Jet Companion https://jetcompanion.com/ Mon, 27 Jun 2022 17:43:37 +0000 en-US hourly 1 https://wordpress.org/?v=6.5.2 https://i0.wp.com/jetcompanion.com/wp-content/uploads/2022/05/cropped-Jetcompacion-favicon.png?fit=32%2C32&ssl=1 Jet Companion https://jetcompanion.com/ 32 32 214669848 The gentleman at the sea: senior relocation to Canada https://jetcompanion.com/the-gentleman-at-the-sea-senior-relocation-to-canada/ https://jetcompanion.com/the-gentleman-at-the-sea-senior-relocation-to-canada/#respond Mon, 27 Jun 2022 17:21:00 +0000 https://jetcompanion.com/?p=702 A medical travel companion is sent from Canada to Guatemala to pick up an elderly expat who needs to be relocated after facing health problems. It happens to be me and I am touched by the story behind this case.

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The gentleman at the sea: an elderly relocation to Canada in the midst of the pandemic

RUDY DE KORT / 27 june 2022

Moving a Canadian senior back home

The gentleman in the seat next to me closed his eyes in silence, as he dozed off for the second half of our flight to Canada.
For a 95-year old he was exceptionally sharp and so full of life. For the last few hours he had enchanted me with his colorful travel stories. Being a former businessman, his work had taken him to a dozen Caribbean islands and almost every Latin American country, before he fell in love with a small fisherman’s town at the Pacific coast of Guatemala. He sold his company in Canada, kissed his adult kids goodbye, visited his wife’s grave one last time, hopped on a southbound plane and started living again…for the next thirty years. It didn’t bother him that he had spent 65 years of his life wondering where on earth he truly belonged, because, as he put it, it was never too late to love and live. “Amar y Vivir” he repeated in Spanish, with a smile on his face.  I believed him: it must have been the sparkle in his eyes, or the enthusiasm in his voice, speaking straight from the heart.
 
But sadly, all good things come to an end. As much as Guatemala became Home, it was time to leave. Dementia, cancer, near-blindness, a nasty fall…the problem list was getting too long. It was no longer responsible to live alone. The kids, now grandparents themselves, decided to move him back to Canada. To be closer to family. To get the care he needed. And one day, to be buried next to his wife.

Travel companion from Canada

So here I was, on a regular Monday morning. Knocking on the door of his house at the sea. His veranda was now full of moving boxes. I introduced myself as the travel companion who had arrived from Canada to pick him up. I couldn’t help but get emotional myself as a dozen friends and neighbors of all ages arrived so say goodbye. They all hugged and cried. This man was loved by many. On paper this was a straight forward mission, to bring him back to Canada.  Yet, this man was closing off a 30-year long chapter of his life. Right here, right now.
 

The journey back to Canada wasn’t complicated at all. I did my regular travel companion duties. The gentleman was chatty, and in good spirits. As we were getting off the plane he was a bit confused, but he quickly remembered that he was on his way to be with his daughters in Canada. ,,Tell my daughter to get me a big fat cheeseburger” he whispered.
What? I thought he was sad about leaving Guatemala, and spending his last days in a care home, in the cold, instead of on his veranda at the sea. Yet, this man was too grateful for all life has given him. Nothing that lied ahead could bring him down anymore.

Rudy de Kort is a medical travel companion based in Edmonton, Canada. His team of nurses gets called in to help with international relocations of seniors and transfers to long term care and family events for people who need extra support. 

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]]> https://jetcompanion.com/the-gentleman-at-the-sea-senior-relocation-to-canada/feed/ 0 702 What to expect when you hire a medical travel companion for someone with dementia https://jetcompanion.com/medical-travel-companion/ https://jetcompanion.com/medical-travel-companion/#respond Mon, 27 Jun 2022 16:50:00 +0000 https://jetcompanion.com/?p=692 Many families don’t know they can access specialized dementia care for air travelers. Yet, that is what we do as medical travel companions: take care for of that one passenger who would otherwise stay home, to avoid problems onboard or at the airport.

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What to expect when you hire a medical travel companion for someone with dementia

Rudy de Kort / 27 JUNE 2022

Dementia care for air travelers

Many families don’t know they can access specialized dementia care for air travelers.

Yet, that is what we do as medical travel companions: take care for of that one passenger who would otherwise stay home, to avoid problems onboard or at the airport. What are some of the challenges and learning we face along the way? How do we keep  family members in the loop throughout the process of relocating someone with dementia? And what inspired me to start this unique service? Keep on reading!

Planning for a flight with someone with dementia

Over time, I discovered that many planned, low-acuity transfers are treated like a transient phase between two places. Care is provided at point A or point B, but not necessarily in between. Only the unavoidable is dealt with en route, and the care plan is assumed to be temporarily put on hold, until the client reaches the destination.

But the distance that needs to be bridged between point A and point B can be quite long in a world where families are spread across continents. We are still doing domestic relocations from Toronto to Calgary, but the next transfer could easily be from Halifax to Sydney or from Moncton to Milan.

Families often feel that they are on their own when they decide to move their loved one over such a large distance, with little guidance on how to organize the care in transit, especially if the trip is from one country to another. They are left with questions like:

  • How do we manage mobility dependency in the plane?
  • Incontinence?
  • Disorientation?
  • Behavior that is not understood by strangers?
  • Anxiety?
  • Insulin?

And all the other things that they’ve successfully managed for years, but never thought about in the context of an airline cabin. A medical travel companion who has done it before, can be very helpful in these cases!

Preventing simple problems from escalating

The average airline passenger is considered to be either independent or only in need of simple accommodations. For those who depend on others for their wellbeing, there is a limit to what an airline can commit to. Airlines are transport providers in the first place, not care providers. But the reality is, there are now more travelers of 70, 80, even 90+, than ever before!

At the same time, we are witnessing the rise of the ultra-long haul flight: commercial flights that are operated by aircraft capable of staying in the air for more than 16 hours non-stop! How do you prevent all sorts of small challenges from escalating into a problem and possibly an in-flight medical emergency? A flight attendant doesn’t have all the answers. Neither does a wheelchair attendant, or a personal care aid who spends many hours at bedside, but never in an airline cabin at high altitude. And that is how Jet Companion started: an accessible, affordable service, that delivers specialized care in the air, while also taking into account the prevention of less obvious challenges like DVT and pain.

Traveling with Dementia is a Family Event

When a medical travel companion transfers a client with dementia, we are typically embarking on a long, international journey and exposing the client to a very dynamic environment full of cognitive challenges. For someone with dementia this can lead to over-stimulation, stress and anxiety, aggravated by physiological stressors associated to flying. Our flight nurses use their professional training and experience to complete these transfers, not only uneventfully, but also in a way that the client can actually enjoy. But the family can’t see that, unless they are traveling along.

Like in any care setting, family involvement is important, and with that comes the need for clear communication and emotional support while we take the whole family through this new experience of flying with dementia. Among many tools that we use to make sure the family and Jet Companion are on the same page, are our Intake, the Customer Briefing and a post-arrival video call.

How to think in solutions and make the trip happen

The type of service a medical travel companion delivers is very specialized. We combine our health care experience with the aeromedical knowledge of problems and situations that are specific to traveling, and flying at altitude.

