The Traveler
 

Issue: October 2015

An informational bulletin on security, medical, and travel related issues
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Security

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Health
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Travel

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Regional Information

Africa - East Asia - Europe - Near East - South Asia - Western Hemisphere

 

Around the World by Plane, Train, and Automobile: Gauging the Safety of Various Modes of Transport Abroad


Part of the fun of international travel is getting to experience new modes of transport, whether it is high-speed trains, ferries, or gondolas that take you high above the city skyline. However, many countries' standards for safety fall far below Western requirements, and many modes of transport abroad may be dangerous. Given the lack of a central authority to assess the safety of various forms of transport abroad, it can sometimes be a challenge to understand which ones are safe, and which are best avoided. It is important to do your research before you leave, to have back-up plans with alternate transportation means, and understand what to do in the event of an emergency. Remember: Even a transit line with a perfect safety record could experience an accident or mechanical malfunction that could result in loss of life, so no mode of transport is 100-percent safe. 

There has recently been a rash of incidents involving ferries, buses, and airplanes in countries where safety standards do not meet Western expectations. The crash of an Indonesian Trigana Air Service plane over a remote jungle in Papua, Indonesia killed all 54 people on board on Aug. 16. A cruise ship carrying hundreds of elderly tourists capsized along the Yangtze River in June, killing more than 400 people. A bus crash along a remote winding road in Brazil claimed the lives of 49 people, including tourists, in March. 

So, how can you reduce your chances of suffering an accident during your trip? 

1) Do your research before you travel: Check reputable websites for verified reviews and feedback from recent travelers. Most embassy websites also provide safety overviews for many destinations. If a mode of transit is off limits to embassy staff, that prohibition is a good sign that you should avoid it, too. Consult with your country's civil aviation authority to confirm whether an airline has been blacklisted. Check the website of the transportation authority in the country, where you will be to see if legislation is being considered that could ban on-demand ride services such as Uber or Lyft, during the time period of your trip. Search the names of transport companies you plan to use to see if they have recently been in the news due to accidents or mechanical problems. Avoid any companies or modes of transport that appear to have a pattern of accidents or mechanical malfunctions. 

Also, before departure, be sure to have your Assist America card downloaded to your Smartphone through our App or have a printed copy. In the event you suffer an injury or medical emergency during your transit, you'll be able to contact Assist America and activate our services. 

2) Know your routes, and research alternative modes of transportation: Check whether trains, buses, or airplanes will transit any rebel-held or disputed areas, where they could be targeted by warring elements. Remember that Malaysia Airlines Flight 17, a commercial flight, was shot down over a war-torn region in Ukraine, killing all 298 people on board. Check to see if maritime piracy is a threat in any areas that you plan to travel by ferry or cruise ship. Smaller cruising vessels have been targeted and raided by pirates in the Gulf of Aden, for example, though the incidence of such attacks has declined sharply in the last two years. It is best to avoid any routes that go through areas experiencing any sort of unrest, if at all possible. 

3) Seek advice from trusted local friends and contacts: Locals generally have a better idea of which bus lines, ferry companies, and airlines to avoid, and they may be able to suggest faster modes of transport or shorter routes. Hotel concierge staff will be able to suggest the best options for reaching your day trip destination. Choose the most direct option, since layovers, numerous stops and other factors increase the likelihood that strikes, delays, and other issues could affect your timeline and ability to adhere to your itinerary. 

4) Check on emergency response and maritime rescue capabilities: A ferry with the best safety record can still experience an emergency, and it is best to know in advance if an area has sufficient rescue capabilities to respond to such an incident. If traveling through a remote, sparsely populated area, check to see where the closest first responders are located and how quickly they are likely to respond to an emergency. 

5) Avoid traveling during periods of inclement weather: Always keep an eye on the weather when preparing to travel and during your trip. Even the safest modes of transport can become dangerous during the rainy seasons in countries where landslides occur frequently or poor road infrastructure can lead to sinkholes, washed out roadways, or flooded roads. 

