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Worldwide Travel Alert

by Lux Joseph 5. August 2013

The United States issued a worldwide travel alert on Friday warning Americans that al Qaeda may be planning attacks in August, particularly in the Middle East and North Africa. Yesterday the US Department of State has closed 21 US Embassies and Consulates around the world due to recent intelligence. This global warning has an affect on all Americans and we want you to know that CME is using caution and the highest level of safety when transporting our patients throughout this travel warning.

On a day-to-day basis, CME is transporting patients around the world with nurses and physicians in an effort to bring them back home with safe and sound. When a travel alert, such as this one is announced to US citizens, remember that safety is our number one priority in every transport. CME would like to remind our clients and patients that the following items are exercised thoroughly to maintain a safe and secure transport:

Ground Transportation

Upon arrival into any country, our medical escorts will be escorted via ground transportation that has been pre-arranged. At this time we encourage our team to not use public transportation when not absolutely necessary. When transporting our patients from the facility to the airport for departure we will also have ground transportation arranged in advance. Each of our ground transportation providers ensure only the highest quality of vendors are utilized for transport. If you are traveling abroad, we suggest you contact the concierge at your hotel to have pre-arranged cars to take you to your destination.

STEP

Each of our medical escorts will be enrolled in the Department of Travel STEP program. The Smart Traveler Enrollment Program is strongly recommended for anyone traveling outside of the country. Even if there is no active threat alert it is encouraged that you enroll in this program. By enrolling in STEP you will receive the latest security updates and your information is on file with the US Embassies and Consulates so they may contact you during an emergency. Ever time a nurse is traveling abroad their trip will be registered. We encourage you to register today at: https://step.state.gov/step/

Know your Surroundings

CME picks up patients from different destinations every week. There is always a significant amount of transports to your major destinations like Paris, London, Frankfurt, Prague, and Amsterdam. However, there are also a variety of new destinations that are unfamiliar to our medical team. It is encouraged that you always be well aware of your surroundings when traveling abroad.  At CME, we will do our best to select American hotels when available for our medical team. We always select hotels that have a restaurant within the hotel therefore our medical team does not need to leave the hotel to find a restaurant. You should also select a hotel with an excellent concierge so they can assist you in making smart decisions. The concierge is the most knowledgeable individual in the area. The concierge can explain to you the safety do's and don'ts for the area around the hotel.

Monitoring Travel

CME closely monitors the latest news and weather updates, as well as the U.S. Department of State website, for travel alerts and travel warnings for all destinations, including those that are most popular with our clients. Should we become aware of an issue for a specific destination, we alert clients and our medical team who may be planning to travel there so they can determine for themselves if they still wish to travel. If CME becomes aware of an issue for a specific destination where a client is currently located, we try to immediately contact the clinician, patient, and client to check on their well-being and work to assist them if they require alternate travel arrangements.

Working with the US Embassies Around the World

CME has established a great working relationship with several of the US Embassies and Consulates around the world. We have worked with many of their emergency personnel in addition to assisting some of our patients and companions acquire the necessary documents to return back to the USA. When traveling abroad, the US Embassies and Consulates are your emergency hotline 24/7. Even with the recent closures of many US Embassies, the emergency contact number is still active. The closures affect routine public services like passport and visa issues.  

CME is here to assist our clients; their safety and well-being is our top priority. We provide the facts so our clients can make an informed decision about their travel plans. This travel warning is in effect until August 31, but analyzing and adjusting CME safely measures is an ongoing effort within our office. When transporting our patients we always look at the most direct routing based on availability. As updated information becomes available, CME will continue to make adjustments to our safety guidelines. You can also stay informed through the following social media channels:

Twitter: https://twitter.com/travelgov

Facebook: https://www.facebook.com/travelgov

Tips for Travelers with Disabilities

by Lux Joseph 12. July 2013

Traveling with a disability may seem impossible. It may make you feel discouraged and at a loss due to the challenges you foresee getting around when going on a trip. This may have been the case several years, but times have changed and traveling with a disability has become easier. The world is now more accessible than ever before. Twenty percent (62 million) of the U.S. population has some form of disability, and the number of these individuals is increasing daily. These people need to, want to, and can travel. If you’re part of that twenty percent, a world of travel awaits you. Cruises, airlines, restaurants, hotels, and even tour groups have implemented a variety of resources and tools to ensure that you travel comfortably and without hesitation. There are still areas around the world that are not set up completely, but accessibility for travelers with special needs has become a focus for the travel industry. Here are some tips when traveling with a disability:

