Managing passengers with respiratory disease planning air travel: British Thoracic Society recommendations

Thoracic, British

doi:10.1136/thorax.57.4.289

Cited by 187 publications

(52 citation statements)

References 69 publications

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“…However, this rule is arbitrary since the kind of pneumothorax, the presence of an underlying pulmonary disease and the kind of treatment are not considered. In fact, if a pneumothorax is treated with thoracotomy and surgical or talc pleurodesis, the probability of a relapse is extremely low and 6 weeks after recovery there are no more restrictions on air travel [1]. On the contrary, in case of other therapeutic options or in subjects with a concomitant respiratory disease or in smokers, the risk of relapse is considerable for at least 1 year after the first episode.…”

Section: Respiratory Diseases and Air Travelmentioning

confidence: 99%

“…On the whole, patients with clinically unstable COPD should be dissuaded from undertaking air travel. The recommendations of the British Thoracic Society [1] and the guidelines of the Aerospace Medical Association [2] also suggest that all COPD patients should undergo a clinical and functional evaluation of fitness for flight before departure.…”

Section: Respiratory Diseases and Air Travelmentioning

confidence: 99%

“…Thus, in an airplane cabin, as the barometric pressure decreases when the airplane reaches cruising altitude, so the air volume in closed body cavities increases. It has been calculated that the air volume of a closed cavity, such as a pneumothorax, can increase approximately 30% when moving from sea level to 8,000 ft osl [1]. Therefore, the presence of a pneumothorax is an absolute contraindication to air travel [1,2], since the pressure in the pneumothorax may critically increase during the trip [31].…”

Section: Respiratory Diseases and Air Travelmentioning

confidence: 99%

“…In healthy subjects exposed to hypoxic mixtures with percentages of oxygen between 15.1 and 17.1%, the PaO 2 may vary between 53 and 64 mm Hg, with a SaO 2 between 85 and 91%, in relationship to age, basal PaO 2 values and minute ventilation [1]. Moreover, it has been shown that in healthy subjects moving from sea level to an altitude of 8,000 ft osl leads to an average fall in the SaO 2 of 4.4% [9].…”

Section: Effects Of Altitude On Cardiopulmonary Functionmentioning

confidence: 99%

“…More than a billion people travel by air each year around the world [1,2]. Among them, the number of people affected by respiratory diseases is increasing [3].…”

Section: Introductionmentioning

confidence: 99%

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Flying with Respiratory Disease

Tzani¹,

Pisi

Aiello³

et al. 2010

Respiration

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Patients with respiratory diseases may be at risk during flight because at cruising altitude an important hypobaric hypoxia may occur. The only absolute contraindications to flying in these patients are pneumothorax, bronchogenic cyst and severe pulmonary hypertension. In order to evaluate the risks related to air travel in patients with respiratory diseases, an evaluation of their fitness to fly, including the hypoxia altitude simulation test, is required. The fitness to fly evaluation can identify patients requiring supplemental oxygen during flight which is provided by most airlines when prescribed by the passenger’s physician. This review deals with the cardiorespiratory effects of flight, the risks associated with respiratory diseases during air travel and the procedures to follow in order to assess fitness to fly in patients with respiratory disorders.

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Section: Respiratory Diseases and Air Travelmentioning

confidence: 99%

Section: Respiratory Diseases and Air Travelmentioning

confidence: 99%

Section: Respiratory Diseases and Air Travelmentioning

confidence: 99%

Section: Effects Of Altitude On Cardiopulmonary Functionmentioning

confidence: 99%

“…More than a billion people travel by air each year around the world [1,2]. Among them, the number of people affected by respiratory diseases is increasing [3].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Flying with Respiratory Disease

Tzani¹,

Pisi

Aiello³

et al. 2010

Respiration

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In-flight Seizures and Fatal Air Embolism

Arnáiz

Lucas²,

Piedra³

et al. 2011

Arch Neurol

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In-Flight Medical Emergencies

Martin‐Gill

Doyle

Yealy

2018

JAMA

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n-flight medical emergencies (IMEs) are unique events for which traveling physicians, nurses, and other health care professionals may render medical assistance. Cruising at 35 000 ft with limited medical equipment, often hours away from the closest medical facility, creates an unfamiliar care challenge for many health care professionals. This clinical review focuses on IME data and offers guidance to assist medical professionals who may encounter these events using both literature and the authors' insights providing airline care guidance for IMEs. MethodsA literature search was conducted in MEDLINE using PubMed for English-only articles published between January 1, 1990, and June 2, 2018, using the terms air emergency, air emergencies, air passenger, air travel, aircraft, airline, aviation, commercial air, flight, and fitness to fly (n = 14 842). Scanning the titles to identify appropriateness and searching bibliographies yielded the final list of relevant articles (n = 765). Each article was assessed for completeness of data reporting and importance to management and prevention of IMEs. Based on this assessment, a total of 317 articles were included in the review. Frequency data were extracted and means and 95% confidence intervals were calculated when appropriate. Observations EpidemiologyThe estimated prevalence of IMEs is 1 in 604 flights based on a review of 11 920 requested ground consultations from 5 large IMPORTANCE In-flight medical emergencies (IMEs) are common and occur in a complex environment with limited medical resources. Health care personnel are often asked to assist affected passengers and the flight team, and many have limited experience in this environment.OBSERVATIONS In-flight medical emergencies are estimated to occur in approximately 1 per 604 flights, or 24 to 130 IMEs per 1 million passengers. These events happen in a unique environment, with airplane cabin pressurization equivalent to an altitude of 5000 to 8000 ft during flight, exposing patients to a low partial pressure of oxygen and low humidity. Minimum requirements for emergency medical kit equipment in the United States include an automated external defibrillator; equipment to obtain a basic assessment, hemorrhage control, and initiation of an intravenous line; and medications to treat basic conditions. Other countries have different minimum medical kit standards, and individual airlines have expanded the contents of their medical kit. The most common IMEs involve syncope or near-syncope (32.7%) and gastrointestinal (14.8%), respiratory (10.1%), and cardiovascular (7.0%) symptoms. Diversion of the aircraft from landing at the scheduled destination to a different airport because of a medical emergency occurs in an estimated 4.4% (95% CI, 4.3%-4.6%) of IMEs. Protections for medical volunteers who respond to IMEs in the United States include a Good Samaritan provision of the Aviation Medical Assistance Act and components of the Montreal Convention, although the duty to respond and legal protections vary across countries. Medical vol...

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Managing passengers with respiratory disease planning air travel: British Thoracic Society recommendations

Cited by 187 publications

References 69 publications

Flying with Respiratory Disease

Flying with Respiratory Disease

In-flight Seizures and Fatal Air Embolism

In-Flight Medical Emergencies

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