Fit to fly?

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Illness during a flight may lead to an unscheduled landing. This is expensive

for the airline and extremely inconvenient for other passengers. There are
relatively few situations where travel by flight is not allowed, but the following
guidance is helpful for anyone with any doubts. Fuller guidance can be
obtained from www.aviation-health.org

Most people are aware that the air gets thinner, providing less oxygen the
higher you go. To help deal with this, commercial aircraft are pressurised to
the equivalent of an altitude of 1500-2000m. This still results in a relatively
small fall in oxygen saturation of the order of 3-5%, which may be significant
for travellers whose oxygenation is already compromised by severe cardiac/
respiratory disease. In practical terms, people with severe heart or lung
disease who can walk 50m on level ground or ascend a flight of 12 domestic
stairs are probably fit to fly.

In general:
Chronic medical conditions should be controlled as well as possible prior to
travel.
Medication should be carried in hand baggage on the person
Help needed during travel must be pre-booked

Anyone who has suffered a heart attack, but who has made a good recovery
will probably be fit to fly three weeks later. Flying within 2 weeks of a major
cardiac or neurological crisis such as a stroke is not recommended.

If there is a history of a thrombosis (a clot of blood in the veins) frequent

leg movements are recommended during the flight. Ensure an adequate fluid
intake (not alcohol or caffeine drinks), and consider support stockings and the
use of a preventative medicine to thin the blood before boarding and after
arrival.

Flying within 2 weeks of most forms of surgery is not recommended.

From the points of view of both expansion of air in body cavities and of
wound healing, air travel should not be undertaken within two weeks of
abdominal surgery. After gastrointestinal bleeding at least one airline
recommends a wait of three weeks before travelling by air.

In the case of laparoscopy (when a camera is introduced into the abdominal

cavity to look at the individual organs, commonly the ovaries) and
colonoscopy (a fibre optic camera is used to look at the lining of the bowel)
it is recommended to wait until 24 hours have elapsed and bloating is absent.
(Gas is introduced into the abdominal cavity/colon in order that an adequate
view can be obtained)

Surgery for retinal detachment with introduction of gas: seek medical

advice from your eye surgeon.

Epilepsy. There is no specific reason why travellers who suffer from

epilepsy should not fly, but they must be aware that tiredness, lack of sleep,
over-indulgence in alcohol and poor compliance with medication during travel
may all increase the likelihood of a fit.

Asthma. There is no specific reason for asthmatic travellers not to fly,

though the dry air in the aircraft may make symptoms worse. Inhalers should
be carried in your hand luggage, together with rescue courses of steroids if
your asthma is severe.

Coughs and colds: Travellers with upper respiratory tract infections may
experience pain in the ears and/or sinuses. Obstruction of the Eustachian
tubes results in failure to equalise pressure during ascent and descent as the
cabin pressure changes. The use of decongestant drops before take-off and
landing may help, as may other methods such as a Valsalva manoeuvre, in
which you close your nostrils and breathe down, yawning, chewing gum or
sucking sweets, or, in the case of small children, crying.

After trauma: A relatively short flight from Europe with a fractured leg in
plaster may not cause too many problems, although there may be practical
difficulties such as access to the aircraft and room in the cabin for the injured
limb. On longer flights, the possibility of swelling of the limb during the flight
could cause damage to a limb in a complete plaster, and if immobilisation in
plaster is necessary the plaster should be longitudinally split. You would need
to speak to your doctors

Psychiatric conditions
Severely anxious, depressed or psychotic patients should be advised against
air travel. The stress of travel may exacerbate their condition and cause
difficulty or danger to themselves, or to other passengers. Less severely ill
patients may be able to travel, provided that they are escorted and that they
have supplies of medication available should their condition deteriorate during
travel. A psychiatric assessment prior to travel may be necessary.

Physical disabilities
Passengers with physical disabilities may need assistance with problems of
transit through the aircraft and access to the aircraft. These facilities booked
in advance, along with such additional cabin space, in-flight oxygen and
special diets. it cannot always be assumed that the same facilities provided
at a UK airport will be available at every destination.

Miscellaneous

After diving: single dives wait 12 hours; allow at least 24 hours after
multiple dives or staged decompression.
Infections: patient with infection may be a hazard to fellow passengers eg
Tuberculosis or chickenpox.
Delay flying after spinal anaesthetic: air may have been introduced.
Severe headache has been reported seven days after spinal anaesthesia
Dental abscess: may be associated with gas production
Pregnancy after 36 weeks: the woman should consult the airline and their
travel insurance.

For further information on contraindications to air travel, contact:

The Aviation Health Institute
8 King Edward St
Oxford OX1 4HL
Tel 01865 739681
Fax 01865 726583
Email aviationhealth.institute@tesco.net

The Medical Information Form (MEDIF) issued by the International Air

Transport Association (IATA), which has a section for the doctor to
complete, should be used to inform airlines about a patient's medical
condition when booking a flight. Patients can obtain MEDIF's from their
travel agent. The airline's medical officer may request further
information. The captain reserves the right to refuse to carry a
passenger.

Dr. R McConnell
Reviewed 23 Dec 03
Click it better with StudentHealth.co.uk
For more information on Travel see our Travel archives.

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between a patient/site visitor and his/her existing physician. If you are in any way concerned
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responsible or liable for incidental, consequential or indirect damages resulting form the use or
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From: Fit to fly

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