Travelling abroad with children/young people who use a ventilator

Introduction

The aim of this leaflet is to answer some of your questions surrounding travelling abroad with your child and their ventilator. Many of our patients and families travel abroad, by air, boat or road out of the United Kingdom.

Whilst children and young people who use ventilation can travel abroad it is helpful to plan in advance. Especially if you are travelling abroad via plane with a ventilator or oxygen.

This information leaflet is a guide and not all aspects will be relevant to your child and their circumstances.

Air travel

If you are planning to travel by aircraft, inform your child’s Long Term Ventilation team (LTV) that you are planning to travel via plane.

Your child’s doctor may request a Fitness to Fly (Hypoxic Challenge test) if they feel it is a necessary safety requirement before air travel. Aircraft cabins are pressurised resulting in the partial pressure of oxygen to be reduced during flight. Some children with certain medical conditions and children who use mechanical ventilation it is important that under these conditions that your child can tolerate the reduced atmospheric oxygen. Most healthy people will tolerate this with a small drop in blood oxygen saturations. If your child’s blood oxygen levels drop below a certain level supplemental oxygen may be started in order to maintain blood oxygen levels. This will give your child’s doctor an indication of how best to keep your child safe during flight.

If a Fit to Fly test is required these can be performed at Addenbrooke’s Hospital or Great Ormond Street (GOSH). If your child has a tracheostomy and Ventilation your child will have their Fit to Fly at Great Ormond Street.

Inform you LTV team with 3-4 months notice prior to travel to ensure all tests and any arrangements for oxygen can be organised in time for your departure date.

Inform the Airline

We advise that you make contact with the airline you are travelling with, for advice regarding travelling on board the flight with your child and their medical needs, including the use of ventilation and oxygen. Some airlines request medical forms to be completed. Please allow a 8 week turn around for letter/forms to be completed by the clinical team at Addenbrooke’s. Before sending the Long Term ventilation (LTV) team your medical forms please ensure you have completed all parts of the form required by the patient or family. Any blank forms will be sent back to the family and this may cause a delay in processing your request.

Travel insurance

Holiday travel insurance is essential for the child/young person and family, we advise you obtain it at the point of booking your holiday in case you have to cancel the holiday prior to leaving.

It is advisable that the cover includes repatriation cover and potentially via air ambulance if your child became unwell and required transfer back to the UK and cannot travel via a commercial flight.

Travelling within Europe

If you are travelling within the European Economic Area and Switzerland it is advisable to obtain a UK Global Health Insurance Card (GHIC). If you are a UK resident, then the GHIC will entitle you to some treatment free or at a reduced cost when visiting a European Union (EU) country.

These can be applied for online via NHS UK (opens in a new tab) or GOV.UK (opens in a new tab) , or application forms can be obtained from the Post Office. There is no charge for applying for a GHIC and they can be beneficial for families whilst abroad.

Please remember a GHIC card is not a substitute for medical insurance Medical insurance should be obtained prior to travel

Travelling with Oxygen

If your child requires oxygen for the flight or travelling abroad, it is not provided by the NHS. If oxygen is required for travel and during your holiday abroad it will need to be funded and organised by the patient’s family.

Airlines are not obliged to provide oxygen at ground level prior to boarding so you will need to arrange this yourself.

Airlines have different regulations about how much can be used during the flight and how much oxygen can be delivered in flow Litres per minute.

There are a number of private companies that offer rental of oxygen to use abroad, ask your current UK oxygen provider for details of these companies.

Using your ventilator during the flight

If you are taking a ventilator abroad it must be taken on the flight as hand luggage (cabin allowance) even If it won’t be used during the flight. The equipment is fragile medical equipment and must not be stored in the hold under the plane.

If you are required to travel with two ventilators they must both be carried as cabin allowance. Contact the airline prior to travel if you require extra cabin allowance.

Ensure you have fully charged all the devices and have sourced extra batteries prior to travel. Check your devices are compatible with the ACDC power supply on an aircraft.

Ensure you have spare, mask, tubing and filters etc in case of breakages on the flight.

Humidifiers for your ventilator cannot be used during the flight.

If your child uses their wet circuit most of the time, then ensure your child has tried time on their dry circuit in preparation for using this on the flight.

Check with the airline if you can use your ventilator during take-off and landing.

Battery life of devices

It is important that the length of travel and time on possible ventilation has been calculated by yourself. Please contact the LTV team if you require additional batteries for your devices for the journey time to the destination and back again.

Travelling with other medical devices

If your child uses other medical devices (cough assist, nebuliser, feed pumps etc) you will need to check with the airline if you can take these devices and associated consumables (tubing, masks, filters, feeding pouches) on board the flight.

Most medical devices are fragile so will be required to be carried on board as hand luggage.

If your child or young person uses a wheelchair, ensure you speak to the airline regarding access to the plane and if you require extra hand luggage for your child’s medical devices/consumables, please contact the airline prior to travel.

What to do if your ventilator breaks while you are abroad

Ensure your child has 2 ventilators for use when travelling and while on holiday. Depending on your child’s condition and length of time on ventilation in 24 hours. We may ask you to take 3 ventilators for your holiday.

If your device breaks while abroad, you have a spare device to use. The local hospital while abroad might be able to assist you with a broken device. The LTV team at Addenbrooke’s might be to offer some simple advice over the phone in UK working day hours, but they will not be able to send a replacement device out to you.

Power supplies

Ensure you have researched the power supplies (especially if travelling to a country prone to blackouts) and voltages of the destination you are travelling to and if your child’s medical devices will be compatible. This information is available to you in the instruction manual for each device.

Location of local hospital abroad

We advise that you research the nearest hospital to your destination that also has a paediatric service. In case your child requires a hospital admission during your holiday.

References and links to helpful websites

• Get healthcare cover abroad with a UK GHIC or UK EHIC (opens in a new tab)
• Away from home with oxygen - Baywater Healthcare (opens in a new tab)
• Fitness_to_fly_F1384_A4_BW_FINAL_Apr16.pdf (gosh.nhs.uk) (opens in a new tab)
• Hypoxic challenge test | CUH
• Hypoxic challenge test | Great Ormond Street Hospital (gosh.nhs.uk) (opens in a new tab)
• Traveling with a Ventilator - ResMed (opens in a new tab)
• Travelling abroad with a ventilator - Resource Library - Sheffield Children's NHS Foundation Trust (sheffieldchildrens.nhs.uk) (opens in a new tab)