People don’t expect that level of expertise when they approach us. They think in terms of wheelchairs and a helping hand to carry luggage and navigate the airport. So we have a good conversation with the family first. We listen and we explain what we do and why.

For example, why someone who doesn’t need oxygen on the ground, might temporarily need some in the air. Or, what can be done to safely transport a bedridden person without the need of a stretcher. Or, how we manage incontinence, medication schedules or sundowning while our plane is crossing time zones.

By all means, it’s not a lecture on how things should be done. It’s rather an exploratory exchange of ideas, as we start planning for the trip. All questions from both sides are answered. The family brings in their expertise about their family member. We bring in the expertise about in-flight care. We discuss the medical and nursing needs. And we learn about the client’s personality, background, and personal preferences.

Passenger, family and Medical Travel Companion as one team

The client with dementia might have his or her own set of questions, expectations, and preferences. So when we have a plan in place, we communicate it in a way that is easily understood. Prior to the trip we send a so called “customer briefing” which is an an overview of all the details of the trip. It summarizes what is going to happen, when, where, how, and why. These crucial pieces of information are highlighted and can be read over and over again by the client, as many times as needed, before, during or after the journey. For the family it also takes a weight off their shoulders when they can confirm that all the smaller details of the trip are also being taken care of. But it doesn’t stop there. When our medical travel companion meets the client with dementia, we chat. We build in time to establish rapport and make sure that everyone involved is on the same page.

Video Call at the Airport

After a long flight, families are anxious to learn how the trip went. They want to see with their own eyes that everything went smoothly and that mom or dad is calm and relaxed. They also know that it’s important to prove that they are still involved, within reach, that they didn’t just leave their loved one behind with a stranger. That’s why we plan for a little break, right after we deplane. As soon as we are in the airport terminal and our nurse can pick up a Wi-Fi-signal, we ask the wheelchair attendant to wait, and we get on a videocall to update the family and allow them to communicate directly with their loved one. It only takes a few minutes, and it is greatly appreciated.

Fit to Fly, if…

What inspired me, was the realization that flying is getting more complex for certain demographics. There is a need out there for services that in many parts of the world, are nobody’s core business.

When families ask their family doctor or the multidisciplinary team at a care facility if their loved one with dementia is fit to fly, too often the answer is a hard “no” but in all honesty, what they mean to say is “with so many factors that we can’t control, we are not prepared to take responsibility for this plan.”

At Jet Companion we’d approach the question from our own angle of expertise and say: “That is exactly why we are here. Let’s have a conversation about what is needed for your loved one to fly. And next we’ll look into how realistic it is to meet those conditions.’’

Don’t get me wrong: every dementia case reaches a point when flying is no longer responsible, whether temporarily or permanently. Healthcare professionals will rightfully consider the evolution of the disease process, recent events, and certain risks factors specific for that client. If red flags are obviously present, we won’t cross that line either.

But what we also see is that care providers tend to err on the side of caution, because they are unfamiliar with patient care in the context of air travel. In that sense, as a specialized service that takes the responsibility for that long-distance transfer, there is certainly a role for us to listen to their concerns, look at the documentation, and explain that we have actually worked out the potential risks, and have a system in place to manage those risks.

Fortunately, for many people out there, we are now often able to say: “Yes, we can make it work, if we plan ahead to manage the care needs that are brought forward, in the degree of detail it takes, and taking into account the challenges that are specific to this setting.’’

Rudy de Kort is based out of Edmonton, Canada, and his team of flight nurses provide in-fligth care, around the world on commercial flights.

This article was previously published on Dementia Map, a global resource for families who are learning about dementia.

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]]> https://jetcompanion.com/medical-travel-companion/feed/ 0 692 Booking a wheelchair with the airline? Keep these 8 tips in mind. https://jetcompanion.com/booking-a-wheelchair-with-the-airline/ https://jetcompanion.com/booking-a-wheelchair-with-the-airline/#respond Sun, 26 Jun 2022 21:12:00 +0000 https://jetcompanion.com/?p=680 Airlines handle wheelchair requests for their passengers on a daily basis. By knowing how it works you can make sure to get exactly the service that you need.

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Booking an airline wheelchair? Keep these eight tips in mind

Rudy de Kort / 26 June 2022

Many airlines allow you to book a wheelchair on their website

When you call an airline and ask for a wheelchair, they will put in a so called “Special service request”. That’s no big deal: airlines transport thousands of wheelchair users each day, so be prepared to answer a few questions, and you should be fine. Keep a few things in mind, for your own convenience:

1. Plan ahead and ask early for a wheelchair when traveling

A wheelchair can be requested last-minute at check-in, but calling the special assistance desk of the airline or booking the wheelchair online is safer, especially during busy times. Expect the airline staff to ask you a few questions on why you need to travel in a wheelchair, as there are many health conditions that will require a fit to fly certificate from a doctor and it’s always best to find out well in advance, while you still have time to get a medical letter. Examples are recent surgery, or injuries that can cause problems at a high altitude. This is not something you want to find out about when you are already at the airport.

2. Be clear about your wheelchair assistance needs

Airlines around the world use standardized codes in their booking systems to define what a passenger needs. That way any employee who pulls up your record knows if they need to arrange for a wheelchair attendant only up to the doors of the airplane, or also an onboard aisle chair, or even a special patient lift to get you into your seat. It doesn’t matter if you switch airlines between connecting flights. All airlines use the same IATA-codes. IATA stands for International Air Transport Association and it is the organization that regulates airline passenger services worldwide.

3. Jet bridge, boarding ramp or muscle power

If you are unable to climb any steps, it’s not a bad idea to check what type of aircraft is used on your flight. Smaller aircraft that commonly service domestic routes like the Dash 8 or ATR-72 don’t always use jet bridges, but most of the smaller regional airports where they fly into have ramps that can be used to avoid the steep steps. There are limits though. If your flight is operated by a float plane or a private jet, getting on board will take some old fashioned muscle power. It’s good to know what to expect, as being carried up and down the stairs in a wheelchair can be a scary experience. If you need to be carried, keep your hands on your lap and don’t hold onto the railings, to avoid injury.

4. Everyday mobility devices cannot be used onboard

Personal wheelchairs, walker frames and rollators need to be checked as luggage and will be labeled and packed in a plastic bag for protection. Smaller, but off-shaped items like crutches and canes can be taken into the cabin, as well as collapsible wheelchairs. There are conditions though! If your cane is equipped with an ice pick it can be used as a weapon, so it will have to be checked. Also: smaller planes don’t have a storage space in the cabin where your wheelchair can be stored. In any case: you won’t be able to use any of your  aids onboard, as the aisles are too narrow. That’s why larger aircraft are equipped with “onboard aisle chairs” that can be operated by the flight attendants.

5. Wheelchair attendants are not caregivers

When you request wheelchair assistance, a member of the airline ground staff or a subcontracted wheelchair attendant will bring you from the check-in desk to the gate, or all the way to your seat on the plane. The transfer can include a ride with an electric golf cart or a wheelchair accessible bus, if your plane is parked in a remote position. Expect someone to pick you up at the plane when you arrive, to assist you with deplaning. It doesn’t matter if you reached your destination or if you are connecting to another flight. However, their job is to help you move around, not to help you in the toilet, or provide personal care. If that is what you need, consider hiring a trained travel companion.

