FOR THE PATIENT ON TRAVEL

When your patient is going on a long travel like pilgrimage or say a south India Tour, he may come to you seeking advice about the care to be taken during traveling and bout what medications he should carry for minor problems during the travel.

You should advise them about –

-Precautions to take – in general, and depending upon the destination, care to be taken in extreme hot or extreme cold weathers, and at high altitudes.

You should give them commonly required medication to carry, as contacting a doctor is difficult during the tight schedules of traveling.

Travels to some areas may require preventive vaccines to e give.

Vaccines:

Typhoid and cholera vaccines should be given a week before the travel. They are a must, if traveling to unhealthy palaces like Kumbhamela, where thousands or lakhs of people gather

If traveling to Bihar, Assam, Kala-azar vaccine is recommended.

List of Drug to carry:

1. For fever : Crocin(paracetamol)
2. For limb pains, backache/Bodyache: Combiflm/Voveron/Nimegesic,
3. for travel sickness: Domstal (Domperidone)
4. For colds: Dristan
5. For cough: Alex cough drops
6. For Acidity: Digene/Gelusil tablets, rantac/Omez/Rabeprazole
7. for loose motions: Lomotil/Lomofen, Fasigyn/Secnil/Ciplox-TZ
8. For giddiness: Stugeron/Stugil
9. For injuries: Band-aids, Soframycin ointment, Voveron Thermagel
10. for Allergies: Cetzin.
11. Antibiotic: For fever/minorinfections: Ciprofloxacin/Sparfloxacin, For Respiratory infections: Odoxil/Roxithromycin

If the person is taking regular medicines,

For hypertension, Diabetes, Angina etc.

Take sufficient stocks to last the duration of travel, because all medicines may not available at every place

Carry essential medicines in hand bag, in case luggage is lost

Carry in your pocket,) a note of Brand name & Generic name of your medicines with dosage and II) a note of allergy to drugs if any, Diabetes and IHD if present.

For children:

Syr. Ultragin for fever, syr. Wikoryl for colds, syr.Tixylix for cough, syr. Dependal-M for loose motions, electoral powder, Wymox-kidtabs (one antibiotic)

Traveling to High altitude (Himalayas):

Patient with compromised cardio-vascular or Respiratory functions should be advised to avoid traveling to high altitudes above 2000 meters.

Care for high altitude (low oxygen saturation):

Carry camphor pieces tied in a cloth, to breath in the smell, a when there is dyspnea at high altitude.

Hypoxia can cause brain edema with disorientation, palpitation and vertigo. To prevent this, always prescribe4 Tab. Dimox (Acetazolamide) 125mg 1 bd for the duration of stay at heights above 3000 meters (9,000 feet) eg kedarnath, Badrinath.

Mountain water may cause abdominal cramps – Tab. Anafortan/Cyclopam S.O.S.

Tab. Deriphyllin S.O.S. for breathlessness.

Portable oxygen cylinders, which are available at these places on Hire, should be carried, if patient has mild exertional dyspnea.

Acute Mountain sickness:  if there is uncontrolled headache, severe nausea & vomiting, insomnia, becomes confused or irrational, the person should immediately descend down (preferably lifted down to avoid exertion) by 1000 meters or to a height where he was asymptomatic. Start Oxygen when available, Tab. Dimox 250mg 8 hrly, Inj. /Tab. Decardron 4mg 8 hrly, and if there is pulmonary edema, nifedipine 10mg sublingually.

Those who travel to high altitude suddenly in helicopter or plane, have more acute and severe problems, which require emergency treatment in Hyperbaric oxygen chamber and transport back to lower altitude.

Trekker’s rule above 3000 meters (9000 feet) – ‘Not more than 300 meters ascent in a day, and spend 2 nights in the same place every 1000 meters’.

Care for Cold Weather:

Proper protective warm clothing as demanded by the place and presence of snow.

Cotton swabs to keep external ear canals closed.

Care for sunburns and snow blindness:

Sunscreen lotion and Lip guard: to protect from solar dermatitis & sunburns. Apply sunscreen half hour before going in the sun, and repeat application after 4-5 hrs.

Protective dark sunglasses (which should filter Ultraviolet rays): a must for looking at snow shining in the sun. Patient with diabetes/atherosclerosis are prone to get Retinal artery spasm and loss of vision.

Traveling to Hot regions: (Eg. Rajasthan):

Instructions to patient:

Always keep head, neck and back well covered from direct sun.

Avoid travel in sun during afternoon hours.

Always use Hat/Cap. & umbrella.

Drink plenty of water and fluids to avoid dehydration. Drink electoral solution in sufficient quantities.

Take cold water bath and sit under a fan – if you feel uneasy, giddiness, and headache.

If sunstroke with high temperature,  sudden unconsciousness, convulsions:

Keep under a fan and sprinkle the skin with water for evaporation

Ice packs

Ice water enema

Massage the extremities to stimulate circulation

I.V. Normal saline to correct dehydration

Traveling abroad:

Take sufficient stocks for all the above listed medicines, as consulting a Doctor and buying Medicines is extremely costly and not practicable in foreign countries.

 When the stay is long, for 3-6 months or even longer, takes a full stock of regular medications for hypertension, IHD Diabetes etc.

In addition, take a stock of supplementary medicines like Vitamin B-complex, iron and calcium.

Before traveling abroad, certain vaccinations are necessary as listed below.

African & south American countries:

Yellow Fever Vaccine (>2 weeks before travel)

General: Typhoid & cholera vaccine.

Saudi Arabi (Hajj yatra at  Mecca):

Meningococcal vaccine.