Typhoons, monsoons and other tropical storms can also ground planes well in advance of the storm's arrival, and may create delays if airports, runways or aircraft are damaged during the storm. Have an alternative method of transport in mind in case your first choice is not available. For example, it may become necessary to take a train to another country and fly out of that country to return home. 

6) Use your time on board transportation wisely: Once you are seated on your plane, train, bus, ferry, or other mode of transport, take a moment to observe your surroundings. Identify the emergency exit closest to your seat, read the safety brochure, and familiarize yourself with emergency exit procedures. Make sure to securely fasten harnesses, life jackets, and seat belts. Follow the instructions issued by transit personnel.   

7) Follow the news while on your trip: Even after you've reached your destination, stay informed about developments that could affect your trip. Pay attention to news of transport sector walkouts, work stoppages, and strikes that could leave you stranded in a remote area if workers refuse to operate buses, trains, ferries, or airplanes. Know your options for continuing your trip using other modes of transportation. Keep enough cash on hand to pay for a taxi or private car, for example, if buses are not running or a strike suspends all train travel. The more information you have, the better prepared you will be to deal with any unexpected transport issues during your trip. 

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Sky High Medical Emergencies: How Flights Deal with Sick Passengers 


With more than 3 billion passengers transiting global skies annually, it is no surprise that in-flight medical emergencies occur relatively frequently. According to a comprehensive study published in the New England Journal of Medicine in 2015, there are emergencies on one in every 604 flights, or about 44,000 in-flight medical crises annually. Many minor issues are quickly resolved and go unreported, so the number is likely higher. Only about 7 percent of medical emergencies that occur in the air lead to diversions, meaning 93 percent are adequately resolved in the air by flight attendants and volunteer medical personnel who happen to be on the flight.

As the numbers of commercial air passengers continue to rise, and passengers are increasingly older or more likely to suffer from pre-existing medical conditions, the number of in-flight medical emergencies is expected to rise in the next five years. With more than 50 reported medical emergencies taking place daily, it is important to understand how airplanes are equipped to handle such situations, so that passengers can be ready if a medical emergency happens to them or to a fellow passenger. 

What happens if you are on a flight when you suffer a medical emergency? 
Flying can take a toll on the human body, particularly given the many things you do on a trip that may not be part of your daily routine. These activities include straining your muscles by hauling heavy luggage, elevating your heart rate by rushing through a terminal to make your flight, and eating different foods, which can cause allergic reactions or intestinal discomfort. Combined with the typical problems that come with flying, such as changes in air pressure leading to ear pain, motion sickness and headaches, the added exertion can sometimes lead to illness on board. 

If you are traveling with a companion, make sure that your associate or partner knows of your medical conditions and medical allergies, in the event that you become incapacitated during your flight. If traveling alone, it is useful to have any medical alert bracelets readily accessible. If you experience pain or discomfort, immediately call a flight attendant and explain any conditions that could be causing your symptoms. The flight attendant will assess your symptoms and make an announcement requesting that a qualified medical professional aboard the aircraft volunteer to provide help. 

Passengers with pre-existing conditions should ensure that they have adequate supplies of their medication, along with copies of their prescription. All passengers should know the symptoms of a heart attack, so they can identify whether they are suffering a cardiac episode and promptly alert a flight attendant. 

How are airplanes equipped to handle medical emergencies? 
There is no international standard for what airplanes must have on board to respond to medical emergencies. The international organizations governing commercial flights, including the International Air Transport Association (IATA), Aerospace Medical Association (AsMA), and International Civil Aviation Organization (ICAO), publish a list of standardized recommendations, but they are not requirements, so not all airplanes will be adequately stocked to respond to all types of situations. 

Per Federal Aviation Association rules, every commercial US aircraft weighing 7,500 lbs. or more, and serviced by at least one flight attendant, must be equipped with an enhanced first aid kit (which must include the three most commonly used items to treat a heart attack: aspirin, nitroglycerin, and oxygen) and an automated external defibrillator (AED). All flight attendants must undergo annual CPR and AED training, and pilots must be trained to use the AED. A flight cannot depart if the pre-flight check determines that the first aid kit or AED is missing. European and other airlines have a large degree of variability in the contents of their first aid kits, but most flight attendants are certified to perform CPR.  

