Syncope and Driving

Guzmán, Juan C.; Morillo, Carlos A.

doi:10.1016/j.ccl.2015.04.014

Cited by 10 publications

(10 citation statements)

References 20 publications

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“…Several mechanisms or factors might trigger VVS while piloting an aircraft, including being in a passively seated position without muscle tension enhances venous pooling in the legs , preexisting dehydration or intravascular depletion, the warm environment of the aircraft leads to cutaneous vasodilatation , and strong emotional stimulation 4,12 . Treatment for preventing VVS while piloting an aircraft comprises avoiding triggering events and reassurance.…”

Section: Preventing Syncope While Piloting An Aircraftmentioning

confidence: 99%

Head-up Tilt Test May Be Useful for Determining Permission of Flight for Regular Passenger Aircraft Pilots with Vasovagal Syncope

Nakamura

Ito

Onuki

et al. 2018

Showa Univ J Med Sci

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To determine the permissibility of piloting an aircraft with vasovagal syncope VVS is a complex responsibility, because it is dif cult to evaluate VVS quantitatively. There are no clear guidelines for aircraft pilots with VVS. In some facilities, Head-up Tilt Test HUTT is used to determine its reproducibility and treatment effect. In most cases, permission is dependent on the strict examinations by specialists and judgement of the committee established for each country. Therefore, we assessed pilots with VVS and designed an algorism of permission for piloting an aircraft. Here, we describe 7 consecutive regular passenger aircraft pilots with VVS who were restricted to y. All patients were men and their mean age was 37 years. All pilots were permitted to y after at least two or more tilt-tests. The observation period was two years after ight permission. None of the pilots in the present study fainted after receiving ight permission. We can make a risk strati cation to determine hypotensive susceptibility by multiple tilt tests. Based on the results of multiple HUTT, we can more quantitatively make the judgement as to whether the pilot s VVS is well managed.

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Section: Preventing Syncope While Piloting An Aircraftmentioning

confidence: 99%

Head-up Tilt Test May Be Useful for Determining Permission of Flight for Regular Passenger Aircraft Pilots with Vasovagal Syncope

Nakamura

Ito

Onuki

et al. 2018

Showa Univ J Med Sci

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“…Therefore, the clinical approach to syncope evaluation, and the recommendations for driving, should not differ with regard to the time or activity related to the presentation of the syncopal episode [14] . Several mechanisms or factors may trigger reflex syncope while driving: the passively seated position without muscle tension (enhances venous pooling in the legs), preexisting dehydration or intravascular depletion, the warm environment of a car (leads to cutaneous vasodilatation), and strong emotional stimulation while driving [1] , [14] , [15] , [16] .…”

Section: Recommendations To Prevent Syncope While Drivingmentioning

confidence: 99%

“…Generally, encouraging frequent breaks while driving, maintaining an optimal environment in the vehicle, and taking appropriate salts and fluids are recommended for most syncope patients [1] , [14] , [15] , [16] . The benefits of pharmacological treatment such as beta-blockers, alpha-antagonists, and mineral corticoids have not been confirmed in long-term placebo-controlled trials, but these agents have shown some benefit in shorter-duration trials [16] .…”

Section: Recommendations To Prevent Syncope While Drivingmentioning

confidence: 99%

“…Non-pharmacological treatments such as counter-pressure maneuvers (including leg crossing, hand gripping, and arm tensing) could increase blood pressure significantly enough to delay or avoid loss of consciousness [16] , although it may be difficult to perform such a maneuver during driving. However, these recommendations are speculative and based on common sense, and there is insufficient evidence to support them at present [1] .…”

Section: Recommendations To Prevent Syncope While Drivingmentioning

confidence: 99%

“…However, since most patients do not want to give up driving, restricting driving privileges leads to strained physician-patient relationships. This must be balanced with public safety [1] . In Japan, motor vehicle driving by patients with recurrent syncope is restricted by the Guidelines for the Diagnosis and Management of Syncope; Japanese Circulation Society (JCS) published online in 2012 [2] .…”

Section: Introductionmentioning

confidence: 99%

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Driving restrictions for patients with reflex syncope

Sumiyoshi

2017

Journal of Arrhythmia

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Reflex syncope is the most common form of syncope that occurs while driving. The 2014 revision of Japanese Road Traffic Laws placed stricter driving restrictions, along with some associated legal penalties, on individuals with recurrent syncope. “Recurrent syncope” is defined as the occurrence of more than two episodes of syncope over a period of 5 years. No restrictions are recommended for private drivers unless they experience syncope without a reliable prodrome while driving or sitting. For commercial drivers, a driving restriction is recommended unless the efficacy of treatment can be confirmed. The “risk of harm” (RH) to other road users appears to be particularly high when commercial driving is involved. The RH formula is calculated using the time of driving, the type of vehicle driven, the risk of sudden cardiac incapacitation, and the probability of a fatal or injury-producing accident. Reducing the driving time or driving a lighter vehicle can reduce the RH. Physicians should talk to their patients about driving and advise their high-risk patients to refrain from driving.

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Vasovagal Syncope

Alagiakrishnan¹

2019

Hypotensive Syndromes in Geriatric Patients

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Syncope and Driving

Cited by 10 publications

References 20 publications

Head-up Tilt Test May Be Useful for Determining Permission of Flight for Regular Passenger Aircraft Pilots with Vasovagal Syncope

Head-up Tilt Test May Be Useful for Determining Permission of Flight for Regular Passenger Aircraft Pilots with Vasovagal Syncope

Driving restrictions for patients with reflex syncope

Vasovagal Syncope

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