6. Prepare for a manual security pad down

Most airport security checkpoints, have a priority lane to fast-track passengers in a wheelchair. Expect a rigorous screening though. All carry-on items go through x-ray, and so do jackets, shoes and belts. A same sex officer will do a pat down of your body and collect swabs from different parts of the wheelchair to test for residue of explosives. You’ll be asked to stand up, and if you can’t, your attendant will be asked to lift you up, just enough for the officer to inspect if nothing is hidden underneath your body.

7. How to access the lavatory if you can’t walk

Large, widebody aircraft like the Boeing 787 Dreamliner or the Triple 7 have “wheelchair accessible” toilets onboard, or at least two adjacent lavatories with a collapsible internal wall and a customized door. Smaller planes don’t have this option.

If you are unable to stand and pivot at all, you’d need someone to assist you in a very cramped space. Flight attendants are generally not allowed to assist you in the lavatory. If you can’t help yourself, consider traveling with someone who can assist you. Also consider that post-COVID, many airlines are planning now flying long-haul routes with smaller, narrow body planes like the Airbus 321 or Boeing 737MAX. Try to avoid those flights when you are booking!

8. What’s a good seat?

Sitting in the aisle makes sense if you can get up to let your neighbor in the window seat pass by for a toilet break. If not, than maybe the window seat will be your best option. If you are travelling with a professional companion, make sure that you are both sitting together in the same cabin, and on the same aisle. In Economy Class, you can opt for a bulk head seat for the extra space in front of you, and for the short distance between your seat and the lavatory. Mind you, that on widebody planes many passengers use this row to shift from one aisle to the other, and that can be extremely unsettling. Besides, the arm rests are not removable because of the built-in tray tables and IFE-screens. You won’t have the seat in front of you to grab onto for support either, and because it is the only spot where on-board cribs can be installed, you can expect families with babies to get those seats.

Rudy de Kort is the founder of Jet Companion and a medical travel companion operating worldwide out of Canada.

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]]> https://jetcompanion.com/booking-a-wheelchair-with-the-airline/feed/ 0 680 Five things to expect during 2022’s “Summer of Airport chaos” https://jetcompanion.com/airport-chaos/ https://jetcompanion.com/airport-chaos/#respond Fri, 24 Jun 2022 20:31:00 +0000 https://jetcompanion.com/?p=662 What can you expect at the airport and onboard your plane during the summer of 2022? A travel companion discusses airport troubles.

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Five things to expect during
2022's "summer of airport chaos"

Rudy de kort / 24 June 2022

what's new about the news?

So, the news is overfilled with awful stories about long queues at airports, massive flight cancellations, staffing shortages, strikes and forced downsizing of some airlines. We see the frustration of travelers who have missed their flight or lost their luggage. There are the thousands of abandoned suitcases on a tarmac, captured by a camera. It could all instantly change your perspective on traveling: whatever travel troubles we had in the past, have now exploded in ten fold this summer. With the prospect of mental torture during countless hours in airplanes and at airports, I guess I’ve got good and bad news to share.

The bad news is that some airports and airlines, mainly in Europe and North America, are indeed facing serious disruptions in their operations, which is where all the horror stories are coming from.

The good news is that at many other international and domestic airports in the world it is business as usual, and both travelers and suitcases are arriving and departing without any significant congestion or disruption.

If you are traveling through Toronto Pearson, Montreal Trudeau, Amsterdam Schiphol, Brussels Zaventem, Newark Liberty, Tel Aviv Ben Gurion, London Heathrow, Dusseldorf, Paris Charles de Gaulle, or a dozen other airports in Europe, please continue reading.  I’ve summed up a few of the struggles that you can expect, and also some tips on what you can do to make your travel experience a bit more pleasant.

1. Long queues, longer queues and the longest queues you’ve seen in a while

Depending on the time of day, the wait times at major hubs can exceed the two or three hours you’d normally need before your departure time. Expect lineups at check-in and at the airport security checkpoints before you fly, and at customs and immigration before you board or after you land. After your arrival, you’ll wait longer for your bags to show up on the conveyor belt.

2. Missed connections, delays and cancellations

The holdups at major hubs cause a chain reaction across the network. One delayed flight into a hub can easily result in multiple passengers missing their connections on different outbound flights. And whatever goes wrong at one major airport can cause delays and cancellations at smaller airports.

3. Frequent gate and seat changes

Think you made it to the gate and it’s time to set up camp until boarding starts? These are no times to get comfortable. You’ll likely change gates a few times. If you are out of luck you’ll be walking back and forth between different concourses and holding areas!  As flights are getting consolidated last minute and passengers are being reseated in the cabin for all sorts of reasons, the preferred seat you selected for yourself at check-in, might not be guaranteed until the very last minute.

4. More waiting: tarmac delays

After a long international flight, it’s quite a relief that the plane has landed and that you’ll finally be able to stretch your legs and be on your way. However, depending on how many flights have landed around the same time, and if customs and immigration are at capacity, your flight’s arrival might be put “on hold” meaning that nobody will  be allowed to deplane until the crew has been given the green light from the local authorities. You’ll spend some time on the apron, waiting in your seat. Lately these tarmac delays have been as bad as two to three hours long!  

5. Customer service gaps

Among the chaos there is less time and fewer options to keep everyone happy. Airline staff is busy all day combining different roles and putting out fires. At the same time they are tired of dealing with passengers who give them an attitude. The same staff member who would normally show impeccable customer service skills in better times, might now be less tolerant or less patient. You’ll still be met by a smile, as many airline staff still do their best to be pleasant and helpful, especially to customers who are also kind to them.

Here are a few tips to make your life easier while you are flying this summer:

6. Take care of your slow-downs before you line up

Visit the washroom, feed the baby, grab a bottle of water and make sure you’ve got all your documents and a pen ready, before you join the line. Have you downloaded the right app to meet your pre-entry requirements? If not, now is the time. Bring sunblock in case you need to wait outside of the terminal for a while. And if you can’t avoid bringing checked luggage, pack wisely so that your luggage is not overweight.

7. Be an early bird: book the earliest flights available

Try to travel at the beginning of the day, when planes and crews are still fresh. Delays and cancellations tend to happen throughout the day, as all sorts of operational set backs start to add up. Also, if you miss one flight, there might still be options to get you rebooked on the same day, rather than being forced into an unplanned layover.

8. Pack essentials in your carry on

Luggage handling at modern airports are generally extremely efficient and reliable and I used to say that the last time that my luggage didn’t make it to the end destination, was more than 15 years ago. But that means nothing this summer, as there is an increased overall risk that luggage will be misplaced or won’t make it onto a connecting flight in time. So do yourself a favor and don’t pack essentials like medication or a CPAP-machine in your suitcase. I also recommend to have at least one fresh change of clothes in your carry on just in case.

9. Choose non-traditional itineraries

Do you usually connect in Newark? Try a stopover in Denver or Minneapolis instead. Do you normally fly between North America and Africa through Amsterdam, Brussels or Frankfurt? Try connecting in Dubai, Istanbul or Doha instead. Be flexible, as there are airlines and airports out there that are not even close to being affected the way Western airports are right now. Mind you, things change all the time, so be on the look out for last minute information. The mainstream news is not always the most reliable source though. Do your own research and find out what is going on at “alternative” airports. Many airports, and airport security agencies like CATSA and TSA publish their wait times in real time on a website or an app: you’ll be surprised!

