06/24/2015 08:22 am ET Updated Jun 22, 2016

Have an Emergency Medical Plan for Your Destination Wedding: True Horror Stories Revealed

When you're hosting a destination wedding someplace that most of your guests have never been, it's a good idea to have a very clear idea of what to do in case of an emergency. Especially if you're getting married someplace that is outside the continental United States or might be considered a "remote" location.

I'm not overstating the importance of having a really solid emergency medical plan - I've planned 500 weddings in eight years and I've had to medevac at least 10 guests off Vieques Island to the big island of Puerto Rico, and babysit dozens more through the emergency room process here, on an island where the staff on duty at the hospital doesn't necessarily speak English depending on what time you happen to visit the Emergency Room.

FACT: 911 is NOT the emergency phone number everywhere. Sometimes it's a different number for police, for fire, and for medical emergencies. Some places don't have a hospital and some do, but how many services are available will vary based on where you're going to be. Anything serious or traumatic gets transported off our island pretty darned quickly. We have good doctors, but we don't have a CT or MRI machine.

True Story: While we were filming "Wedding Island" for TLC, I had a Mother of the Bride become very, very ill the day after she arrived. She was a surgical nurse and she didn't like the local hospital's initial assessment so we decided to fly her to the big island separately so she could go to the hospital of her choice. The trick was getting her onto an airplane quickly so she could get the care she needed. She was throwing up blood. No lie.

(Note: In many places where patients must be transported for a serious medical issues, you have to know THE NAME OF A HOSPITAL and THE NAME OF A PHYSICIAN in order to choose where you end up. Otherwise, you could end up in the big public hospital in the closest city and that's not always where you want to be.)

As we arrived at the local airport, my husband recognized a helicopter on the tarmac that looked a lot like one we had recently used to bring a bride to her wedding, and I called the pilot to see if it was actually him. It was. I explained the situation and he wanted to help - but he was on the island with the governor. He'd brought him over for a meeting and had to wait til the big man returned.

I got panicky, and Carlos showed mercy. I didn't think they were going to clear the airfield fence because he took off so fast once we got her into the helicopter. It was nothing short of a miracle that he was there. A commercial flight - or even arranging a charter - would have taken quite a bit of time.

Fortunately, the pilot made it back to Vieques before the governor got back to the airport. He never knew we'd hijacked his ride until the show aired!

Unfortunately, the Mother of the Bride checked herself out of the hospital that night and returned to the island, only to become very, very ill the next morning and require a second evacuation from the island. They didn't show that on TLC. This time I left it in the hospital's hands because she was too sick to argue with them and they brought in one of the big medical helicopters. She survived, but just barely.

Most of the medical "emergencies" I have to assist with are a result of an overindulgence in alcohol. I've spent many evenings in the emergency room with bridesmaids who've had about 20 too many cocktails in their enthusiasm for celebrating the wedding. This can be really ugly - and really messy - but at the end of the day, alcohol poisoning is no joke and you have to go to the emergency room when somebody truly loses consciousness or throws up blood. Those cases can get fixed up here on my island, but in other places, even a drunk would need a medevac.

I've only had an actual bridal injury once - but she had to be flown to the big island for a CT scan in the middle of her wedding. She made a misstep and twisted her ankle, and when she came crashing down, she smacked her head on the pavement and got a heck of a concussion. We had to have an ambulance take her to the ER because she wasn't staying conscious and alert, and they had to send her off to another hospital for a head CT. She was able to return for the farewell festivities the next day, but she had a hell of a headache, the poor thing. She hadn't even gotten to cut her cake. The only good part is that she told me she didn't really remember much from when she smacked her head til the next morning, so she only remembers the fun parts of her wedding!

What's the moral of these wedding emergency horror stories? Have a plan in case something goes wrong and somebody gets hurt. It isn't always something crazy. I've had to help get a grandfather having a heart attack transported to the big island. And he survived too. Everybody who came to one of my weddings has made it home in one piece, eventually. But the trick was knowing who to call for what and how to push the right buttons to get somebody transported. Not all the hospital staff understand that most major U.S. health insurance companies will pay for the helicopter if their subscriber is sick on vacation someplace they cannot be treated.

If you have a wedding planner, feel free to grill them in advance with any and all medical questions. I've taken many a call from a guest with a specific medical condition and questions about facilities on this island. Sometimes, it's not the right place for somebody in delicate health to visit. Your wedding planner should know all about the nitty gritty details of dealing with medical emergencies.

For the DIY brides and grooms planning their own destination weddings, this is information you should have on hand - and copied in more than one place. It doesn't help if the emergency info is in the bride's phone and she's the one unconscious. Find out the following and list it several places, including in your welcome letter information, if it's very obscure stuff:

1) The number to call the local police

2) The number to call the fire department

3) The number to call an ambulance

4) The name of the hospital at your destination and what services are offered

5) Under what circumstances does your destination transport patients to a different location or hospital, and how it's actually done, and the name of the hospital they're going to be sent to so their family can find them (there's not always room for an extra person in the helicopter).

In this case, preparing for something you probably won't need will give you the peace of mind to answer your guests questions about emergencies and to respond should, God forbid, something unfortunate happen to one of your guests at your destination wedding. Hoping you'll figure it out when something happens doesn't cut it. You have to have a plan in advance.

Until next time, happy wedding planning from Weddings in Vieques and Sandy Malone Weddings & Events!