Most aircraft have the capability to contact a ground-based medical consultation service that can provide guidance in the event of serious emergency. Contact with these services is made via radio or satellite phone, and the medical professionals at such centers can assist volunteers onboard with assessment of the patient's condition and deciding whether the flight should be diverted. 

What can flight attendants do to help? 
Flight attendants are not permitted to diagnose illnesses, and can only help treat visible symptoms. They are prohibited from administering medication and using many of the items in the first aid kit unless under the direction of a licensed medical professional; in the event of an emergency, an announcement is made to request the help of any medical professional on board the aircraft. A volunteer medical professional responds to about 80 percent of in-flight medical emergencies, though it sometimes takes several announcements for one to volunteer. In half of these instances, the medical professional is a licensed physician, but nurses, emergency medical technicians and other medical professionals are often the only qualified passengers on board a flight. The Air Carrier Access Act of 1998 ensures that a medical professional who volunteers his or her help during an in-flight medical emergency—meaning he or she is not compensated for the medical care—cannot  be held liable for damages unless there is proof of gross negligence in the administration of medical services during such an event. 

Although any medical professionals aboard the flight are not required to help, and cannot be prosecuted for failure to volunteer, many believe it is their duty to assist any individual whom they are qualified to help. If the medical issue can be resolved quickly, the volunteer medical professional can return to his or her seat. If ongoing care is required, they may be asked to stay by the patient's side for as long as necessary, or until the flight lands. All volunteer medical professionals must complete a form detailing their involvement and any medications administered, for the benefit of the emergency medical team to which the patient is transferred, and to document the incident in official statistics. 

What sorts of medical emergencies are typically handled in flight? 
The most commonly treated in-flight emergencies are syncope (the temporary loss of consciousness caused by a sudden drop in blood pressure) and gastrointestinal issues. Dizziness, lightheadedness, respiratory problems, nausea, vomiting, and seizures are other common medical situations. Many of these issues are more likely to affect passengers with pre-existing conditions or elderly passengers who have not arranged for proper oxygen supplies or other equipment for the flight. 

Instances of cardiac arrest or stroke, though dramatic and most likely to earn a news feature, are quite actually rare, totaling only about 0.3 percent of in-flight emergencies. Obstetrical or gynecological emergencies, that is, female passengers going into labor or suffering a complication related to pregnancy, account for 0.5 percent of situations. In most cases, the symptoms are non-life threatening, can be treated on board, and the flight continues as scheduled. However, in about a quarter of cases, the affected passenger receives additional medical evaluation upon landing, and in about 9 percent of those cases, the passenger is hospitalized because his or her condition is serious enough to warrant additional medical care. As a result, it is always a good idea to make sure that travel medical insurance policies purchased before departure cover the cost of medical care or evacuation while abroad. 

When are flights diverted? 
Flights are rarely diverted; flights were diverted to the nearest airport in only about 7 percent of cases in the New England Journal of Medicine study. The ultimate decision to divert the plane lies solely with the pilot in charge of the aircraft. Flights are most commonly diverted if a passenger suffers cardiac arrest or stroke, which are medical emergencies that cannot be effectively treated in the air. Emergency medical teams meet the flight immediately after landing to evacuate the affected passenger, and the flight is then allowed to continue on to its destination after the short delay. However, in cases where an airplane has to be diverted to a remote airstrip while on a long-haul flight, the flight can be delayed by as much as 24 hours before it can continue its journey.

On domestic flights within the continental US, a plane can typically be diverted to the nearest airport within about 15 minutes, increasing the likelihood that sick passengers can quickly be transferred to the care of emergency medical teams on the ground and transported to a hospital that has the proper equipment to treat their condition. On international flights, diversions may take hours, if the plane is over the ocean when the incident occurs. Given cramped quarters, limited medical equipment, and lack of proper personnel to treat illness, complicated medical problems are harder to treat, and stabilizing the passenger is the main concern. As a result, patient deaths, while rare, are most likely to occur on long-haul flights. 

