Abstract
Travel requires some preparation and adjustment to the timing of doses because of time zone changes. Wear medic alert identifier and take more medication than you think you need. Assume that you will need double doses for the duration of the trip. For flights all medication needs to be carried as hand luggage. Diarrhoea is a particular problem due to the fluid losses. Oral rehydration solutions such as Dioralyte should be used. Make sure there is good regular urine output. Seek medical advice early especially: if there is a fever, blood in the diarrhoea, the person becomes confused, the diarrhoea does not stop after 24 hours, there is associated vomiting. Follow the usual sick day rules. If you think that your child is ill, double or treble the hydrocortisone dose. If there is associated vomiting intramuscular hydrocortisone should be administered. If you have used the intramuscular injection of hydrocortisone, take your child to the nearest Accident and Emergency department as soon as possible and get blood tests for salt balance and blood glucose undertaken. In any situation of doubt insist that your child is admitted for glucose, electrolyte and blood pressure monitoring. Give an additional double dose of hydrocortisone at 4 a.m. (04:00) (more@4). Do not double fludrocortisone dose.
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