10. Build in longer stopovers

Transit times of 45 minutes to one hour usually give you plenty of time to change planes at the hubs. But don’t risk it this summer. Plan ahead, and have a general understanding of what needs to be done in the time that you have. Do  you have to change terminals? Have you been to that airport before and do you know what distance you are dealing with, walking from gate B1 to E5? If you have to go through immigration or collect luggage for inspection, factor in wait time, but also factor in a tarmac delay and a buffer for toilet stops and such. Give yourself at least two hours for your straight forward stopovers that would normally take one hour.

11. Arrange special assistance well in advance

In all cases where special assistance is needed for an elderly passenger, or for any traveler whose journey is complicated by a medical condition, plan ahead and make sure that arrangements have been made to accommodate all care needs. Be it wheelchair assistance, pre-approval for medical devices or an on-board medical travel companion, make sure you make the phone calls long before the travel date to avoid disappointments.

Rudy de Kort is a medical travel companion and his company Jet Companion organizes in-flight care for airline passengers across the world.

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]]> https://jetcompanion.com/airport-chaos/feed/ 0 662 Why flying with your CPAP-machine is no big deal https://jetcompanion.com/flyingwithcpap/ https://jetcompanion.com/flyingwithcpap/#respond Thu, 23 Jun 2022 08:07:00 +0000 https://jetcompanion.com/?p=645 Can I travel with my CPAP machine? A medical travel companion discusses everything you need to know about taking your CPAP on a plane.

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a travel CPAP on a tray table onboard an airplane

Why flying with your CPAP-machine is no big deal

Rudy De Kort / 23 June 2022

1. CPAP-machines are considered a medical device

It won’t count as your personal carry-on or a personal item. You won’t be expected to give it away at the door of the aircraft if all the overhead bins are full, and you can often use it onboard, if you meet all the conditions of the airline. If you are on a full flight, you will likely be asked to keep it with you underneath a seat, rather than stowing it away in an overhead bin.

2. Be prepared if you plan to use a CPAP-device onboard

I don’t recommend going on a long-haul flight without the CPAP-machine, especially if you are flying at night, on a so called “Red eye flight”. Most airlines will allow you to use it onboard, as long as you carry a battery pack. They don’t want you to plug your CPAP in, as the power supply of the aircraft is meant to charge cell phones and small devices, and the voltage can be too unstable for the larger medical device to work properly in-flight. The airline might ask you for a negative COVID19-test, taken within 24 hours before boarding the flight, if the airline still has a masking policy onboard their aircraft. Make sure you call their customer service in advance to find out what their rules are. That way you won’t be disappointed.

3. Check your CPAP power supply

Instead of reaching your international destination, only to find out that your CPAP-machine can’t be plugged in, do a quick Google search. Most CPAP-machines come with a universal power supply that works with different voltages, but you’ll still need an adapter.  Don’t find out in your hotel-room, at bedtime, when everything is closed.

4. Be smart about your limited space

What looks small on your night table, can be too bulky in your carry-on or in the cramped space around your seat when you are flying. You can certainly carry the machine separately in its case, but if you also have a laptop or a child with you, that might not be very practical. Detach the humidifier if you can. It will save half the space, and lots of power too, especially if you are using a battery pack. And, you’ll also avoid any water damage when your machine is moved around. Use your tray table as your night table if you plan on sleeping with your CPAP-device.

5. Consider a travel CPAP

If you travel frequently, the investment will pay off. Travel models like the ResMed AirMini, Trascend3 or the Z2 Auto CPAP are about the size of a smartphone, and exceptionally lightweight. The tubing is also less bulky. Check which battery pack is compatible with your choice of travel CPAP, and how much battery life you can get based on the air pressures that you need. Portable battery packs like the Medstrom Pilot 24Lite, Freedom V2 and the ResMed RPS II are designed to support travel, with a CPAP machine. Order yours long before you travel, as the distribution of the batteries can be affected by  worldwide production delays. Once you try a travel CPAP out, you’ll never want to carry anything bigger on a flight.

6. Don’t ever pack your CPAP in your checked luggage

Baggage handlers generally don’t throw suitcases around, as airlines will start asking questions if they start receiving too many claims of damaged luggage at specific airports. It’s no guarantee though. Bags can accidentally fall from height, and baggage handlers are generally under tremendous time pressure when they get to your plane.  A highly refined CPAP- machine is easily damaged if your bag accidentally falls off a loader. If it happens, the first argument you’ll hear is that it should have never been packed in your suitcase in the first place.

7. Get the CPAP machine registered in your booking record

If you plan on using your CPAP onboard the airplane, the specific brand and model needs to be pre-approved by the airline. If you often travel with the same airline, you can have their customer service leave a note in your customer profile that you are flying with a pre-approved CPAP device. Airlines want to make sure that your specific model is on their list. Whenever they approve your machine, it will show in their booking system. Wait times are long, and you won’t necessarily save time by calling, but you don’t want to risk showing up at the airport with a machine that will not be allowed onboard. If you can’t get your device pre-approved, try to show up early at the check-in desk, so that the device can be cleared for travel.

8. Carry a letter

It’s not a guarantee that all airport staff will recognize a CPAP-machine. Like anywhere else, you could encounter inexperienced staff. Be prepared by asking your doctor to write a short statement that your CPAP-machine is essential for the treatment of your obstructive sleep apnea. You can also download a standard letter from the manufacturer’s website, in your language of choice. That letter will classify the machine as a medical device. If for whatever reason your machine gets damaged during your trip, that letter will prove useful as supporting documentation for your insurance claim as well.

9. Label your carrying case

There is a decent chance that your CPAP-machine is not the only one onboard your flight. They all look the same and so do the carrying cases. Can you imagine accidentally grabbing the wrong machine out of the overhead bin? It happens! But it’s not even the plane where it happens most. The spot where you should definitely follow your machine with your eyes without interruption is the security checkpoint. That’s where multiple identical CPAP-machines can end up side tracked on the same conveyer belt for additional inspection. Unless yours is marked somehow, it will be difficult to tell them apart.

10. Protect your breathing machine from germs

Security checkpoints are high frequency public places, and a hotspot for all kinds of micro-organisms.

Putting your CPAP-machine in a bin where everyone’s shoes go, is pretty nasty. I have seen many airports where those bins are just stacked up without being wiped down. To solve this problem, you can have your CPAP-device ready in a clear transparent plastic bag. The tubing or the mask will not be inspected separate from other items, so you can keep those in your bag. If you are asked to take the machine out of the transparent bag, you can politely refuse that, for reasons og hygiene and personal protection. The machines are often side-tracked anyway for swabbing for residues of concealed explosives.  Oh, and please don’t drop the word bomb at an airport security checkpoint. Ever.

11. In-flight power issues

The power outlets at your seat are meant for your phone charger, not a CPAP-machine. The power can be unstable. Some airlines will only allow you to use your own battery pack, which you can buy at any sleep clinic. Plugging in the battery pack should not be a problem. But in any case, if a flight attendant asks you to unplug it, please do so.