 Traveling by Air

Going to visit your grandson in Florida, but hesitant about getting through the airport and boarding the plane? At Commercial Medical Escorts, our role is to assist those travelers with medical conditions and disabilities home via commercial airlines. Although each of our patients is traveling with a nurse, the airlines and airports have a variety of resources to assist those travelers traveling alone. TSA has a dedicated contact number for those travelers needing special assistance. They recommend that you call 72 hours prior to departure. This program is called: TSA Cares Helpline.  You can e-mail them at TSA-ContactCenter@dhs.gov or call toll free at 1-855-787-2227. This program is dedicated to providing individuals with disabilities an additional resource to ask questions regarding what to expect at security, screen policies, and can specifically address your individual concerns.

Once you know what to expect from TSA, working with the airlines to ensure you have the necessary accommodations in critical to smooth travels. If you are traveling and need the assistance of a wheelchair, understand that there are a variety of different wheelchairs available. The first step is to contact the airline or your travel agent and they will append it to the reservation.  The different types of wheelchair assistance include:

 WCHR - Wheel Chair to Ramp - passenger can ascend/descend steps and make own way to/from cabin seat, but requires wheelchair for distance to/from aircraft

WCHS - Wheel Chair to top of Steps - passenger is able to walk but unable to ascend or descend stairs

WCHC - Wheel Chair in Cabin - passenger is paraplegic/quadriplegic, requires an on-board wheelchair and must be carried to/from cabin seat

Once you arrive at the airport wheelchairs are available at the doors. A Skycap will take you through security all the way to the gate. When the aircraft is ready for boarding, the same person will come and take her down the jet way to the aircraft's door.  Since the airline knows there is need for a wheelchair, one will be waiting with a Skycap at the destination airport, right at the aircraft's door. This person will take you as far as baggage claim, and even assist in getting baggage from the carousel. 

If you are a passenger that uses oxygen at home to get around don’t think that you are unable to fly. FAA has approved several portable oxygen concentrators and they are the only medical oxygen devices approved for inflight travel. Depending on the airline there are different rules and regulations to inform the airline you will be using one. Be sure to contact the airline at least 72 hours prior to departure. Some of the common FAA approved portable oxygen concentrators include:

·         AirSep FreeStyle

·         AirSep LifeStyle

·         AirSep Focus

·         AirSep Freestyle 5

·         Delphi RS-00400 / Oxus RS-00400

·         DeVilbiss Healthcare iGo

·         Inogen One

·         Inogen One G2

·         lnogen One G3

·         lnova Labs LifeChoice Activox

·         International Biophysics LifeChoice / lnova Labs LifeChoice

·         Invacare XPO2

·         Invacare Solo 2

·         Oxylife Independence Oxygen Concentrator

·         Precision Medical EasyPulse

·         Respironics EverGo

·         Respironics SimplyGo

·         Sequal Eclipse

·         SeQual SAROS

Remember you are not alone at the airport and onboard the airplane. These resources are available to you so next time you are preparing to fly simply ask your travel agent or contact the airline to ensure you have all the necessary requirements.

 Traveling by Sea

Cruise vacations can be an excellent choice for travelers with disabilities as long as you have all the necessary special assistance services available. One of the biggest resources to those travelers going on cruises is the Special Needs Group, the leading global provider of special needs equipment for the travel industry, have unique, specialized knowledge about how to help individuals with disabilities enjoy a wonderful, hassle-free and memorable trip.. The Special Needs Group has been recommended by the major cruise lines for several years. They support over 55 cities and ports, and over 20 countries around the world.

Here are a few tips from Special Needs Group to ensure that when your next travel opportunity arises, you are ready to go.

Outline your travel needs

 Take time to evaluate the logistics of your trip in relation to your ability to keep pace. What modes of transportation will you be using? Airplane, motor coach, train, ship, transit vans for ground transfers? Make a list, referring to relevant brochures, your trip organizer or travel agent to make sure you don’t miss anything.

Now, make a list of your specific requirements. Be honest: what types of special needs equipment do you depend on at home? What do you use or need (or wish you had!) when shopping, sightseeing locally, dining out or going to the movies, attending concerts, the theater, street fairs or sporting events at home? 

Can you hear and see clearly without special auditory equipment or visual aides?  How far can you walk without a rest break? Are stairs difficult? Can you get in and out of the tub or shower at home without handgrips or other assistance?

