Boat Travel

During ascent or descent, cabin pressure changes relatively quickly. If gas cannot move freely in or out of your middle ears and sinus cavities, a pressure differential may occur, which can cause pain or discomfort in your ears or sinuses or in rare instances can rupture your eardrum. It is important to remain awake during ascent and descent so you can actively equalize your ears’ pressure (see DAN.org/Health/Ears). If you are congested or suffer from excessive postnasal drip, consider taking an over-the-counter or prescription decongestant to help keep open your sinus passages and improve your ability to equalize middle-ear pressure.

Long international flights can cause fatigue. The more time zones you cross, the more likely you will experience jet lag (see Section 2). Other contributors to heightened fatigue include the noise level on a plane, dryness of the cabin air, irritants that may be present in the cabin environment and the physical inactivity resulting from long flight. Avoiding alcohol and caffeine and using a sleep aid may help mitigate this problem. Try to build extra time into your schedule for rest after a flight through multiple time zones.

Sitting in a cramped airplane seat for a long time may cause some travelers to develop a severe condition known as deep vein thrombosis (DVT) or blood clots in the legs (see Section 2).

Billions of people fly each year, so just about any kind of medical emergency may occasionally occur on a plane. An estimated 24 to 130 in-flight emergencies occur per 1 million passengers.11 If an incident does occur in flight, crew members have some first aid training but are not medical professionals, and they have limited equipment available to them. They usually depend on remote medical assistance through a service such as MedAire (MedAire.com), which provides medical advisory services to airlines worldwide.

Some airline personnel check for visibly sick passengers in their waiting areas and during the boarding process. If you look like you may be sick, you may not be permitted to board the plane.

If you get sick while you are on a plane, note the following:

• Tell a crew member as soon as possible. • If you cough, you will be asked to wear a surgical mask or cover your mouth and nose. • If your illness is severe, crew members may move you to a different part of the plane or, if necessary, have the plane rerouted to the nearest airport so you can deplane there and be transported to a medical facility.

MOTOR VEHICLE TRAVEL

Motor vehicle accidents are the primary cause of disability or loss of life among travelers. A variety of factors contribute to these accidents, most of which can be prevented or diminished. Primary among these factors is seat belt usage.

If you plan to drive, reduce your accident risk by familiarizing yourself with local traffic laws and patterns before getting behind the wheel. Be aware that locals’ observation of traffic laws in some regions may be limited. Know

Motor Vehicle Accidents

• Every year, 20 million to 50 million people worldwide are injured and 1.3 million are killed in motor vehicle crashes. — 90 percent of these casualties occur in developing countries. — 25,000 of the deaths are among tourists.

• Road-related accidents are the No. 1 cause of preventable death among healthy American travelers.

• Nearly half of medical evacuations tothe United States are the result of a car crash.

• A medical evacuation can cost more than $100,000.

Source: Sauber-Schatz et al. 201912