Medical emergencies and the threat of terrorism 
It should be noted that, following the September 11, 2001 terror attacks, flight attendants have been warned that terrorists could pretend to have a medical emergency in order to divert attention and carry out an attack on the airplane. As a result, flight attendants responding to a reported medical emergency will take steps to verify the validity of the complaint and ensure that there is no threat to the airplane's security. To date, this ruse does not appear to have been used by any individuals detained on terror charges, but given the heightened level of security onboard airplanes, it cannot be ruled out as a tactic.   
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10 Things You Should Never Touch on a Plane

It's enough to make you want to wear a hazmat suit on your next flight. The website Travelmath is making news with a new study on the cleanliness, or lack thereof, of airplanes and airports. The site sent a microbiologist to swab and analyze samples from various locations in five airports and four flights to analyze the bacterial presence on each surface. The study found that airports and airplanes generally are even dirtier than a public restroom. 

"You don't want to think about these things; you'll have nightmares," Dr. Michael Schmidt, a professor and vice chair at the Department of Microbiology and Immunology at the Medical University of South Carolina, tells Yahoo Travel. Although he wasn't the microbiologist who collected the Travelmath data, he's not surprised by the findings. Then there's another recent study at Auburn University that found that armrests, tray tables, and even seatback pockets can become long-term residences for bacteria—especially the antibiotic-resistant staph MRSA as well as E. coli.

 "The planes are constantly in motion and they typically only clean them on a fixed schedule," Schmidt says. "It's dependent upon the airline itself as to how often they vacuum the seats and vacuum the plane."

No one's saying this is an airborne health hazard, nor is anyone suggesting you go through an entire flight without touching anything. Still, some parts of an airplane are dirtier than others, and touching them—or worse, touching them before touching our eyes, mouths, noses or the food we're eating— can lead to illness. So here are 10 parts of an airplane, according to Travelmath's, study that you might want to think twice about touching:

Tray Table
- The plastic tray tables where we eat our food are the dirtiest part of the airplane, by far. Schmidt is not surprised. "The only thing that bacteria love better than human skin is plastic," he says. Schmidt says the problem is the textured, porous plastic you see on tray tables. That texture helps keep your cup of Diet Coke from sliding across the table but, according to Schmidt, it's also "creating mountain ranges where the microbes can attach themselves." And of course, there are parents who use the tray tables to hold their babies' dirty diapers. You might want to think about that the next time you consider eating peanuts right from the tray table.

Bathrooms - Surprisingly, these aren't nearly as bad as tray tables. And bathroom stall locks, which you'd expect to be filthy, aren't that bad either. Part of that is due to care. Bathrooms in airports and planes generally are cleaned more often and more regularly than your average plane's tray tables (which usually get just a once-over at the end of a day after carrying hundreds of fliers). 
But Schmidt says it's also a matter of design. He notes that airplane lavatory flush buttons tend to be made of smooth plastic, as opposed to the bacteria-catching plastic ridges you find in tray tables. "Those press buttons are often smoothed; they don't have that texturized plastic," says Schmidt. Better yet, he says, is the aluminum used on the more traditional toilet handles, where it's harder for microbes to attach. 

Overhead air vents - These tend to be slightly dirtier than toilet handles. Generally speaking, though, the overhead air vents aren't very hospitable to bacteria. "You're turning on the air and that's going to dehydrate the microbes," says Schmidt

Seatbelts - "The seatbelt buckle is smooth," he says. So just like aluminum toilet handles, the metal buckle is slightly harder for microbes to attach itself to. The actual fabric belt, though, is another story. "The seatbelt itself is porous, so the microbes can literally live in between the fibers on the debris of a person's skin." 