Travel, whether solo or in a group, is no time for roughing it or trying to “tough it out.” If a wheelchair, scooter or portable oxygen will make your trip easier, place that item on your list. Many people who do not use wheelchairs or walkers at home feel more comfortable using these mobility aides for tour and excursions. In fact, most of Special Needs Group’s wheelchair and scooter rentals are to individuals who only use such aides when traveling.  

 Plan Ahead

 If you already own a scooter or portable oxygen, it’s important to know the policy and procedures for bringing that equipment onboard all the transport vehicles included in your itinerary, from planes to taxis to ferry boats. Does that transport have a way to stow your scooter or wheelchair? Is oxygen allowed on board? Some airlines prohibit certain types of batteries, such as wet cell batteries, or oxygen cylinders. Airlines operate under strict rules, so there may be packing procedures to follow if they do allow the equipment. Keep in mind, most airlines need at least 48 hours’ notice to make special arrangements, and be prepared to fill out forms. 

Overall, cruise ships are more lenient in allowing oxygen, but some disallow certain types of oxygen. All require that the oxygen be delivered to the ship, and that you have enough for the entire voyage. Oxygen may never be brought aboard in your luggage. Requirements vary, so check your cruise line for proper instructions.  Again, documentation and paperwork are required. 

Whether you are headed for a cruise ship, hotel or all-inclusive resort, double check for wheelchair access at that venue, plus any venues you will be visiting on the trip.  Confirm that accessible hotel rooms, resort accommodations or ship staterooms are available for your travel dates. The earlier you book, the better your chances of securing fully accessible accommodations. And early booking increases your chances of securing a ground floor hotel room or cruise stateroom near the elevator, if these issues are important.

Check on the access to public rooms, restaurants, bars, toilets, the swimming pool, hot tub, beach area and other amenities. Are there TDD phone devices? How will you get in and out of the shower or bathtub? Are there flashing lights to accommodate hearing? Braille room numbers? Knowing in advance the scope of your needs gives you time to arrange advance rentals of any necessary equipment, scheduled to arrive when you do. Everything from scooters, lifts, ramps, TDD kits and special mattresses, including special needs cribs, is available for rental.

Will road travel or car excursions be part of the trip? Many car rental companies have vehicles that are modified for drivers or passengers with mobility limitations. Check ahead to make sure a suitable vehicle will be available for your travel dates. If you will be hiring a car or van, make sure the company is aware of your special needs.

When traveling with a limitation or disability, full travel insurance for medical coverage abroad and trip cancellation insurance are even more important and strongly advised.

Ask the Right Questions

When making the final bookings, be sure you ask the right questions, even if the accommodations or cruise stateroom are categorized as “accessible.”

For example, are doorways wide enough for the largest wheelchairs? Do the doors open outwards or into the room? 

Are all the public areas of the hotel, resort or ship accessible? Do you need to make special arrangements in the dining room to accommodate the wheelchair or scooter?

Will the bathroom facilities truly fit your needs? Is the bathroom large enough for the wheelchair or scooter? Is there a roll-in shower? Grab-bars?

Are there facilities for companion/assistance animals?

Are there shopping and entertainment facilities close by if you are staying at a hotel or resort? 

On shore excursions or tours, does the van have a lift and method for transporting wheelchairs and scooters? 

Simply stated, don’t take anything for granted. It’s easy to arrange for almost every situation, and the world is wonderfully accessible, once you know what’s needed, what’s available and how to find the necessary equipment.

The world around us is continuing to grow and develop. Having a disability should never hinder or stop you from traveling. The resources and support are available to you worldwide. It is critical that you use the tips outlined above to ensure your travel goes smoothly and free from aggravation.

Critical Communication with a Medical Escort Repatriation

by Joey 28. June 2013

Every day Commercial Medical Escorts faces different challenges in the efforts to bring patients back to their home country with a medical escort. These challenges include patients in obscure locations, patients in locations where our medical team will require a visa, different medical requirements, flight availability, and many more. Each medical evacuation receives individualized and specialized attention. Here is some insight to a case that proposed a challenge and how the team at Commercial Medical Escorts discovers a solution to bring the patient home safely and efficiently.