12. Don’t be embarrassed

If you feel uncomfortable using your CPAP-machine in your seat with 100+ random strangers around you, wear a hoodie or cover yourself with a blanket. But honestly, ask yourself these three questions:

What are the chances that you’ll ever see these passengers again somewhere else? If you do see them again, will they remember? If they remember…will they care?

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]]> https://jetcompanion.com/flyingwithcpap/feed/ 0 645 5 golden tips when flying with an elderly traveler https://jetcompanion.com/5-golden-tips-elderly-traveler/ https://jetcompanion.com/5-golden-tips-elderly-traveler/#respond Wed, 22 Jun 2022 06:38:00 +0000 https://jetcompanion.com/?p=610 Taking a commercial flight with an elderly traveler might be a regular occurrence for some families and caregivers, while others face certain age-related challenges for the first time. I am happy to share a few tips from a professional travel companion standpoint!

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5 golden tips when flying with an elderly traveler

Rudy De Kort / 22 June 2022

Taking a commercial flight with an elderly traveler might be a regular occurrence for some families and caregivers, while others face certain age-related challenges for the first time. I am happy to share a few tips from a professional travel companion standpoint!

1. Lean packing for elderly travelers

Make things easier for yourself. Reserve the space in your carry-on luggage for valuable items and items you’ll need during the journey. Use side pockets for things that need to be accessed easily, for the airport security check or during the flight. Keep gels and small bottles of liquids in a zip lock bag, as well as any medication. Use your larger compartments for stuff that don’t need to come out during the flight. Keep your passports and boarding passes close by until you are seated in your aircraft, as you will have to show them a few times. 

2. Take care of basic needs before boarding

As a flight paramedic, I quickly learnt to do as much as possible prior to boarding, and as little as possible during the actual flight. As soon as you are in th air, space and options are limited. Doing a number 2 in a cramped lavatory, or eating from a small tray table will be challenging if your traveler has a tremor, vision problems, a weak grip or numbness in the fingers. So try to use the washroom shortly before boarding, and find out in advance which restaurants are open in the airport terminal so you can grab something to eat while waiting for the flight. Rely on an airline meal, only as your last option, but do bring a bottle of water from the airplane with you if you have to spend some time in the terminal waiting for your next flight.

3. Airport lounges as part of your care plan

Contrary to popular belief, airport lounges are not always restricted to holders of certain credit cards or travelers who fly business class. Ask if you can buy a daypass, and if the answer is “no” ask if there are other lounges in the terminal that do offer the service. A lounge does not only give you access to a quiet and comfortable place to rest, and wait for your flight, but it also includes drinks and more meal options, private washrooms and even shower facilities. The lounge can be pretty empty outside of peak hours, offering some privacy to take insulin or change a dressing, but the same place can quickly get busy and crowded when multiple flights are scheduled to depart.

4. Dealing with impatience from fellow passengers

If your senior traveler is acting confused or needs extra time and space to move around and go the lavatory, most other passengers will quickly understand what’s going on. In my experience, random people onboard airplanes tend to do be very helpful and understanding. For the few who will give you a dirty look or make a salty comment: you don’t feel obligated to offer an explanation. You are there to take care of your senior traveler and you don’t need the extra stress of having to deal with the opinion of other passengers. Keep in mind that not everyone can always be pleased.

5. Caregiver stress

Like your senior traveler, every caregiver has his own limitations. Caring for someone in an airplane cabin is nothing like homecare or working in a nursing home. You’ve got to factor in stressors like limited space or NO space, having the full attention of strangers in a cramped cabin and the time pressure when things don’t go as planned, boarding is in progress and your gate is still a mile ahead. Fatigue is also a big one! Don’t underestimate the effects of traveling into other time zones on your own circadian rhythm! Ask yourself: is it reasonable to take the responsibility of flying along with my senior traveler, or is it a better idea to hire a professional travel companion?

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]]> https://jetcompanion.com/5-golden-tips-elderly-traveler/feed/ 0 610 Why you shouldn’t sweat it next time your plane hits turbulence https://jetcompanion.com/turbulence/ https://jetcompanion.com/turbulence/#respond Wed, 22 Jun 2022 06:27:00 +0000 https://jetcompanion.com/?p=594 The relationship between flying into turbulence and the severe anxiety, experienced by some passengers is self explanatory. Understandably, if you are a traveler with a fear of flying, a bumpy ride is the last thing you need to add to your list of stressors.

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Why you shouldn’t sweat it next time your plane hits turbulence

Rudy De Kort / 22 June 2022

The relationship between flying into turbulence and the severe anxiety, experienced by some passengers is self explanatory. Understandably, if you are a traveler with a fear of flying, a bumpy ride is the last thing you need to add to your list of stressors.

Yet, the fact that you made it onto the plane is already an accomplishment to be proud of. Many people with flight anxiety struggle to even book the flight, and are miles away from boarding the plane, let alone live the experience of flying through turbulence!

As a flight paramedic, I used to fly on small air ambulance planes. As an international medical escort my flights are now on large commercial airliners, but the dynamics of flying are the same, regardless of the size of the airplane. I have had my share of bumpy flights, for sure, so if the thought of turbulence gives you a knot in your stomach, I wrote this blog post for you. Hear it from a a professional frequent flyer.

Hopefully I can help you relax a bit on your next flight.

Facts about turbulence: 100,000 safe landings every day

You are never alone when your flight goes through turbulence. At any given moment you can expect close to 10,000 airplanes up in the sky. These planes are criss crossing the globe with thousands of people onboard. Roughly, 100,000 flights take off and land every single day, somewhere in the world. The vast majority of these planes will fly through some degree of turbulence before they land at their destination. And you know what? Every single one of them will be landing safely! If something goes wrong…it is not going to be because of turbulence.

Turbulence and silent panic

Commercial pilots are very proactive when it comes to the safety of all passengers. When turbulence is expected, they’ll tell everyone to return to their seats, fasten their seatbelts and not use the lavatories. Flight attendants are also prompted to return to their stations and sometimes meal services are suspended, either temporarily or all together. The reason is to prevent people from getting hurt, if they are walking up and down the aisle and they loose their balance because of a sudden movement of the aircraft. It’s a standard procedure.

At this point, some passengers in the cabin will likely be feeling anxious. They might be silent, but their palms are definitely getting sweaty, their hearts racing, and their eyes are going back and fort, to gauge the reaction of the flight attendants, and other passengers. For a few it will even get worse than that, triggering a fight-or-flight reaction, and eventually a full blown panic attack.

Air flow is all but smooth

Look at turbulence on a plane the way you look at a boat that breaks through the waves of the ocean.

Air is no different than water in that sense. It’s perfectly natural to have bumpy spots. Actually, tons of them, and more so than in the ocean, because up in the sky you go through different layers of air, at different flight levels!

Air doesn’t necessarily flow smoothly. It moves up and down, in ripples, it changes speed, it changes direction, and this happens all the time, while you are flying. The plane should be moving around like a piece of paper being blown out of the window by the wind. But then came technology and engineering.