Seat back pockets - No one talks about this, but these pockets where airlines put their safety cards and in-flight magazine are another unexpectedly gnarly part of the plane. A study by Auburn University's found MRSA can live for 168 hours on a cloth seat back pocket. Schmidt says it's no wonder these seat back pockets can get so dirty. "Everybody puts their stuff in there," he says. Passengers often leave uneaten candy bars, nuts, crackers—food that often leaves crumbs—into the seat backs. "Microbes will go wherever there's crumbs," Schmidt notes.

Window shades - Also potential germ farms. The Auburn study found MRSA can live for 120 hours on the window shade, about as long as it can last on a tray table. Like tray tables, window shades tend to be made of porous materials allowing microbes to attach to it.

The floor - This is the prime place for all our dead cells to fall and accumulate. "We've created the flip-flop generation," says Schmidt, "and flip flops are an avenue to dump [dead skin cells] in the environment." So if you drop a piece of food on the floor, an airplane might be a good place to suspend "The Five-Second Rule." 

Your luggage - A great way to take all the filth from your travels with you. According to a study cited in The Daily Mail, luggage comes into contact with up to 80 million bacteria before it and you reach your destination. How do these items get so dirty? "Basically rolling down the street," says Schmidt. And when we roll suitcases from the filthy sidewalks onto the airplane, whose floor is teeming with dead skin cells from passengers, the problem compounds. Says Schmidt, "Luggage is actually a vehicle to move the microbes among the airplane."

Blankets and pillow - Just like other items that contain porous fibers that may or may not be cleaned regularly, blankets and pillows are questionable and are another vehicle to transmit microbes.

In-flight entertainment systems - People put their grubby hands all over in-flight entertainment systems, especially touch screens and remote controls, which is another way of spreading microbes.

Now that you're freaked out, there is some good news. For one, there's a natural protection against all these airborne germs: your own body. "When you're healthy, you don't really have to concern yourself all that much because your immune system is working well," Schmidt says. "And that's why even though there are horrible concentrations of bacteria on planes, as long as we're relatively healthy, we can protect ourselves if we just practice simple measures like hand hygiene." And that brings up the best thing you can do to protect yourself from airplane germs: washing and sanitizing your hands. "We know the alcohol on the hand gel is at 66% ethanol and that's sufficient to inactivate the microbes on your hands," says Schmidt.
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From the Assist America Case Files

Multiple medical conditions complicate travel

Rima* had a history of complicated medical issues.  Struggling with dementia, she was prone to falling and injuring herself and with many drug-related allergies, she was a challenging patient to care for.  Hoping for the best, her children brought Rima on a trip to Southeast Asia, far from her home in the Middle East.  

Unfortunately, history seemed to repeat itself, as Rima fell, fracturing her leg and hand.  She was brought to a local hospital—however, her unfamiliar surroundings had a negative effect on her dementia. She was resistant to treatment and became combative with the staff.  Her children saw that the local hospital was not equipped to deal with a patient who needed Rima's level of care and called Assist America.

Assist America's coordinators agreed that Rima would be better suited receiving care from a more qualified facility in a nearby larger city.  Assist America arranged and paid for Rima's' air ambulance evacuation to a more capable hospital and continued to monitor her care once she arrived there and was admitted.

Rima's children were much more satisfied with the care that she was receiving at the second hospital and ultimately decided that once Rima had made enough of a recovery they would be able to travel home with her for continued care and rehabilitation.

*name changed for privacy
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8 Things You Probably Didn't Know About Air Travel

It's easy to complain about the inconveniences of travel—after all, drunken flying incidents are on the rise and air travel fees are increasing. So if you've become jaded by paying too much to check luggage and gone tone deaf from all those screaming babies, then here's a few fascinating facts that might reinvigorate your interest in flying:

1. Food tastes differently on an airplane because our ability to taste salt and sweet decreases inside the cabin. Dryness and pressure actually reduce your taste buds' sensitivity by about 30%. Spicy, sour, and bitter, however, remain the same as if you were on the ground. The cabin dryness also means you can lose about two cups of water for each hour spent in the air.

2. The captain and copilot never eat the same meal in-flight. This is done in case of food poisoning, so that if one pilot gets sick the other can maintain control.

