The authors showed that half of British companies taking clients to remote high altitude destinations did not bring basic drugs to prevent or treat altitude illness. The study did not inquire about other important drugs, but they did discover that several of the companies did not carry group drugs because of fear of liability.

An international flight over the ocean is also a place remote from emergency medical care. Two decades ago, most international airlines did not carry emergency medications on their airplanes. Beyond the expense and logistics of keeping these kits stocked and up to date, there was a fear that flight crews could not be expected to utilize these first aid kits appropriately. After some high profile medical emergencies in the course of long flights, congressional hearings were held in the United States to analyze the issue.[3] It was discovered that almost every flight had DAPT cost medical personnel on board as passengers who would volunteer to help in an emergency—if drugs and equipment were available. Since that time, virtually all airlines carry well-stocked first aid kits

and even automatic external defibrillators.[4] A similar situation exists in many www.selleckchem.com/products/dabrafenib-gsk2118436.html adventure travel destinations—medical personnel can frequently be found in an emergency and could be effective if an expedition medical kit was available. The fear of being sued has clouded not only the issue of having drugs available on an expedition, but also who should be in charge of those drugs. If there is a problem as a result of offering medical care on a foreign expedition, the liability issue is more complicated than it might seem. If a physician was along on a trip as a regular client, whether he/she is construed as practicing medicine by helping a fellow client would depend on whether a doctor–patient relationship has been established, implicitly or explicitly. In many parts of the world, good-faith medical care in an emergency is protected by “Good Samaritan laws” that protect bystanders from being sued

for their efforts to help a stranger in an emergency, as long as their efforts are not grossly negligent, wanton, or willful. CHIR-99021 order In these instances, a doctor–patient relationship is not considered to have occurred—mainly because of the absence of a preexisting duty to the victim or an intent to charge for the services. If, however, physicians have been offered a financial incentive or a discount to accompany a trek, legal advisors have argued that these physicians are no longer “bystanders,” but de facto employees of the adventure travel company with an implied or express contract to provide medical services, and therefore not protected under Good Samaritan laws. The decision as to whether the person who offered medical care was a Good Samaritan or an employee of the company would only be relevant if there was a law suit.