King Edward VII Memorial Hospital has an effective protocol in place for emergency treatment of visitors who may need to be flown off the island for specialized treatment—as long as health insurance or upfront funds are provided. An air-ambulance journey from Bermuda to the U.S. East Coast costs $10,000–15,000. Keep on hand your information about any preexisting medical condition, as well as the name and contact number of your primary doctor, so that if air-ambulance transport is necessary, hospital staff can arrange for your doctor to be the receiving physician at the destination.

The hospital’s social workers have the time-saving option of using a Bermuda-based air ambulance to fly patients to the mainland in emergency situations. The only on-island air ambulance is run by Bermuda Air Medivac Ltd. (tel. 441/295-1963 or 441/799-2366, fax 441/295-1098, airambulance [at] northrock [dot] bm), a private company that can fly patients anywhere in Canada, the United States, or the Caribbean and can be at a patient’s bedside within 2 hours of contact (compared to the 24-hour wait for a foreign air ambulance to fly in and turn around). Based out of L. F. Wade International Airport with a local flight crew, the 11-seater Citation SII plane offers doctors, registered nurses, and paramedics trained in critical care, and is equipped with defibrillators, ventilators, and other standard lifesaving devices. The basic fee (without an accompanying doctor) for a flight to Boston, for example, is $16,000. Cash and credit cards are accepted.

Among their myriad tasks, “Pink Ladies” and “Pink Men” volunteers (whose title refers to their rosy uniforms) help families find emergency accommodation if a relative or traveling companion ends up having to stay in the hospital. Limited space in the nearby nurses’ residence is available for such a scenario at minimal cost, about $75 a day. Many island hotels and guesthouses also try to accommodate visitors during emergencies, but space is very tight during the high season.

Patients who have been checked into the hospital need a “fit-to-fly” document signed by a local doctor in order to leave. The other possibility is for patients or their families to sign an “against medical advice” form, or AMA, but departure from the island’s airport under such circumstances ranges from difficult to impossible. For cruise ship passengers checking out of the hospital, doctors will confer with the ship’s physician to ensure all necessary equipment (oxygen, for example) is aboard the vessel before it leaves port.

The U.S. Consulate General (Crown Hill, 16 Middle Rd., Devonshire, tel. 441/295-1342, duty officer 441/335-3828, fax 441/295-1592, www.hamilton.usconsulate.gov) can aid American citizens when things go awry, particularly those lacking travel insurance. Staff may sometimes contact relatives or credit card companies to help pay out-of-pocket expenses.