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Travelling abroad with a ventilator

The aim of this resource is to answer some of the questions you may have about travelling abroad by aeroplane. Whilst families with children on ventilators are able to travel abroad, we would recommend that it is important to plan in advance, especially if you need to use either oxygen or ventilation on the aeroplane or in resort. Please remember the information in this resource should be used as a guide, and will not apply to all patients in all circumstances.

Can my child travel by air?

Many people who use ventilators can travel safely by air. However for some, this may be a problem. This is because the air pressure in the cabin is lower than ground level, which means the oxygen levels in your blood will fall. For people with a respiratory or cardiac condition this may cause complications such as breathlessness or discomfort. They may require supplemental oxygen or increased respiratory support via their ventilator on the aircraft.

How do I know if my child is fit to fly?

It is important you check with your respiratory specialist to judge the level of risk involved and any recommendations they may have.

Please let them know as soon as possible in case any investigations need to be booked. This will include a clinical assessment called a ‘Fitness to Fly’ test to make your child is safe to travel on an aeroplane, and see what extra respiratory support they may need.

This may include supplemental oxygen whilst in flight. The respiratory consultant will need to give you a letter confirming that your child is fit to fly and what extra support they may need. A Medical Information Form (MEDIF) provided by the airline may also need to be completed by the respiratory consultant. This form is often found on the airline’s website. Please check with the airline if this is required, and check as soon as possible to avoid delays.

Do I need to let the airline know?

You need to contact your airline as soon as you decide to go abroad. Often your tour operator will be able to provide you with the contact details. Different airlines have different rules about passengers with medical needs and the transport of medical equipment. The majority of airlines have a special services desk or page on their website. This will tell you what the requirements are, what forms they need, and anything else they consider relevant.

Do I need holiday insurance?

Holiday insurance is essential for both your child and their equipment. Often your tour operator will be able to help you or there are specialist insurance companies who cover children with medical conditions. Your tour operator or your respiratory team may have more information about this. Please make sure that any travel medical insurance you take out includes the cost of coming back by air ambulance if your child becomes too ill to return on a commercial flight.

If you are travelling within the European Economic Area and Switzerland it is advisable to get a European Health Insurance Card (EHIC). If you are a UK resident, then the EHIC may give you some free or reduced cost treatment cost when visiting a European Union (EU) country. These can be applied for online via NHS or government website , or you can get application forms from the Post Office. There is no charge for applying for an EHIC and they can be beneficial for families whilst abroad.

Information:

Please remember an EHIC card is not a substitute for medical insurance. You must get medical insurance before you travel.

Travelling with oxygen or ventilation on an aeroplane

Oxygen

Oxygen on air flights or for use abroad is not provided by the NHS. On the aeroplane the oxygen is often provided by the airline and the airline may charge for this. Please remember that airlines will not provide supplemental oxygen in ground terminals, before or after the flight, if you require oxygen on the ground you need to arrange this separately.

Each airline has their own rules regarding oxygen and not all airlines will provide oxygen routinely. Some need families to provide their own oxygen on the flight and this will mean you would need to rent a device from a private supplier in the UK.

Information:

Most commercial airlines can only supply oxygen at the rate of between 2 or 4 litres per minute, if your child requires more oxygen than this they are usually considered to be unsuitable for air travel.

If you need oxygen routinely or need oxygen to be provided whilst you are on holiday, you will still need to rent a device from a private supplier in the UK. The cost of this rental can vary depending on the length of the holiday and the amount of oxygen needed. The equipment provided is usually a concentrator providing a maximum of 3 litres of oxygen, and an appropriate number of batteries to make sure the concentrator can run safely in case of a power failure. There are a number of private oxygen suppliers in the UK who provide rental equipment for holiday use, and these can be found on the internet. Your respiratory specialist or oxygen provider may be able to help you with find one.

Using the ventilator on an aeroplane

If you are planning to carry your device on a flight you must only do so as hand luggage. The machine is fragile medical equipment and must not be stored in a hold in case it is damaged.

If you are deemed highly dependent on the machine, then you must have at least one spare ventilator and battery. For example, if you cannot risk having one night without your machine. Make sure you have a letter from your respiratory consultant on hand stating that it is medical equipment.

Carry a user manual for the ventilator to help security personnel or cabin crew to understand its purpose.

Make sure you have spare batteries with you as part of your hand luggage. Most airlines need you to have enough batteries to cover 150 percent of the flight and in case of any delays. For example, on a 10 hour flight they would need enough batteries to last for 15 hours.

Most ventilators are not suitable to be used with a humidifier system whilst on aircraft.

Not all ventilators are compatible with the AC or DC power source on an aeroplane so please check this with your airline or respiratory specialist before the to flight.

