As a student traveling abroad years ago, I didn’t dwell on safety issues. My focus was on enjoying new experiences, and I trusted that if any challenges came up, they would simply be worked out. Good stuff, eh?
Fast forward to the present. I’m now a father of two, a certified W-EMT, and have ten years of experience as an international mountain guide under my belt. I’ve always loved travel and adventure, and know first-hand how valuable these influences are on young lives. Yet I’m also realistic about the inherent risk in these activities, and the responsibility of program leaders and guides to participants who don’t have the same experience that they do. As a parent, I’m that much more invested in doing the best I can to offer safety, while still allowing the freedom necessary for growth. Now in my work at Remote Medical as an account manager, I get to use my experience and client care focus to help groups manage their medical challenges. Every client is different, but the general process remains the same. Here’s a recent example for illustration:
Case Study: International Youth Adventure Travel
You run a large adventure travel program for American teens, with multiple teams traveling simultaneously in locations ranging from the high mountains of the Andes to tropical Asia. Safety of the participants is your top concern, yet a variety of scenarios is possible, from common incidents worst case situations. You have had success in the past due to effective staff hiring and training, well thought out itineraries, and logistical support systems, yet you want to stay proactive regarding managing medical risk. You need support available around the clock that is easily accessible by phone, access to a worldwide network of evacuation services, and medical kits substantial enough to manage issues that require the right response within the first hour. Where do you begin when trying to tackle this logistical nightmare?
Identify the Specific Challenges
Tackling this challenge requires knowing the territory. First thoughts: identify the chief challenges in order to help define what’s needed from the solution. In this case these include:
- Large numbers of participants to be managed
- International scope of program
- Diverse locations and environments- from tropics to high altitude
- Creating useful medical kits
- Liability concerns
- Budget realities
- Common medical issues- blisters, gastrointestinal, altitude illness, infections
- Worst case issues- medical emergency requiring immediate assistance then later evacuation
Consider the Options
Specific options for managing such groups are pretty diverse, and could range from a basic medical kit and a short training to sending a paramedic equipped with a full kit along with each group. Another option might be a medical evacuation service subscription. Â
Weeding Out Imperfect Solutions
Obviously, just sending groups out with a basic kit isn’t going to cut it, or could be considered hopeful at best. When traveling abroad, things can happen and access to Western-level medical care may not be an option, so it’s important to be self-sufficient to some degree. Risk management and liability concerns also are an issue: you must demonstrate that your program’s risk management systems are at or above the standard level of care of your peers’. At the other end of the spectrum sending a paramedic along would be great, but for most programs is cost-prohibitive, to put it lightly. Having a medevac service subscription may make a lot of sense, but it doesn’t help to manage life threats that require quick resolution such as anaphylaxis from a common bee sting. In other words, relying on a medevac service alone is not a complete solution.Â
What’s NeededÂ
What’s required in this case is a medical support system that is dynamic, allows the teams a degree of self sufficiency, and can be of assistance in medical emergencies. Something that augments and supports their existing training and systems without confusing staff, or getting in the way. As a director or employee of such a program, you know how to deliver great travel experiences. You need to develop a system or find a qualified partner who can, to help you deliver great, safe, travel experiences!
The Solution
We took into account the group’s goals, mission, and budget. Using these as a starting point, we did the front-end work required to give them the best possible solution, utilizing extensive risk-management, outdoor education and guiding, and wilderness medical care experience. Services generated for this group’s solution included:
- Single point of contact to manage their services
- Generating custom medical kits that handled wound management and contain select antibiotics and medications to manage medical issues, specific to each group’s location
- A way to regulate use of the prescription elements and track incidents
- 24/7 access to higher level medical backup including American Emergency Physicians from anywhere in the world, with ability to keep contact and logistical info for each group easily accessible
- Access to evacuation services worldwide
- Worldwide restock of medical kits, with automatic tracking of expired medications
- Simplicity: complex systems don’t get used, and can be confusing during an emergency.
Results
How did it go? This summer’s season is over, and the upgrade was a big success for the program. Direct benefits included:
- The telemedicine service fielded calls from across the globe. Team leaders valued having immediate access to higher level medical support, and the participants were comforted knowing that they could speak with a doctor any time, regardless of the severity of their situation
- Contact information was appended to each team’s file on record, so that in the case of a medical emergency, appropriate contacts could be made simultaneous to delivery of support
- Custom built medical kits were delivered packed according to the group’s exact specifications, within their timeline. Groups’ kit contents lists were uploaded to their information files to help the telemedicine support their care efficiently
- A single point of contact managed all of their communications. As is common, things came up and changes needed to be made. Understanding that, we stayed on top of the project, knowing that the participants’ safety was the top priority
- Provisioning, billing and shipping were managed closely via CRM software to ensure organization and accountability
These benefits were a big upgrade that spoke directly to the group’s initial needs when they first approached us. Indirect benefits were also realized, including:
- Documentable evidence of investment in risk management
- A way to allay parents’ (or prospective participants’ parents’) concerns about safety of their kids
- Peace of mind for program directors, field staff, and participants
Conclusion
Adventure travel programs have so much to offer to youth. It’s valuable work that helps develop responsibility and character and expand horizons. While challenge is an important element, preparedness is a basic prerequisite. Managing safety and medical concerns is a big part of the program’s responsibility. To avoid being overwhelmed, break the process down into steps, and if your hands are already full with operations, consider partnering with a qualified provider of medical support services. It’s impossible to eliminate risk, but by being proactive and systematic, enhanced safety and peace of mind can be attained.
Tom Milne
Remote Medical ACCESS Account Manager
tmilne@remotemedical.com
