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Disney World Implements a New Disability Policy

by Lux Joseph 11. October 2013

On a daily basis, CME is working with individuals with disabilities. Those individuals who have special needs and disabilities require special assistance from our team and we focus on delivering individualized quality service to meet those needs. As we have mentioned before, every traveler has different needs and we tailor each of our transports ensure their travel home is comfortable. Breaking news from the Walt Disney World Company this week was presented to those travelers with disabilities about a policy change at their theme parks and how those travelers will be affected in their upcoming visits.

Obviously this policy does not affect Commercial Medical Escorts, Inc. when we are transporting patients around the world, but I think it is important to recognize policies that are affecting the population that we assist each and every day. On Wednesday, Disney introduced a new policy for those travelers with disabilities to reduce the number of people that have been abusing the policy. Over the years numerous guests to the resort have hired tour guides that are disabled to go to the front of the line of every ride attraction. For those individuals with a disability, this seems reasonable and appropriate, but when people start faking a disability, utilizing crutches or other disability tools, or hiring a disabled tour guide to zip to the front of every line the policy gets abused. That is exactly what happened and Disney World is taking action and taking a firm position to address the situation.

It is a sad and disappointing situation for those travelers with true disabilities however, the Disney World Company believe they are effectively finding a solution. With any change to policies and procedures there will always be someone who is not satisfied with the result, but it is important for the resort to look at different perspectives and find the best system to assist the travelers with special needs. It may appear that the disabled travelers are being punished for actions completed by those who exploited the program, but at this time the program has only been in place for three days and I believe improvements will continue to take place with this program.

The new system is similar to the Fast Pass program that is currently in place for guests to return to an attraction ride at a later designated time to reduce the wait time in long lines. The new Disability Access Card will act similar to that program.  The Walt Disney World website outlines the program as the following:

The DAS Card is designed to accommodate guests who aren’t able to wait in a conventional queue environment due to a disability (including non-apparent disabilities). A Disability Access Service Card will be issued at Guest Relations main entrance locations and will offer guests a return time for attractions based on the current wait time. As soon as the Guest finishes one attraction, they can receive a return time for another. This service can be used in addition to Disney’s FASTPASS Service and Disney FastPass+ service. (www.disneypakrs.disney.go.com)

Everyone has their opinion about the program but the purpose of the program is to eliminate the abuse that the system has had over the years. Disney takes pride in ensuring that each guest is treated as an individual and providing assistance to those travelers with disabilities will always be a focus of the program. Each and every case will be handled by Disney on a case by case basis.

Commercial Medical Escorts takes the time to ensure our travelers with disabilities have a positive experience on their way home with our medical escort. From airline tickets, airport accommodations, ground transportation, and helping the patient get settled into their home/residence, CME takes time to make sure our patients have everything they need to travel comfortably.

Our in-house travel department has travel professionals who are accessible travel advocates certified by Special Needs Group www.specialneedsgroup.com, the leading global provider of special needs equipment for the travel industry. These individuals have unique, specialized knowledge about how to help individuals with disabilities enjoy a wonderful, hassle-free and memorable trip. By having our travel department specialized in this area, we can ensure our patients and clients, that we are doing everything possible to provide the highest level of patient care.

 

The Importance of the Pre-Flight Assessment

by Lux Joseph 4. October 2013

During each and every transfer that CME completes for our clients it is important that our medical personnel complete a thorough pre-flight assessment. This is the opportunity in which our medical team confirms all the information they received is accurate and that the arrangements that have been set up meet the needs of the patient. During the pre-flight assessment the nurse or physician communicates directly with the operations staff and makes any adjustments to the travel arrangements. Below is an example of a situation in which the pre-flight assessment altered how the transport was completed.

74 y/o M PT who was on a cruise and fell. Upon docking, Patient was disembarked and taken to the ER. After a workup which showed multiple pelvic fractures and multiple rib fractures he was admitted. He had physical and occupational therapy. Patient had limited weight bearing. No pneumothorax.

Upon arrival of the medical escort, 5 days after the incident, the escort received report that the patient's condition changed. The patient now complained of right upper quadrant pain. He also had an increased WBC and elevated liver enzymes. CXR showed no sign of pneumonia.

