CF Guidelines - Travelling Abroad

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CF Guidelines - Travelling Abroad

Key things to remember and check before you travel:
	-	Ensure that you have adequate medical insurance cover. The CF Trust may be able to provide advice on this.
	-	Medication should be carried in hand luggage (but not needles, glass vials or ampules of fluid) and we can provide you with a letter to help get through customs. CF Trust will do letters in any language.
	-	Long-haul flights can pose problems in that there is slightly less oxygen in aeroplanes flying at high altitude and the humidity is often very low, which may lead to drying of chest secretions. The best way to guard against this is by doing extra physiotherapy before and after the flight (possibly during the flight if it is long) and ensuring that you drink plenty throughout the journey but avoid alcohol and caffeine (coffee, tea and coke) as these can promote dehydration.
	-	If you are travelling to a hot climate, it is important to protect medications from getting warm. Creon is inactivated if its temperature goes over 20º C, and it may not work as well afterwards. Pulmozyme and insulin need to be kept at 4ºc, in a cool-bag during travel and in a fridge on arrival.
	-	In hot weather you may lose more salt in sweat, which can cause tiredness and muscle aches and pains. It is therefore useful to have additional salt on food or take salt tablets (Slow Sodium 600mgs two or three times a day).
	-	It is important to check that the electrical supply in the country of destination is compatible with any electrical equipment, such as nebulisers. If there is any doubt, talk to our CF Nurse because we do have some portable compressors, which we can lend to you for the holiday and which are compatible with US or European supplies. Eflow nebulisers are multi-voltage and portable.
	-	It is sometimes worth taking a stand-by extra course of antibiotics for any coughs or colds whilst away, particularly if the holiday is long. Some medications such as ciprofloxacin may increase sensitivity to sunlight. A broad rimmed hat and sun block cream is advised.
	-	Some people with cystic fibrosis require supplementary oxygen on flights and it is important to enquire from us whether this may be the case, well in advance, as only certain airlines can provide extra oxygen. We may need to do a special check of the oxygen saturation levels in your blood at an oxygen level similar to that of a plane.
	-	You may require additional vaccinations depending on your destination. The booklet ‘Health Advice For Travellers’ includes information on immunisation requirements or recommendations around the world. It can be obtained from travel agents, the Post Office or by telephoning 0800 555 777 or on line at: www.dh.gov.uk. Anti-malarial prophylaxis may be required and potential interactions with other medications needs to be checked before travel.
	-	If you are spending a considerable time abroad e.g. as a student, you may want to find out the name and address of the local CF clinic. We can provide a summary of your medical problems to carry.

Fitness to fly with Cystic Fibrosis:
		Sea level resting hypoxaemia of ≤93% carries a risk of desaturation at altitude or during flight. This is more important in long haul flights and where sleep may be required. Oxygen may be required. Simulation of high altitude flight by breathing 15%? oxygen (commercially available gas mix, or air dilution with nitrogen) can be undertaken to test the individual response to hypoxia. A plethysmography body box can be used for this purpose, and if hypoxaemia is detected, the flow of oxygen via nasal cannulae to normalise pulse oximetry can be determined. Not all airlines will provide oxygen, and most but not all charge for provision.

		Dowloadable PDF File - PDF File
			Document approved - 2011
			Document due for review - December 2013

		Acknowledgements: The Peninsula CF team acknowledges the use of guidelines produced by The CF Trust, Manchester, Papworth, Leeds and Brompton CF teams during development of these local Peninsula protocols and guidelines.

Disclaimer: While efforts have been made to ensure that all the information published on this web site is correct, the authors take no responsibility for the accuracy of information, or for harm arising as a consequence of errors contained within this web site. If you have concerns regarding treatment, drugs or doses then consult your local CF consultant.