Modern airplanes are designed so well that most of the time you won’t even notice all this activity. Commercial aircraft got so stable over time that you can now have a flight so smooth that you fall asleep before the doors close and only wake up because everyone else has already left. You would almost forget that air is not smooth at all, and that turbulence is still a very natural occurance.

The myth of wings breaking off during turbulence

The bumps that occur when the plane starts descending in preparation for landing or if you are flying at a low altitude on a very short flight are to be expected.  The closer you get to the ground, the thicker and hotter the air will be. You are going to feel that! It’s normal.

But let’s go back to the boat for a second. As long as you stay out of some sort of bad storm, your boat is made to handle the waves of the ocean without any issues.

The same thing applies to airplanes. They are meant to fly in turbulent air. They are made for it.

The wings are flexible, they can go up and down several meters without ever breaking off. The wings are designed to take incredible stress. Much more than you will ever experience during a commercial flight.

Bad weather and storms

All right, how about bad weather?

Commercial pilots are highly trained to keep everyone onboard safe and comfortable. To start with, they  want to keep everyone far away from any storms. Well before you board that plane, the pilots are already somewhere in the airport, preparing the details of your flight. They are looking at the latest weather data that come from all kinds of live sensors and they are choosing the right altitude and the right flight paths to avoid trouble. If needed, they will even delay the flight for weather conditions, until it is safe to take off. That’s not a personal matter of how much risk the pilots are willing to take. Civil aviation is one of the most regulated industries on earth, with very clear standards and conditions on what is considered safe.

Last-minute weather changes

Of course not all bad weather can be predicted. A storm can develop after the plane has already departed.  But while in the air, pilots are continuously alert for changes in weather conditions.

When they look outside the cockpit, they know which clouds are the ones that will cause trouble.

If it’s pitch black outside, they are using instruments that alert them of heavy clouds, and they are also talking to air traffic control and to other pilots who are up in the air at the same time. If a pilot sees a thunderstorm on the horizon, every other pilot on the radio will know.

Say that there is bad weather ahead. The pilots can do a few things. A change in altitude for example.

They can also fly away and around the clouds. They can also slow down the airplane, just like you’d slow down your car when you see a pothole in the road.

Clear air turbulence

There is a catch! Turbulence can hit without any warning, with no clouds whatsoever.  It’s called “clear air turbulence”, and it can be quite severe too! Yes, I’ve seen videos on YouTube of those horror flights, with oxygen masks dropping from the ceiling, and meal trays full of food on the floor of the aisles.

It even makes the news, because those cases are very, very rare. There are actually numbers of how often it happens. The average airline pilot with lots of experience, hits severe turbulence for about 5 minutes for every 10,000 hours he spends up in the sky.  A fulltime commercial pilot spends about 100 hours per month in the air. That means that on average, that pilot will fly for eight years or so, to accumulate 5 minutes of bad turbulence!

Flying over the mountains

Me, I don’t fly as often as a commercial pilot or a flight attendant. Over the years, I have experienced only one incident of turbulence myself that got me scared. It was over 15 years ago, and we were flying over the mountains of the Andes in South America. The day was just perfect and we had just started our descent into the capital of Colombia. The flight attendants were preparing the cabin for landing.

Then the plane suddenly went nose down and every lose item was up in the air, then on the floor! The flight attendants lost their balance and some of the passengers were screaming in horror.

The pilots reacted quickly and leveled the plane again. You could hear the engines roar louder.

Then they found a moment to talk to us. They explained that we had hit a zone of turbulence, and reassured us that nothing bad was going to happen. The whole ordeal didn’t last for longer than 15 seconds.  It was a case of clear air turbulence. And yes, it was scary, and for a split of a second I thought that I was going to die in a plane crash. But the truth is that we were never in danger. We were still high up in the air in a safe aircraft, despite the shot of adrenalin that everyone felt.

So clear air turbulence does happen, and it is the reason why you are asked to keep your seatbelts fastened at all times as a precaution when you are flying.

Pick the best seat in the airplane

Now, where is the best place to sit in an airplane? The front of the plane is pretty quiet and stable, but if you are not flying business class, that’s not really helpful, is it? If you are flying Economy, I recommend sitting over the wings. That is the most stable spot.  Definitely avoid the back end of the cabin, because the tail of the plane is going to be bouncing up and down the most.

Next time you fly, remember that turbulence is part of the deal, and no matter how bad it gets, you are going to land safely just like the other 99,999 planes that are sharing the same sky that day, somewhere around the globe.

Rudy de Kort is a flight paramedic and the founder of Jet Companion, a Canadian provider of medically trained travel companions.

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]]> https://jetcompanion.com/turbulence/feed/ 0 594 Arranging travel support for a client with severe health issues https://jetcompanion.com/pa-booking-a-client/ https://jetcompanion.com/pa-booking-a-client/#respond Wed, 22 Jun 2022 06:09:00 +0000 https://jetcompanion.com/?p=573 At my office in Canada, we get calls from personal assistants, executive assistants and travel agents.

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Arranging travel support for a client with severe health issues

Rudy De Kort / 22 June 2022

At my office in Canada, we get calls from personal assistants, executive assistants and travel agents.

When one of their clients is of advanced age, but still needs to travel, sooner or later they’ll face a common scenario, that sounds very familiar to us:  ,,I am booking an international trip for my client. His health has declined lately, and he can’t really travel alone anymore. He doesn’t need an air ambulance or a doctor, but I am unsure how to manage this properly.”

Medical travel companion

As a Canadian provider of travel companions for hire and aeromedical care, we are often able to take the stress out of the situation. All of our so called commercial medical escorts or medical travel companions are professional flight nurses  in the first place. They are trained to care for individuals onboard a plane. A crowded cabin at 36,000 feet is their workspace, so they are very familiar with all the challenges and options. When someone needs continuous support while flying, due to aging, or after surgery or illness, the services of a medical travel companion can be the missing piece to the puzzle. In fact, whether these passengers are considered “Fit to Fly”, or denied boarding by the airline, often depends on this type of arrangement. 

Medical emergency onboard

Thirty times a day, somewhere in the world, an in-flight medical emergency is declared. It’s not really surprising: now more than ever, we see airline passengers who are 80+, or travelers of any age group with serious pre-existing conditions like dementia, heart disease or cancer. The added stress of flying doesn’t help with their daily struggles. There are also more ultra-long-haul flights, connecting cities at opposite sides of the world, non-stop. Nevertheless, many of these high-risk travelers will arrive at the airport unprepared. Most make it to their destination, with or without problems. Some get bumped off a flight. And some get into trouble and become part of the statistic.

More often than not, all it takes, to mitigate the risk of something going wrong halfway to the other side of the world, is having a trained set of eyes onboard who is able to recognize small issues, before they ever escalate. Hiring a flying companion comes at a cost, but it offers the best chance of a seamless trip.

Care needs while flying

We see travelers with a broad range of conditions: be it permanent disability after a stroke, or severe anxiety after a mental health crisis, or people who suffered a complication after surgery overseas. Some missions are time sensitive, for example someone who is terminally ill, with only a narrow window of opportunity to fly back home before getting to sick to fly. Others are planned well in advance, like in the case of an elderly expat who is transferred to a long term care facility, closer to family.

