6 ways to avoid a trip to the ER while on vacation

Source: Web exclusive, January 2011

You’ve saved for months and planned meticulously to take a trip to that special place you’ve always wanted to visit’and then the unexpected happens. Nothing will ruin the most detailed and meticulous vacation plans like a sudden illness or injury. Not too many years ago, my then 6-year-old daughter came down with walking pneumonia while we were on vacation on the island of Barbados. We spent five hours in the ER of a local hospital waiting for my feverish daughter to be seen, and for blood tests and X-rays. 

While the ER took great care of my daughter and her attack of walking pneumonia, the whole experience made me think that burning time in an ER is the last thing I want to do when I’m on vacation with my family. Here are some tips on how to avoid unnecessary trips to the hospital while you’re enjoying some time away.

1. Get your shots up to date

Many cuts can be managed with a bit of cleaning, some antibiotic ointment and a bandage. However, some cuts’especially those that are contaminated’can become infected with tetanus. I’ve seen many patients in the ER who don’t need stitches, but do need a tetanus booster shot. Before you go on vacation, check with your doctor to make sure your immunizations and those of your family members are up to date.

2. Bring a generous supply of prescription medications

Count carefully the number of actual days (including partial days) you’ll be away from home. Make certain you have more than enough prescription pills to get you through the trip. Same goes for insulin, needles, syringes, alcohol pads and glucose test trips for travellers with diabetes. I usually take an extra week’s worth of medications and supplies if I’m heading to a remote area with infrequent flights. Remember to keep your medications in their original containers in case you need to renew them while abroad. Also, be certain you have a more-than-adequate supply of controlled substances such as prescription narcotic pain relievers, because some physicians may view requests for renewal of narcotic prescriptions with suspicion of drug abuse.

3. Know how to reach your own physician

The best part about having a family physician is that they know your medical file. Your family doctor is often the best person to help you decide whether to go to the ER or to try and manage on your own. Before you travel, program your doctor’s phone number and other contact information into your cellphone or PDA. Email is a great way to communicate quickly with your physician, but make sure he or she doesn’t mind being contacted by email during your trip.  Also remember that you may be trying to contact your personal physician across time zones, and your doctor will likely not be checking emails in the middle of the night. If your symptoms are getting worse your doctor has not replied within a couple of hours, you should probably head to the nearest ER.

4. Pack your own ‘ER-avoidance’ tool kit

In addition to packing prescription medications and related supplies, bringing a few extra items to treat minor injuries and ailments can also prevent a needless trip to the ER. Bring an over-the-counter pain reliever, such as acetaminophen and ibuprofen, to treat fever, headaches and backache, as well as pain due to sprains and minor burns. I find that ibuprofen works best for headache and pain due to injuries. Take an antihistamine such as diphenhydramine to treat allergy symptoms. Don’t forget an antinauseant, such as dimenhydrinate, for car- and air-sickness. I also take supplies for cuts and scrapes’adhesive bandages, tape, steristrips, antiseptic cleanser, topical antibiotic, antiseptic hand gel and a thermometer. A small instant ice pack will help strains and sprains, while an over-the-counter anti-diarrhea medication, such as loperamide, provides quick relief relief and makes longer car or bus trips more tolerable.

5. Need travel medical advice? Visit a specialist

Travel medical clinics keep up-to-date information on infectious diseases in the countries you plan to visit and how to prevent them. They can provide everything from shots to malaria pills, and can also prescribe a supply of antibiotics for acute gastroenteritis or food poisoning.

6. Contact a local physician

Vacationers often visit the local ER because they think that they have no one else to turn to. You can avoid an ER trip simply by asking for the name of a competent, English-speaking physician in the area you are travelling to, before you leave home. There are several ways to do this. Travel medicine clinics in your hometown may have a list of recommended physicians who work in your travel destination. And if you purchase supplementary travel insurance, the company will likely have a list of preferred health providers in the area where you vacation. Call or check the travel insurance company’s website, or ask your travel agent.

Dr. Brian Goldman is both an emergency room physician at Mount Sinai Hospital and author of The Night Shift (HarperCollins Canada).

Disclaimer: The above information is for entertainment purposes. Speak to your doctor if you want further advice on any of the conditions discussed.