Top Toolbar

 

Travel Letter

When traveling with a person with a bleeding disorder bring a prescription for clotting factor from their doctor, and a travel letter from the doctor or Hemophilia Treatment Center (HTC) that contains a brief description of the person's condition and the need for the medication.

Sample Travel Letter
Date:
RE: Travel letter

To whom it may concern:

[INSERT NAME OF PERSON WITH BLEEDING DISORDER](INSERT DOB: XX/XX/XXXX) has [CIRCLE ONE] mild/moderate/severe [CIRCLE ONE] hemophilia A/B (factor VIII [8] deficiency)(Factor IX [9] deficiency). Hemophilia is a blood clotting disorder that can cause painful and debilitating bleeding episodes into joints and muscles. Bleeding episodes are treated with IV infusions of clotting factor. Mr Doe treats bleeding episodes with a factor VIII (8) concentrate [INSERT BRAND NAME].

 

Because [INSERT NAME OF PERSON WITH BLEEDING DISORDER] has hemophilia, he/she must travel with clotting factor and dilutent water at all times. Infusion supplies such as syringes, needles, and tourniquets are required to infuse the product (does PATIENT need to have the infusion supplies on him?). Clotting factor should be maintained at room temperature (not exceeding 86°F) and, ideally, be packed in a cooler or a container with cold packs or in a refrigerator (36°F to 46°F). Clotting factor should never be frozen. If the medication exceeds these temperatures, there is a high risk of it losing its potency and effectiveness.

 

Please note that this special medication consists of multiple manufacturer-sealed glass vials of sterile water and white powder. We recommend that this medication stay with the patient during travel, including planes, trains, or cars, because of its glass and temperature fragility and because the patient might need it urgently for a bleeding episode, which can occur at any time. Being unable to quickly administer this medicine can be life threatening. This medication must not be opened until needed.

 

Mr Doe also should use aminocaproic acid for dental, mouth, or nose bleeding episodes. This antifibrinolytic drug is used to maintain clots and to prevent rebleeding. It is available in 500-mg tablets or in a 250-mg/mL elixir.

 

Please feel free to call [INSERT NAME OF HEMOPHILIA TREATMENT CENTER] at [INSERT PHONE NUMBER (XXX) XXX-XXXX] for further assistance.


Sincerely,
[INSERT NAME OF DOCTOR]
[INSERT TITLE]
[INSERT NAME OF HOSPITAL/HEMOPHILIA TREATMENT CENTER]

[INSERT NAME OF NURSE]
[INSERT TITLE]

Print out a copy of this sample Travel Letter.