The degree of assistance can vary. When I say that we specialize in low-complexity medical travel, we mean that we transport people who are capable of flying safely on a commercial aircraft if we manage for example their incontinence, or their confusion. For these cases we don’t need to send an ICU-nurse with critical care gear. That also greatly reduces the cost of a mission. We are however licensed professionals, practicing to our full scope. So things like in-flight oxygen, symptom relief drugs and a stretcher onboard a commercial plane, can be easily arranged. People who were previously considered too sick to travel to a wellness retreat or a specialized treatment center, now have more options to get where they need to be.

Wing-to-wing, bed-to-bed transfers

No two missions are the same. Airport-to-airport transfers are common, for example in the case of a

young adult who is brought to an addiction treatment center overseas. Our nurse meets the family at check-in, and at the final destination someone else will be waiting. Later that week, that same nurse will take a cab and travel 300 kilometers across an international border to pick up an elderly client in a nursing home. Together they’ll travel 300 kilometers back to the airport in an ambulance, before boarding a transpacific flight. Around the same time, but in a different continent, one of our nurses will be doing a wing-to-wing transfer of a patient who is arriving on a private jet, and leaving on a commercial flight an hour later.

Rudy de Kort is a flight paramedic and the founder of Jet Companion, a Canadian provider of medically trained travel companions.  

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]]> https://jetcompanion.com/pa-booking-a-client/feed/ 0 573 What happens when a passenger has a medical emergency onboard a flight? https://jetcompanion.com/medical-emergencies/ https://jetcompanion.com/medical-emergencies/#respond Wed, 22 Jun 2022 05:58:00 +0000 https://jetcompanion.com/?p=555 The cabin of an airliner, 40,000 feet up in the sky, is a pretty bad spot to suffer a medical emergency. Yet, I can tell you why the vast majority of cases have a happy ending!

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What happens when a passenger has a medical emergency onboard a flight?

Rudy De Kort / 22 June 2022

The cabin of an airliner, 40,000 feet up in the sky, is a pretty bad spot to suffer a medical emergency. Yet, I can tell you why the vast majority of cases have a happy ending!

30 daily in-flight medical emergencies

Consider that in general people are older and sicker today, compared to roughly ten years ago. So is the population of air travelers all over the world. People don’t stop flying because of their diabetes, asthma or cancer. At the same time, we have more long haul flights than ever before, and even ultra long haul flights that take you from Kuala Lumpur to New York or from London to Sydney, without making a stop.

Now, for as long as air travel is affected by travel restrictions and flight cancellations, it’s not the best time to pull statistics. But, to give you a general idea, I will tell you that pre-COVID, all airlines combined,  dealt with an average of 30 medical events onboard commercial flights, anywhere in the world on any given day.

Anything can happen onboard

Most medical events are minor and have a good outcome. Some common occurrences are head injuries caused by carry on luggage falling out of the overhead bins, hot liquid burns, motion sickness, elbows that are struck by a trolley, panic attacks and abdominal pain due to gas expansion. 

At the other side of the spectrum, there are the more serious cases like a seizure, a mental health crisis, or an allergic reaction. In extreme cases someone delivers a child onboard, and unfortunately some passengers also suffer life threatening events while they are flying, like a sudden cardiac arrest. In fact, once every five days someone dies onboard a commercial flight, somewhere in the world. Again, these numbers are pre-COVID, when airports where packed with passengers. As we speak, many airlines are cancelling flights again due to a variety of reasons.

Duty to care for passengers

So, if you ever experience or come across an in-flight medical emergency, the chances are very real that this is not the first time that the cabin crew have dealt with one.

In general, flight attendants of reputable airlines are very well trained to provide first aid and CPR in the flight environment and as a professional group, they’ve built up a lot of experience over the years.

That’s not a matter of luck. Airlines have a duty to care for their passengers, provided that medical expertise is not readily accessible in the air. They take this responsibility very serious. Major airlines will have procedures in place to respond to common medical problems in the air, and flight attendants re-train these procedures every year.

No, they are not medical professionals, but when it comes to how the human body responds to flying at altitude, an experienced flight attendant or a commercial pilot might very well be your best friend.

They do know a thing or two about dehydration, gas expansion, low oxygen levels and thrombosis in the legs.

Emergency equipment on an airplane

Also take into account that commercial airlines around the world are likely better equipped than you might think. Of course this will vary from airline to airline, but expect the world’s main carriers to be better prepared for medical emergencies than in the past, as they have their own medical departments that make sure that their aircraft are up to date with lifesaving medical supplies.

I know from first hand experience that major airlines in North America, Latin America, Europe, the Middle East, Asia and Australia not only carry first aid kits, but also oxygen, automated defibrillators and complete medical kits that are better equipped than most ambulances in the world. Emergency drugs and intravenous fluids can be started within minutes if there are trained medical professionals on the flight.

Is there a doctor onboard?

Contrary to popular believe, grabbing the PA-system and calling for a doctor is not necessarily the first line of action if something happens. In all cases, flight attendants will step up and provide first aid to a passenger who needs help. If you are flying on a smaller airline, the crew will be more likely to ask for help from any medical professional who happens to be onboard as a passenger. And in reality, it would be a lot of bad luck, to not have any passenger onboard who has had some degree of medical training. It’s more common to have multiple passengers step up. German airline Lufthansa goes a step further and keeps a list of medical professionals who voluntarily signed up to be called upon if they happen to be flying.

There are risks involved: the airline does not have knowledge of the level of training and experience of medical staff who volunteer to help. And understandably, not all doctors, nurses or paramedics will necessarily be helpful in an emergency, despite all good intentions. Relying on the skills of random passengers is a potential liability issue.

Therefore, larger airlines have continued to look for more options to respond to their passengers’ needs, under more controlled circumstances. And that is how telemedicine is increasingly becoming a widespread tool in commercial aviation.

Doctor on the ground

There are call centers on the ground, staffed by doctors who are trained in aviation medicine. And they can be contacted 24/7. No matter where in the world a plane is flying, the pilots can pick up a satellite phone and call an aviation doctor. The doctor will tell the crew in the air what questions to ask, and what to do. And that includes very specific instructions to administer lifesaving treatment or medication from the medical kit. That way, most medical events can be controlled safely and at the same time an unnecessary emergency landing can be prevented.

If the patient needs more complex interventions, that same doctor on the ground will instruct the cabin crew to find out if there is a trained medical professional onboard who can assist. One thing is for sure: every single thing that happens onboard will be carefully documented.

To land or not to land

Ultimately, it is the captain who will decide if the flight can continue, based on different factors.

One of the considerations is that even if there is a suitable airport close by, a diversion will take time.

For example: if a passenger went into cardiac arrest at cruising altitude and high quality CPR is being performed, the first few minutes are critical for survival. Let’s assume that medical professionals onboard are able to deliver shocks and inject medication, but nothing is helping. In the best case scenario, if the plane is flying over land, it can easily take up half an hour to come down from 40,000 feet all the way to touchdown at an airport. If the plane was crossing the ocean, reaching an airport could take much longer. The patient in cardiac arrest doesn’t have that much time. If he doesn’t respond to CPR in the next few minutes, he will not survive. The most reasonable option would then be to accept the death of the passenger and continue flying. Believe it or not, Singapore Airlines even keeps a special locker onboard their aircraft where the body of a deceased passenger can be discretely stored.

