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Bon Voyage!Travelling with a bleeding disorder

PURPOSE

Travelling is often an adventure filled with challenges, especially for people with bleeding disorders.

With the right planning these challenges can usually be overcome. The goal of this module is to help people with bleeding disorders reduce the risks of travel so they can enjoy their adventure to its fullest.

1. Travel CHALLENGES

2. Travel INSURANCE

3. INFORMATION to carry

4. PREPARATIONS with your treatment team

5. TRANSPORTING clotting factor CONCENTRATES

6. SPECIAL NEEDS

7. INFUSING EN ROUTE

8. Top 10 travelling TIPS

BON VOYAGE!TRAVELLING WITH A BLEEDING DISORDER

TRAVEL CHALLENGES

CHALLENGES

CHALLENGES FOR TRAVELLERS CHALLENGES FOR TRAVELLERS WITH BLEEDING DISORDERSWITH BLEEDING DISORDERS

Getting through airport security and border crossings with factor products, needles and syringes.

Packing bulky clotting factor concentrates.

Ensuring you carry medical information.

Knowing where to find medical care.

Arranging for special travel needs.

Obtaining travel insurance.

TRAVEL INSURANCE

BENEFITS…INSURANCE…

Strongly recommended outside Canada!

Pre-existing conditions may be covered unless, in the last 3 to 6 months, you…

− consulted a physician (other than for a regular checkup);

− were hospitalized;

− were prescribed or received a new treatment or medication;

− were prescribed a change to an existing treatment or medication.

TRAVEL INSURANCE

BENEFITS…

When applying for insurance,

always tell the truth about your

bleeding disorder.

Failure to provide all health

information will void any claim.

INSURANCE

INFORMATION TO CARRY

BENEFITS…INFORMATION TO CARRY…

FactorFirst or TreatFirst cards

MedicAlert bracelet or necklace

Letter of authorization from HTC to carry concentrates, needles and syringes, contact information for HTC. The letter, written in English, should include:− Name of patient− Description of medical disorder− Contact information for HTC− Name of physician− Type of medication− Types of supplies− Types of implants that might setoff security alarms

MEDICAL MEDICAL INFORMATIONINFORMATION

BENEFITS…

It is essential to have a list of all the hemophilia treatment centres (HTCs) on your itinerary.

The World Federation of Hemophilia publishes an annual list of the HTCs in over 100 countries.

INFORMATION TO CARRY

INFORMATION TO CARRY…

HTCHTCss AROUND THE WORLD AROUND THE WORLD

www.wfh.org

BENEFITS…

Emergency contacts at home

Your treatment centre contact information

Contact information for treatment centres on your route

Travel insurance provider information

Health insurance provider information

Use the CHS Travel Card!

INFORMATION TO CARRY

INFORMATION TO CARRY

EMERGENCY CONTACT EMERGENCY CONTACT INFORMATIONINFORMATION

PREPARATIONS WITH TREATMENT TEAM

BENEFITS…PREPARATIONS…

1. Should I take a dose of factor before boarding the plane?

2. Should I change my prophylaxis schedule or temporarily adopt a prophylaxis regime?

3. How many doses of my treatment (factor concentrate, desmopressin or antifibrinolytic) should I take?

4. How should I pack and store my medications?

5. How should I keep my infusion records while travelling?

6. Do I need to carry prescriptions for these medications?

SOME OF THE QUESTIONS YOU NEED TO SOME OF THE QUESTIONS YOU NEED TO ASK:ASK:

PREPARATIONS WITH TREATMENT TEAM

BENEFITS…

7. Should I bring analgesics with me and, if so, which ones?

8. Should I bring a First Aid kit with me and, if so, what should I put in it?

9. Do I need to see a travel clinic for vaccinations?

10. Should I contact the HTC at my destination before leaving home?

11. Should I sign a Release of Medical Records form at my HTC so my records can be forwarded to another health care facility if needed?

12. What should I do in an emergency?

PREPARATIONS…

PREPARATIONS WITH TREATMENT TEAM

BENEFITS…

The Canadian Association of Nurses in Hemophilia Care (CANHC) has published a booklet called

Planning Travel:Planning Travel:A Guide for People with Bleeding DisordersA Guide for People with Bleeding Disorders

PREPARATIONS…

TRANSPORTING CLOTTING FACTOR CONCENTRATES

BENEFITS…

Check the package insert (or product monograph) for precise temperature storage instructions.

NEVER leave factor in the car in the hot sun!