Problem

In 2011, a 79-year-old woman was traveling alone ona 12-night cruise on the Pacific Princess. During the cruise, the patient began to experience lower back pain, which she believed was coming from an injury sustained through dragging luggage around the harbour a few days earlier. Several days of continuous acute back pain that began to get increasingly worse prohibited the patient from leaving her cabin, effectively ruining her vacation. After being evaluated by the ship’s physician, it was determined that she was having chronic back pain and an X-ray showed a compression of FX L2. The patient had PMH (past medical history) of peripheral neuropathy, spinal stenosis and aortic stenosis. Whilst the physician recognized the need for the patient to return home, the cruise was currently at sea in the Mediterranean, quickly approaching the Port of Piraeus in Athens, Greece. The Pacific Princess would arrive into the port at 9:00 am on Saturday and would depart promptly at 4:00 pm the same day. The patient was travelling alone.

The physician’s medical recommendation was a nurse escort repatriation to the patient’s home with pain management. The medical escort provider received the request for transport at noon on Friday; all necessary arrangements had to be finalized quickly, as the nurse’s departing flight to Athens was at 4:30 pm on the Friday evening. If the nurse did not depart on the Friday evening flight, she would not have made it to Greece to meet the arriving ship; not meeting the ship would have required an unnecessary hospital visit for the patient, cost to the insurer and more complex paperwork for all involved.

The patient was currently on Coumadin and would need morphine for her pain during the repatriation; something that the treating physician would have to personally provide the flight nurse with upon arrival at the ship. For these reasons, it was critical that the nurse meet the ship prior to its departure.

Solution

The travel assistance company, as the insurance policy provider for the patient, was contacted. The treating physician communicated with the medical director at the travel assistance company to review the patient’s medical history and determine what would be needed for medical evacuation. The travel assistance company contacted a medical escort provider to provide a nurse escort for this case. Commercial Medical Escorts had to provide a quote in an efficient manner to be reviewed by the travel assistance company to ensure that the patient’s benefits covered the repatriation.

The nurse’s flight departed at 4:30 pm, and this was the only flight that would enable the nurse to get to the port in time. The flight would land in Athens at 12:20 pm, and the Port of Piraeus was one hour from the airport. Ground transportation was arranged to pick up the nurse at the airport and bring her directly to the Port of Piraeus, where she would be greeted by the port agent. After arranging the nurse’s flight, contact was made with the doctor on the Pacific Princess, whilst the ship was still sailing the Mediterranean Sea. The doctor was provided with a copy of the itinerary, the nurse escort’s name, passport number, passport expiration, and date of birth. All of this information was required for her to gain security clearance once she arrived at the dock. Commercial Medical Escorts Chief Flight Nurse maintained contact with the ship physician throughout the case management process. All necessary documents were obtained, including fit-to-fly documents for airline medical clearances. The patient’s medical condition and fit-to-fly documents were sent to the airline, at which point the airline noted the reservation, alerted the airport ground staff, and flight crews. Wheelchair assistance was confirmed for the patient, which would allow her to move quickly through the airports without having to walk long distances, and wait in long lines.

Meanwhile, the treating physician distributed medical disembarkation details to all the appropriate parties on the Pacific Princess. The patient remained within the medical centre until the arrival of the nurse escort. Arrangements were made through the Pacific Princess staff, the medical escort provider and port agent for the nurse to come onboard the ship when she arrived at the terminal. Commercial Medical Escorts communicated throughout the process with the treating physician to ensure all clearances had been made, and that upon the nurse’s arrival to the port, access to the ship and patient would be granted. As the nurse was boarding the ship to pick up the passenger, medicine (morphine for pain management) and all the necessary medical records, the cruise was already boarding passengers for its next departure, which was taking place in one hour.

Result

The flight nurse arrived into Athens on time and after going through customs and immigration, ground transportation took her to Port of Piraeus. Upon arrival at the port, the flight nurse was greeted by the port agent, who paged the ship for the treating physician. The patient was seated up in a wheelchair, alert, and very excited to see the nurse who would accompany her home. The treating physician and the nurse exchanged medical information, and then the flight nurse was given the pain medication prescribed to the patient as well as the fit-to-fly letter and discharge paperwork.

The patient and the medical escort were escorted off the ship whilst crew members assisted with the patient’s luggage, and ground transportation then took the nurse and the patient to the airport hotel, where two adjoining rooms had been arranged. At the hotel, the flight nurse assisted the patient with in-room dining, and the following day the flight nurse transported the patient from Athens, Greece to Atlanta, Georgia, in the US. The patient experienced no issues throughout the transport in business class seats and was delivered home safely.


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