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The Middle of Nowhere

A strange question, but I think there are some people who live in quite remote areas here who may be able to help or others may have similar experiences.

I live in central London 5 minutes walk from a major teaching hospital. I know what to do if I need help, where to go or when to call an ambulance and I'm very confident of being able to get help if needed. People I live with and my sister also know what to do.

However, next week I'm going on holiday to the Hebrides and Small Isles with my sister. I've been looking forward to and planning this for months and felt quite well enough with good asthma control to go (we're doing quite a lot of walking), however in the last month and a half or so, my asthma has deteriorated quite significantly (and is getting worse), my PF is well down, I'm very symptomatic and needing reliever treatment several times a day. I saw my consultant yesterday, he's said I can go but I'm back on high dose pred (annoying as I was doing so well) to cover me.

What I'm concerned about is how you judge when you need help and how you actually get it in such an environment (I'd rather know for worst case scenarios, plus it's fairer on my sister to at least have a plan) where there aren't hospitals and for much of the time we'll also be 'off-road' in the forests/hills/coastline or even in boats. Logically I can answer this as we have quite a lot of previous summer mountain walking experience, know how to summon help on the mountain (and have had to do this previously for others and certainly we will be fully equipped) and we're both qualified in first aid. We know what we're doing, we check weather forecasts and we wouldn't take unnecessary risks. However, and this is the big 'but', I'm struggling in my head to say that (although logically I know it's right) an asthma attack needs to be responded to in the same way (in terms of getting initial help if in the hills for instance - the first aid is obviously different!) as a broken leg, possible spinal injury, suspected heart attack etc. I know it's stupid but I'm still struggling with it.

Also the more likely scenario (because we simply wouldn't go off into the hills if I was unwell - that would be stupid and would potentially put others in danger if I needed help) is needing help if my asthma continues to deteriorate once there - we'll be staying in bunk houses but will mainly be in very small places with small populations - the idea of the holiday is to get away from it all!! How do people who actually live in that sort of area get help on a day to day basis - I have found for instance the name/number of a GP in one large village but that's it and we're not going to have any transport other than our feet and very limited public buses/ferries.

I hope all of the above makes some sense. I want to reiterate that I'm not going to be taking unnecessary risks and my consultant and GP have said I can go. I just want to be totally prepared as this will be my first holiday since my asthma became severe. We're going to an area we love (we'd rather go there than abroad) and I don't want anything to ruin it.

2 Replies

Hello Ratty!

Having travelled to the far flung Falkland islands (South Atlantic Ocean) I understand what you mean! being around 80 miles from the nearest hospital, the only way off the islands would be by an RAF Sea King helicopter.

I have a good tour leader, a good protocol and all my emergency meds to hand along with some antibiotics just in case. Be cautious if you deteriorate fast and get someone to call help

ASAP so a chopper or plane can be scrabled. Even if you are not as bad as usual.

Explain to your sister etc what to do and what drugs you need in an emergency while waiting for help.

Is there any medical facilties on the isle at all? Some small isles may have someone trained up as a first responder who may have O2 etc. contact the health authority to see if the isle has a resident dr too!

Get all this info etc but ...... enjoy your holiday in a fabulous place. All that fresh air will do you good!

Hope that helps!



Usually there will be a first responder on the island in most places these days some can give Nebs and if there in an ambulance they are more likely to treat you at home.

However you have to act earlier than say you would at home. But dont go phoning an ambulance without trying you reliver/neb.

There will always be access/plan for the sick even if this involves a helicoper!


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