3. On long flights, pilots sleep in shifts, so it's more than likely there are actually four people flying your plane instead of just the captain you hear over the speaker. Also, pilots are required by law to get a minimum amount of shuteye during a shift. And between flights, they must get ten uninterrupted hours of rest.

4. Despite what you've seen on TV and in the movies, it is impossible to open an airplane door during a flight because of the cabin pressure.

5. If it seems your flights just keep getting bumpier, it's because turbulence actually is worsening. The amount of carbon dioxide in the air affects how smoothly your flight goes, and some scientists say turbulence could intensify between 10 and 40% by 2050. Don't worry though — only 30 to 60 cases of turbulence-related injuries occur each year, and two-thirds of those injured are flight attendants.

6. Commercial flight has only been around for just over 100 years. The first passenger to pay for a commercial flight was Abram Pheil on January 1, 1914; the flight lasted 23 minutes. It cost $400.

7. The President and the Vice President always fly separately, as do Prince Charles and Prince William (even if that means Prince William has to fly Ryanair).

8. All airliners have built-in lightning protection systems, so you're less likely to encounter a lightening-related disaster on an airplane than you are standing in an open field.

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Be an Airport Ninja: Insider Secrets for Airport Survival

Navigating the airport is often the second challenge air travelers face—right after deciding what to pack and just before fighting with your seat mate over the armrest. Getting to and through airports is both a science and an art. Most importantly, doing it right can mean the difference between starting your vacation on a pleasant note, or missing your plane and beginning your vacation stressed out, cranky, and late.

For tips on how to conquer the airport, we turned to Juan Carlos "J.C." Liscano, an insider who knows their ins and outs. He's the head of American Airlines' operations for Los Angeles International Airport, and with 20 years in the industry, his familiarity with airports has made him a bit of an airport ninja. "I think when the airport really is your environment—where you come in everyday and leave everyday—you sort of have to figure out how you maneuver within that environment," J.C. says about his seriously tight airport game, which has served him well in his own travels, both business and personal. "For me, it's about efficiency," says J.C. "I really don't want to spend one more minute at the terminal than I need to."

Now, J.C. is sharing with his tips and hacks that can help make you an airport ninja too. While some of these tips are specific to his home turf of LAX, you'll find them useful enough to help you grease your way through many other airports.

Plan ahead - People spend so much energy planning their flights, hotels, and trip itineraries only to completely turn off their brains once everything's booked. If you don't take at least some time figuring out your airport game plan, you're just asking for headaches. Don't let that happen to you; never go to the airport without a plan of attack.

Don't be a slave to the arrival / departure lanes - On the road to the airport you come to a fork, with one sign pointing the way for "Departures" and the other pointing you to "Arrivals." Because you're catching a plane, you naturally drive toward the "Departures" lane, but it turns out to be jam-packed with cars and you find yourself screaming and tearing your hair out as you slowly, maddeningly, inch towards the terminal or its parking lot. The question is, "Why?" There's no law that says if you're departing you must take the "Departures" lane. "You should never really be limited to a Departures-only or an Arrivals-only [lane]," says J.C. At many major airports, LAX included, the Departures lane feeds cars to one level of the terminal, usually the upper level, and Arrivals feeds cars to another level, usually the lower. But no matter what level you're on, you can still get to the same terminal and the same parking lot. So just pick whichever lane has the least traffic."

You don't always have to park at your terminal - Similar to how you shouldn't let the signs dictate which lane you take into the airport, you don't have to let them determine where you park. Again, take LAX, which has several different terminals you can drive up to. Suppose you're driving to catch an overseas flight out of the International Terminal, and the airport lanes are backed up. "Nobody tells you that you can't park at the lots for nearby Terminals 4 or 3," says J.C. "You can get out of your vehicle and walk [to the International Terminal] with your bag a lot quicker than if you wait to park at the one parking lot that says 'International Terminal."

Pack Light - This may be the most obvious of tips, but it's still a crucial part of pain-free airport navigation. Avoid checking a bag as much as possible for the fastest way in and the fastest way out of the airport.