NEVER put factor in your checked baggage!

If bulky, re-package vials,needles and syringes inspecial carrying case.

NEVER let the security agenttouch your supplies withoutclean gloves.

PREPARATIONS…TRANSPORTING FACTOR…

BENEFITS…

Carry a personalized letter.

Know the latest airport security rules.

Ensure the medication is properly labelled.

Declare medication separately from other liquids.

TRANSPORTING CLOTTING FACTOR CONCENTRATES

AIRPORT SECURITYAIRPORT SECURITY

TRANSPORTING FACTOR

SPECIAL NEEDS

BENEFITS…

If you expect to need assistance at any airport on your itinerary, contact your airline, when possible at least 24 hours in advance.

Beware! Quality of service varies.

SPECIAL NEEDS…

MOBILITY MOBILITY ASSISTANCEASSISTANCE

BENEFITS…

By contacting your airline, it is possible to request a seat:

with movable armrests

close to the washrooms and exits

with extra legroom

See www.seatguru.com

SPECIAL NEEDS

SPECIAL NEEDS

SPECIAL SEATING ON PLANESSPECIAL SEATING ON PLANES

EXPRESS/PRIORITY EXPRESS/PRIORITY LINESLINESAirport security and even some tourist attractions have express/priority lines for

people with mobility limitations. Just ask!

INFUSING EN ROUTE

BENEFITS…

If you need to infuse on a train or plane, ask for a place where you have sufficient room and can concentrate.

In an airport, if you cannot find a quiet, suitable location to infuse, ask for help in finding a First Aid station.

If none of these suggestions work, find a table (as secluded as possible), lay out your supplies and give your infusion. There is no reason to be shy!

INFUSING EN ROUTE…

INFUSING EN ROUTE

It is critical that “sharps”, that is, needles, be disposed of safely after use.

If you don’t have a “sharps” container, carefully replace the plastic guards on the needles and store them together inside another secure container. If your trip is short, bring them home to dispose of.

If your trip is longer, find a medical facility that will accept to dispose of them for you. Some airports have “sharps” containers in washrooms.

INFUSING EN ROUTE…

WHAT TO DO WITH “SHARPS”WHAT TO DO WITH “SHARPS”

Vials and syringes can be discarded in the regular waste disposal.

INFUSING EN ROUTE

BENEFITS…

If you use a paper-based infusion record, take your forms along with you.

If you use an electronic or Web-based device, and can’t take it with you, make your own paper log. Record:

− Date and time of infusion

− Lot number

− Number of units infused

− Reason for infusion: Bleed (indicate site), prophylaxis or immune tolerance induction therapy.

INFUSING EN ROUTE

KEEPING INFUSION KEEPING INFUSION RECORDSRECORDS

IT IS JUST AS IMPORTANT TO KEEP GOOD INFUSION RECORDSWHILE TRAVELLING AS WHEN AT HOME.

TOP 10 TRAVELLING TIPS

BENEFITS…

1. Discuss your travel plans with your treatment team.

2. Carry a personalized letter from your treatment centre describing what supplies you have and why you must carry them with you.

3. Carry an up-to-date FactorFirst or TreatFirst card.

4. Wear a MedicAlert necklace or bracelet.

5. Have a list of all the hemophilia treatment centres on your itinerary.

6. Carry several copies of your emergency contact information.

7. Obtain travel insurance, if possible.

8. Check the package insert (or product monograph) for precise instructions on the storage conditions of the product you use.

9. Never keep your medication in your checked luggage!Always keep it with you.

10. Keep good infusion records while travelling.TRAVELLING TIPS

ACKNOWLEDGEMENTS

The CHS would like to acknowledge those people who contributedto the development of Navigating the emergency department.

CLARE CECCHININational Program Manager, Canadian Hemophilia Society (retired)

MYLENE D’FANAVice-President, Canadian Hemophilia Society

DEB GUE, RNNurse Coordinator, Hemophilia Program, Adult Division, St. Paul’s Hospital, Vancouver, BC

ALEX LITTLECalgary, AB

DAVID PAGENational Executive Director, Canadian Hemophilia Society

NORA SCHWETZ, RNNurse Coordinator, Bleeding Disorders Program, Health Sciences Centre, Winnipeg, MB (retired)

Supported by

Navigating the emergency department

Charting your course

Home care: The road to independence

Destination fitness

Roadmap for managing pain

Bon Voyage!Travelling with a bleeding disorder