Travel Advice
Horizons in Hemophilia, November 2011
By Jeff Cornett, RN MSN, Director of Training, Research, & Advocacy
By carrying their factor and other medicines with them, people with bleeding disorders can travel more easily than ever before. A little planning is all it takes for travel to go smoothly.
Any traveler who has a health problem needs to carry a letter from his or her doctor. The letter should tell what the problem is and how it is treated. Your hemophilia treatment center can give you this letter. It should tell what kind of bleeding disorder you have and its severity (mild, moderate, or severe). If you are carrying factor and an infusion kit (syringes, needles, etc.), the letter should explain why you are doing this. Lastly, it should tell what to do in an emergency.
If you are going to another country, this letter might speed up going through customs. If you are going to a country in which English is not commonly spoken, take a letter written in a second language. Keep a medical ID card in your wallet, too.
Always wear a MedicAlert® necklace or bracelet. This could save your life. Emergency workers are trained to look for MedicAlert® tags. Letters or cards in wallets can be lost.
People who use factor concentrate to treat their bleeding should always travel with their factor and an infusion kit. Hemophilia of Georgia provides free factor travel kits to Georgians with bleeding disorders. How much factor to take depends on whether or not you can give yourself factor; where you are going; and how long you will be away. For instance, if you are going to a city with large hospitals, you can be fairly sure there will be factor. On the other hand, if you are going camping, you will need to take enough factor to handle any emergency for the entire trip.
Think about how you are going to store your factor. The paper inside the factor box tells you how to store your brand. If you expect hot weather or if your factor will be put in the trunk of the car, carry the factor in a container that will keep it cool.
If you are not able to inject your own factor, you have to know where you can get help during your trip. Find out where you can get treatment along the way and at your destination. The Centers for Disease Control and Prevention has an on-line listing of hemophilia treatment centers in the United States. The World Federation of Hemophilia (WFH) has a listing of hemophilia treatment centers in 118 countries. The WFH page also has more tips for travelers and sample travel letters. The U.S. State Department has tips for traveling outside the U.S. If you need medical care outside the country, the U.S. consulate can help you get treatment. Read the Medical Information for Americans Abroad before leaving home. Also check the website of the U.S. embassy for the country you will be visiting.
If you can’t inject factor yourself and will need to go to the emergency room for help, call ahead to the hospital in the town you will be visiting. Make sure they have the type of factor concentrate you use. If they do not, you can either send a supply to be held for you or take your own supply with you. If you take your own factor with you and go to an out-of-town emergency room, the ER staff may refuse to use your factor. Ask if the hospital will accept a signed letter from you releasing them from liability for problems caused by the use of your own factor.
Traveling by airplane, bus, or train
Whether you are flying or taking the bus or train, keep your factor and supplies with you in carry-on bags. Otherwise, they may be lost or stolen. Be sure to take needles, syringes, alcohol wipes, gauze, bandages, and a tourniquet. Some people with hemophilia may have a bleed when they fly. For this reason, some choose to take factor before they get on the plane.
The Transportation Security Administration has information on its website for travelers with medical conditions. The guidelines for persons with diabetes also apply to people with bleeding disorders.
• At the screening checkpoint, notify the Security Officer that you have hemophilia and are carrying your medication and supplies with you.
• You can carry an unlimited number of unused syringes with you as long as you are also carrying factor.
• You can carry a sharps disposal container with used syringes inside it.
• The effect of repeated x-raying on factor is not known. You can ask for a visual inspection of your factor and supplies instead of putting them through the screening machine. The instructions for doing this are found on the TSA website.
Getting rid of used needles
Getting rid of the used equipment after you take factor can be a problem when you travel. It is not safe to put them in the trash can in a hotel or motel room. The cleaning person might get stuck with the needle or get blood on him or herself. Always carry a small sharps disposal container for your used needles.
Medical insurance for travelers
If you are planning a trip to another state or country, check your medical insurance before you leave home. Some policies do not cover you outside your home state unless you pay an extra premium. Also make sure your policy is paid up and won’t expire while you are away. If you have state insurance such as Medicaid, find out if it covers you if you get sick or injured out-of-state.
Plan ahead so your travels can be enjoyable and safe.