Don't check-in at the airport if you can help it - In today's modern world, if you're carrying-on (which you should be), there's no reason not to check-in and have your boarding pass before you get to the airport—either via the airline's website or, better yet, through its app.

Get TSA Pre or Global Entry - A crucial airport time saver. "It is almost a must-have to have TSA Pre," J.C. says of the TSA program that allows low-risk passengers access to expedited screening at airport security checkpoints (membership requires an application, an $85 fee for a five-year membership and approval by the TSA). Passengers with this privilege usually face much shorter security lines and they don't have to take off their belts, jackets, and shoes. "That is really the fastest and most convenient way to get through the checkpoint," J.C. says. But J.C. says a better choice for people who fly internationally is Global Entry, a program run by U.S. Customs. Global Entry speeds you through customs when you return to the U.S. But with your membership (and its $100 application fee), you also get TSA Pre eligibility. "Global Entry is only $15 more [than TSA Pre] and you really get this amazing experience at the checkpoint," says J.C. "I think that's really the smarter way to go."

Depend on the kindness of strangers - When you're dealing with a monster security line and your flight is dangerously close to leaving without you, now's not the time for shyness. Go ahead and try asking your fellow passengers if you can go in front of them. Airport staffers will often make arrangements to help pressed-for-time elderly passengers through checkpoints as well. Or you could avoid the problem altogether—many airlines have premium travel programs that come with expedited security which also helps. 

Ship your gifts beforehand - With the holidays coming up, this is an especially good tip to save you time and stress at the airport. If you're planning to fly home with a bunch of gifts, save yourself some trouble and just ship them ahead of time. If you choose not to, all those gifts can hold you up at the airport, require you to check bags and might even force you to pay additional fees for overweight baggage.

Learn your airport shortcuts - One thing about airports is that they have lots of road signs navigating you out of them. Problem is, everyone else is following those signs, too — meaning that on high-traffic days, everyone is funneled into the same crowded roads. If there's an airport that you use regularly, especially your home airport, take some time to study a map of its surrounding roads to see if there are any shortcuts you can use to bypass backups.

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Regional Information

For the latest, up-to-date information regarding key regions, click on the links below:

Africa

 

East Asia

 

Europe

 

Near East

 

South Asia

 

Western Hemisphere

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For more information, contact Assist America at the number on your membership card, or via e-mail at services@assistamerica.com.
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Additional sources for Sky High Medical Emergencies: How Flights Deal with Sick Passengers:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789915/
http://www.ncbi.nlm.nih.gov/pubmed/23718164 
http://www.nejm.org/doi/full/10.1056/NEJMra1409213
http://www.nejm.org/doi/full/10.1056/NEJMoa1212052 
http://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&tpl=/ecfrbrowse/Title14/14tab_02.tpl
https://www.advisory.com/daily-briefing/2013/05/31/the-most-common-in-flight-medical-emergencies
https://www.washingtonpost.com/lifestyle/travel/is-there-a-doctor-on-board-managing-medical-emergencies-at-30000-feet/2015/08/06/9ea7037a-0afa-11e5-9e39-0db921c47b93_story.html 
http://www.theatlantic.com/health/archive/2013/04/medical-emergencies-at-40-000-feet/274623/ 

Other sources:
https://www.yahoo.com/travel/10-things-you-should-never-touch-on-a-plane-128853181477.html
http://roadwarriorvoices.com/2015/07/12/8-things-you-probably-didnt-know-about-air-travel/
https://www.yahoo.com/travel/be-an-airport-ninja-10-insider-secrets-for-129091315812.html

For pre-trip information: Assist America members may directly access travel information via the Assist America website, www.assistamerica.com. Log in using your Assist America ID/Reference number.

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The content of this edition of AssistAlert is for informational purposes only and is not intended to replace further investigation or personal observations. If you are planning travel, or are traveling in or proximate to the locations identified in this newsletter, you are encouraged to contact SecurAssist for additional information.


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