The doctor stated that the patient was not going to fly and would be worked up for a possible gallbladder problem; which is unrelated to the original diagnosis. Several diagnostic studies showed gallstones with possible biliary duct obstruction. The physician decided to remove the patient's gallbladder the next day. The transport was delayed.

17 days later the patient had his gallbladder removed, now has an open wound with closure to secondary intention. Here were some complications post op.

  • The patient developed an ileus.
  • The patient is C-diff positive and is on contact isolation.
  • He is on a full liquid diet with TPN supplementation. However, the patient is now able to bear weight and uses a walker.
  • Due to bed rest and atelectasis, the patient is now on supplemental oxygen at 2 LPM and his pulse ox is 95%.

Recommendation for travel is commercial airline, business class, RN escort, oxygen 3 LPM, W/C assist and home oxygen.

The patient did very well throughout the flight. He was in no pain and maintained oxygen sat of 97% or higher on supplemental oxygen. The patient was delivered home pain free, safely and in good condition.

In a recent conversation the Director of Operations at CME stated, “During the pre-flight assessment communication with the medical personnel and our logistics coordinators is critical. Prior to the medical team member arriving, our medical team receives information via medical charts and speaking with the facility. With variation in medical practice around the world, it is essential for the face to face pre-flight assessment. The pre-flight assessment ensures a smooth safe transfer for the patient.”

In our next blog we will share with you a travel story with one of our patients that we transferred and the story of his life. Each patient we transfer has a story to tell and we are fortunate to be able to share it with all of you.

A Honeymoon Vacation Case Study

by Lux Joseph 13. September 2013

Each case that CME is presented with is unique and original. There are no two cases that are similar or alike. With that in mind, CME treats each case individually and responds appropriately depending on the needs of the patient. Below is an example of a situation in which CME was presented and had to act accordingly to safely bring the patient(s) back home.

 
When you pictured your perfect honeymoon did it involve images of being struck by a boat while snorkeling in Belize and needing medical repatriation back to the USA? Somehow this isn't the kind of scenario that most couples foresee when they are planning their honeymoon, but it is something that can and did happen to a couple this past September.
 
A husband and wife, while on the very last day of their honeymoon in San Pedro, Belize, were snorkeling when a 38-ft. Water Taxi struck both of them. The husband’s leg was severed by one of the boat’s propellers and his wife sustained several injuries. Both individuals were air evacuated to a local hospital, Heusner Memorial. After being seen by the physician the wife’s injuries were determined to be a fracture of left ring finger, a palmar laceration of the right hand, and a fracture of the right ulna. The palmar laceration, which was nearly circumferential, was thoroughly cleaned and sutured by the attending physician.  The right ulna was placed in a cast. The husband’s leg injury was very severe and would not be able to support his weight, therefore, the decision was made to amputate the leg.  Surgical debridement and primary closure above the patient’s right knee occurred in the operating facility.
 
Solution
 
Treating doctor informed the assistance company that both patients were ready to return to the U.S. for further care and can travel by commercial air with a medical escort. The medical escort provider received the request, and
determined that two escorts, both a medical and non-medical would be needed to bring the husband and wife back home.
  • Treating medical physician gave both patients a Fit-to-Fly letter and explained the difference between evacuation and repatriation.
  • Patient will need hi-lift to plane in Belize, aisle wheel chairs for on and off plane, and wheel chair throughout the airport.
  • After the medical escorts arrival and pre-flight assessment it was determined a ground ambulance would be needed to get the patient to and from the airport
  • The treating physician would need to provide the nurse escort with pain medication for both patients for approximately 12 hours of traveling.
 
Result
General supportive care including pain management was administered throughout the transport back to the U.S.  Upon arrival in Richmond, Virginia, a ground ambulance met the patients and medical escorts and all were transported for the 2-hour trip to the receiving hospital.  Patient and wife were both admitted to the E.R. where members of both families awaited to provide support for the newly married couple.  The patients experienced no issues throughout the transport in business class seats and were safely delivered to the admitting facility.
 
CME will take care of your needs and you can feel rest assured you will receive individualized and specialized attention to your case. When looking for a medical escort provider, it is important to find one that provides only the highest level of patient care.

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