interesting story involving multiple continents, the golden age of Hollywood and how proud she was of her very talented children. She didn’t say but it was my belief she may have told me things she had never told anyone else, even her family. Her family contacted me just a few days after I got her home to tell me she passed away at home with her children at her side. It was what she had wanted and I was happy to have helped. 

What areas of expertise do you have experience in? Most of my experience is in the ER large and small. I have also worked in ICU, surgical ICU and CVICU.  

When you are not flying what do you do? I live in south Florida with my wife Pim. We like to ride bikes, explore the many waterways on our stand-up paddle boards and walk on the beach. We also travel yearly to visit with our extended family in Thailand. We always get travel insurance. 

What would you tell future clients of CME? First and foremost, get travel insurance. I've seen it work so well over and over again. Pay attention to local conditions and remain situational aware. Make copies of all of your travel documents and e-mail them to yourself. Most importantly have fun, put down your phones and tablets and enjoy yourself. If trouble comes, we'll come and get you. 

 Please describe a difficult trip and the outcome:  I performed an around the world transport. Miami, JFK, Istanbul, Toulouse, Frankfort, Seoul, Brisbane, LAX, Miami. 52 hours in the air over 6 days. Lay overs in airport infirmaries in Germany and Korea. 6 different lift trucks plane/deplane processes. The client had suffered multiple traumas, was on a stretcher, and required constant care. All transitions went without a hitch, the ground personnel where very helpful, the cabin crews on the different carriers were great. His family was very appreciative. “We were so afraid he would never get home again.” The client had a long recovery ahead of him but he was home with family and friends. It was a great experience.

 

 

 

Understanding the Tarmac Delay Rule

by Lux Joseph 18. January 2015

Every day we have nurses, physicians, and patients traveling to different parts of the world via commercial airlines.  We arrange travel for our clients on more than twenty airlines and in a single day we can have more than ten transports occurring simultaneously.  With this data, one can only imagine the number of delays that can occur since we are using commercial airlines. It is one of the challenges CME and other medical escort companies face however; it is one challenge that cannot be avoided. Sky Cap Corp, our in-house travel department, works tirelessly to ensure appropriate connection times for our escorts and patients, but one can never tell what type of delay may occur on daily basis due to weather, mechanical, air traffic, or even a strike by an aviation union. CME is fortunate that Sky Cap Corp is continuously monitoring our flights to ensure seamless transfers and if a delay is going to affect a transport a backup plan is in place.
 
If you are traveling alone or made your own arrangements you may be left out in the cold “figuratively speaking” in an event of a delay or cancelled flight. As a passenger it is important for you to understand your rights and what airlines are and are not responsible for. Recently the Transportation Department fined Southwest Airlines $1.6 million dollars for violations of the tarmac delay rule that occurred during a snowstorm in January 2014. But do you know that the tarmac delay rule is and what rights you have?


The Office of the Assistant General Counsel for Aviation Enforcement and Proceedings issued an announcement in 2011 that outlined the tarmac delay:
 
A reportable tarmac delay is a tarmac delay at a large, medium, small, or non-hub U.S. airport that lasts for more than three hours. The 3-hour limit begins when passengers no longer have the option to get off of the aircraft, which usually occurs when the doors of the aircraft are closed. However, if an aircraft is at the gate with the doors open, and passengers are not allowed off the aircraft, the time limit would start at the point when passengers were no longer permitted to deplane. If the flight that experienced the reportable tarmac delay is reported under the Airline Service Quality Reports required by 14 CFR Part 234, the data for that flight should be reported under Part 234 instead of Part 244.
 
In the final rule, we state that covered carriers should file Part 244 reports for any reportable tarmac delay of “three hours or more.” This standard is inconsistent with the tarmac delay contingency plan requirements under Part 259 and the existing reporting requirements of the Department’s Bureau of Transportation Statistics (BTS), both of which use a “more than three hours” standard. We intend to correct this inconsistency in a future rulemaking to make it clear that carriers do not need to file a report for a tarmac delay of exactly three hours. In the meantime, as a matter of enforcement policy, we will accept reports under Part 244 that meet the “more than three hours” criteria. For additional information, please refer to BTS Accounting and Reporting Directive No. 303A, issued on August 12, 2011.
 
Europe has a similar policy in place in regards to tarmac delays as well. Keep in mind though, delays due to weather does not require the airline to provide any particular compensation to passengers affected by weather related delays. Within the European Union, if a plane is boarded and sits on the tarmac for more than five hours, passengers will have the right to demand to be let off. If the tarmac delay is more than an hour, the airline must provide air conditioning, use of toilets and water.
 
In reference to recent events surrounding the Ebola virus the tarmac rules do not apply. In the event that a passenger on board an aircraft is suspected to have Ebola or another serious contagious virus or illness, passengers may be held on the plane to ensure health and safety policies are followed. No fines will be assessed to the airline. A safety relation or security related reasons are the only incidents that may exempt an airline from the hefty fine.
 
In the recent incident with Southwest, the assessed fine was much higher than previous incidents recorded by the DOT. The DOT advised this was due to the large number of passengers and flights that were affected. Southwest claimed that is was due to a shortage in staff, and the DOT advised there should be an appropriate amount of staff available as a contingency plan in the future to prevent this from happening again. Weather was a factor in this particular incident, but the DOT is making it very clear that they are serious about their rules and regulations. Southwest’s fine was more than the total amount of fines that have been issued since 2009 (5.24 million).
 
As a passenger on a commercial airline it is critical to understand that the tarmac delay rules don't just impact what happens when you're onboard a flight that's stuck at the gate. Airlines are required to post flight delay information on their websites for every domestic flight. You can even visit www.flightaware.com to see the statistics of on time arrival for a particular flight. You can compare delay trends flight-by-flight (and airline by airline) to lessen your chances of a lengthy delay.
 
If you are subject to a tarmac delay, we encourage you to call the airline or check their website to get information on filing a formal complaint. To learn more about the new federal tarmac delay rules, visit http://airconsumer.dot.gov/, the official site of the U.S. Department of Transportation Office of Aviation Enforcement and Proceedings.


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