Over the years I have come across some very knowledgeable airline crews, and in combination with health care professionals onboard and medical consultation on the ground, a lot can be done in the event of a medical emergency. I can’t say the same thing for every airline I have flown with. But I can easily list multiple major airlines that are very well prepared for medical emergencies. 

As a medically trained professional myself, I feel at ease, that if I became ill on a flight, I would be well taken care of.

Rudy de Kort is a flight paramedic and the founder of Jet Companion, a Canadian provider of medically trained travel companions.

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]]> https://jetcompanion.com/medical-emergencies/feed/ 0 555 Can a bed-ridden person be transported by air? https://jetcompanion.com/flying-lying-down/ https://jetcompanion.com/flying-lying-down/#respond Wed, 22 Jun 2022 05:38:00 +0000 https://jetcompanion.com/?p=533 Some people have compelling reasons to travel, but can’t sit up because of severe pain, discomfort or weakness. They might be unconscious or sedated, or suffering from late stage dementia.

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Can a bed-ridden person be transported by air?

Rudy de Kort / 22 June 2022

Some people have compelling reasons to travel, but can’t sit up because of severe pain, discomfort or weakness. They might be unconscious or sedated, or suffering from late stage dementia. They might even be in a palliative state, and on their way home. These are the cases where airlines team up with commercial medical escort companies and other specialty service providers to safely transport the passenger to the scheduled destination. And where air travel is not possible, there are also other options to transport a stretcher-bound patient over a long distance. I’ll explain.

Can a bed-bound person be transported on a commercial plane?

It is a question that many families face after their loved one suffers a stroke, severe injury or in the wake of major surgery. In these cases, arrangements to support daily life at home or in the community are readily available. But what happens if someone needs to travel by plane, but can’t sit up for a long time? I’ll discuss different options. Each come with a price tag, but while there are many reasons why people can be medically unfit for air travel, being immobile, alone, isn’t necessarily a reason to keep a traveler on the ground.

Flying Business Class when you can’t sit

Upgrading to Business Class can solve the problem. Sometimes. International long-haul flights and busy domestic routes are often operated by aircraft with lie-flat pods. The extra space, complimentary pillows and the option to recline to a position of comfort, can take away a lot of pain and discomfort. Lie-flat seats are in that sense more comfortable than an airline stretcher.

But you’ve got to be sure though what seat you are getting on your flight, as Business Class can also mean a wider seat, with no full recline, or even a Kurt row of Economy Class seats of which the middle seat has been left unoccupied. The same route you are familiar with could be operated by a Dreamliner with lie-flat pods on the 8 am flight, while the 10 am flight is flown by a narrow body Airbus with classic Business Class seats.

It is also important to know that every passenger who boards a commercial flight needs to be able to sit up for at least thirty minutes for take off and another thirty minutes for landing. If a passenger shows up at the gate, and is not able to sit properly in a wheelchair, the airline staff will deny boarding until a doctor can provide a fit to fly letter. So, in all cases where someone can’t sit at all due to for example severe pain, weakness or paralysis, a lie-flat pod won’t be an option either.

Book a commercial airline stretcher on your plane

Most of the larger commercial airlines in Europe, Asia, Africa, Australia and the Middle East allow a stretcher onboard. Not only can the patient travel on the stretcher for the full duration of the flight, but there are special procedures in place to board and deplane the aircraft in private, without obstructing other passengers. The stretchers are designed to fit in an airline cabin. They are usually installed in the back of the Economy cabin, after blocking off six to nine seats. Some privacy is offered by a small curtain around the stretcher, and space is always limited. A commercial airline stretcher can only be booked if the patient is accompanied by a medical travel companion or a commercial medical escort who can provide in-flight care. This service is a separate booking, with a specialized company, independent from the airline. It is often best to speak to the medical escort company first, and have them book the stretcher with the airline, as part of their service. The cost of flying on a stretcher is significantly higher than booking a Business Class seat, but also significantly lower than chartering an air ambulance, especially on ultra long-haul flights. A commercial airline stretcher is not always an option though. There are body weight restrictions. Airline stretchers are also not offered by low cost carriers, for operational and logistical reasons, and if you need to travel domestically within North America, the option is completely unavailable. None of the Canadian or American airlines offer stretcher services on their aircraft. So can a bed-ridden person fly within Canada or the US? If they are flying internationally, directly to or from North America, they can book a stretcher with any of the foreign carriers that support air stretcher service and depart or arrive at one of the major airport hubs. But on any connecting domestic flights, a commercial airline stretcher is not an option in either the USA or Canada.

How to transport a sick person to another state or province by air

People in the United States or Canada can fly in on a stretcher, if they are coming from let’s say Asia or the Middle East, but they can’t transfer to a stretcher on a connecting domestic flight within the country. If the final destination is in another state or province, there are two options left: an air ambulance or a long distance ground transfer by a long-haul ambulance service. The fastest and most practical option, is the air ambulance. It is also the most expensive option. It is after all a private charter plane, with a crew of pilots and aeromedical staff and a fully equipped cabin that supports patient transport. But even air ambulances come in different colors and flavors. Cost will depend on a number of factors like, what type of aircraft is being used? And how many fuel stops need to be made to bridge the distance? What level of care is needed? That last question is important to keep in mind. A patient who needs critical care during the transfer, will be transported by an expensive ICU-equipped air ambulance, with a critical care team onboard. But a patient needing only a basic air stretcher setup, can be safely transported by a basic air ambulance, with a single flight nurse and overall a lower price tag. So make sure the service offered is suitable for the patient’s care needs.

Long distance patient transport when flying is not an option

There are long-haul ambulance companies out there, that take interstate patient transfers across the US or from one province to another in Canada. They provide an excellent and much needed service for those who cannot fly, not only because they need to lie down, but for a broad range of reasons when someone is considered unfit to fly by an airline. Even cross-border transfers are done on a daily basis by ground ambulances between the US and Canada, with distances up to 1500 kilometers covered. Long distance ground ambulances come with entertainment screens, food and beverage services, comfortable mattresses for the patient and a family member, and extra drivers who can swap, drive or rest every so often. It’s a great resource, but whether it is a viable option needs to be evaluated by professionals, as case-specific factors are now in play, to balance out patient safety, comfort and cost. Does the itinerary include multiple stopovers? Is the distance manageable over the road or will the transfer simply take too long? Will the extra space in the back of the ambulance and the ability to make road stops add to patient safety and comfort, or will the length of the trip and the changes in road conditions cause more stress and discomfort?

Organizing the in-flight care for a traveling stretcher patient

So a very sick person who cannot sit up can travel by air, if he is otherwise fit to fly. But it’s important to realize that a stretcher on itself is not the answer to the question how to transport a bed-bound patient on a flight. The care provided in-flight needs to be solid. Lying down on a narrow stretcher for hours and hours at altitude comes with the risk of pressure sores and blood clots, and other complications. So frequent positional changes are needed, as well as professional observation and monitoring and  symptom control with medication and oxygen. Also consider that toileting on a stretcher, in a confined space, will take the help of an experienced air medical escort.

Rudy de Kort is a flight paramedic and the founder of Jet Companion, a commercial medical escort company based in Canada.

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