Guidelines on Fitness to Fly

1. Guidelines on Fitness to Fly Eppie Habashi

2. Notifying an Airline of a Medical Condition • Cabin crew can administer first aid • Airlines have medical advisers who when given info in advance can decided whether a passsenger is “fit to fly” • Nature of condition, stability, severity, medications, mobility • Info over the phone or via MEDIF form

3. Physiological Effects of Flight • Altitude – decreases alveolar partial pressure of oxygen, sats around 90%, tolerated if healthy • If resp or cardio disease or severe anaemia may need supplementary oxygen • Barometric pressure changes – gas expands so problems with urti, pneumothorax, abdo/eye surgery, lung bullae, bubbles in insulin pumps etc • Low humidity • Jetlag – med timing

4. Cardiovascular Disease

5. Diabetes • Medication in hand luggage • Never put insulin in the hold as can be too cold, degrade • Plan if on insulin and time difference may need more/less insulin • Pump may deliver more when at high altitude and cause hypoglycaemia, reduction in delivery on descent

6. Haematology • Supplementary oxygen for severe anaemia, sickle cell disease • If at risk of DVT consider stockings and possibly LMWH • Risk of aspirin>benefit

7. Pregnancy • Delivery or diversion for delivery not favourable • Single pregnancy can’t fly from 36 weeks • Twin pregnancy 32 weeks • Most airlines require certificate after 28 weeks to say pregnancy progressing normally and EDD

8. Respiratory If a patient can walk 50 yards or climb one flight of stairs without dyspnoea, unlikely to need supplementary oxygen on flight

9. Surgical

10. www.caa.co.uk (civil aviation authority)