Make sure you have spare equipment hand on the plane in case they break, such as extra mask, filters tubing and so on.

Information:

Most airlines will not let you use your ventilator during take off or landing unless you are 24 hours ventilated or in an emergency situation.

Travelling with other medical devices

If you use any other medical devices you will need to check with the manufacturer and airline about its suitability and whether it is allowed to be used during a flight. These can include a cough assist device, nebuliser, humidifier or suction machine.

At time of writing, neither a cough assist machine nor a humidifier are eligible to be used on a flight. Nebulisers and suction machines are allowed, but remember to check before you fly. Most medical devices are fragile and it is likely they would need to be carried as hand luggage. If you intend to take a wheelchair on the flight with you, please tell the airline as soon as possible. They may wish to know details of the wheelchair, such as the weight and if it needs batteries.

What if my child becomes ill on board the aircraft?

If you child falls ill, tell a member of the airline staff to let them know.

Consider putting them on the ventilator of not already using it. The airline does carry emergency oxygen which they could provide if needed. Cabin crew have the ability to contact emergency medical support and make a diversion before final destination if required.

What about while we are abroad?

Mains power systems differ in terms of voltage worldwide. The majority of ventilators have an internal converter to make sure electrical supplies remain compatible with your ventilator. Check in the user’s manual or with your respiratory team if you are not sure.

Remember to take an appropriate plug adaptor for the country you are travelling to. In some countries the electrical supply may not be reliable, so make sure you have taken spare batteries with you. Take an extension lead, as there may not be a convenient plug socket near your child’s hotel bed. It may be worth telling hotel front desk staff that you will be keeping a ventilator in the room and ask that it is not moved by hotel staff.

Make sure that you have taken enough spare supplies for your ventilator, including dust filters. Filters may have to be changed more frequently if there is higher humidity or the climate is arid or dusty. Make sure you have a basic idea of where the local hospital is, and how you would access it if needed.

What if my child’s ventilator breaks while we are abroad?

You may be able to get help from the local hospital. This will depend on the local hospital resources and local services. Make sure you take your child’s ventilator, any documents and contact details provided by your respiratory team in the UK, and your insurance certificate. You may be able to contact your respiratory team in the UK for simple advice, however they will not be able to provide you with a replacement ventilator.

If your child is deemed highly dependent on the machine, for example they cannot risk having one night without your machine, then you will have been provided with a spare ventilator and batteries. Swap to this ventilator immediately but advise your respiratory team in the UK that you have had a ventilator failure as soon as possible.

If there is a power cut or you have problems with the power supply whilst in resort, the ventilator has internal battery capacity and spare battery capacity. Please remember the average life span of each battery is between 4 to 6 hours. This should provide adequate time to get to an alternative power supply or to contact the local hospital.

Information:

If your child is very reliant on their ventilator (such as they cannot go one night without using it) and it fails, then always use the local hospital as a ‘place of emergency’ and attend as soon as possible.

If you have any doubts about your child’s safety, call the local emergency number.

What to do if my child becomes unwell when abroad?

Seek appropriate medical advice locally. Resorts often have links to local doctors or walk in clinics. If your child is admitted to hospital for any reason while abroad, you should take your ventilator with you into hospital. Also take all documents provided by your UK respiratory team describing both the reason for the ventilator and also the usual settings. If your child gets a chest infection while abroad, this must be treated before you fly home. Your child should have medical approval before they fly home if they have suffered a chest infection while abroad.

Summary

Most children who use ventilators are able to safely travel abroad.

Key points to remember include:

  • Plan ahead.
  • Check with your respiratory specialist to make sure your child is fit to fly and if any further tests are required.
  • Insurance for children with pre-existing medical conditions can be expensive. It is worth getting quotes early in the planning.
  • Make sure you have told the airline as well as the tour operator. Airlines may have their own forms and checklists to complete.
  • Oxygen will need to be arranged privately by yourselves if your child requires it. This can also be an extra cost to the holiday.
  • Make sure that you have all appropriate documentation, including ventilator prescription, care plan for child, ventilator service manual and insurance certificate.
  • Always take your ventilator in your hand luggage.
  • If your child is deemed to be highly dependent on the ventilator you will need to take a spare ventilator and batteries
  • Make sure you have enough spare parts such as tubing, mask and filters in case anything breaks.
  • May tell the hotel and resort staff before to departure regarding your child’s ventilator requirements.
  • Have a general idea of where the local hospital and emergency services are in relation to your accommodation.
  • Make sure you take appropriate travel power adaptors for the country you are travelling to.
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Disclaimer

Please note this is a generic information sheet relating to care at Sheffield Children’s. The details in this resource may not necessarily reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If you have specific questions about how this resource relates to your child, please ask your doctor.

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