Assessment of adult patients for air travel
- Melissa Mattison, MD, SFHM
Melissa Mattison, MD, SFHM
- Assistant Professor of Medicine
- Harvard Medical School
- David J Lucier, MD, MBA, MPH, CPPS
David J Lucier, MD, MBA, MPH, CPPS
- Instructor of Medicine, Harvard Medical School
- Assistant in Medicine, Department of Medicine, Massachusetts General Hospital
- Director of Quality and Patient Safety for Hospital Medicine, Massachusetts General Hospital
In the United States, the Department of Transportation has issued specific regulations to prevent discrimination against passengers based on disability and requires airline carriers to accommodate patients with disabilities . Similar regulations exist in Europe and many other countries.
Clinicians are frequently asked to make recommendations to patients about travel safety. Air travel exposes people to different factors that could have an impact on their health status. There is also limited availability or absence of medical care in the event of medical emergencies . This topic review will present an overview of issues for clinicians to consider when evaluating the risks posed by commercial air travel.
Multiple topics in UpToDate discuss specific aspects of air travel. Related topics include:
●(See "Jet lag".)
- http://www.ecfr.gov/cgi-bin/text-idx?tpl=/ecfrbrowse/Title14/14cfr382_main_02.tpl (Accessed on November 17, 2015).
- Naouri D, Lapostolle F, Rondet C, et al. Prevention of Medical Events During Air Travel: A Narrative Review. Am J Med 2016; 129:1000.e1.
- Aerospace Medical Association. Medical Considerations for Airline Travel http://www.asma.org/publications/medical-publications-for-airline-travel/medical-guidelines-for-airline-travel (Accessed on April 19, 2017).
- Possick SE, Barry M. Evaluation and management of the cardiovascular patient embarking on air travel. Ann Intern Med 2004; 141:148.
- Johnson AO. Chronic obstructive pulmonary disease * 11: fitness to fly with COPD. Thorax 2003; 58:729.
- Gendreau MA, DeJohn C. Responding to medical events during commercial airline flights. N Engl J Med 2002; 346:1067.
- Evans RW, Purdy RA, Goodman SH. Airplane descent headaches. Headache 2007; 47:719.
- Coker RK, Shiner R, Partridge MR. Is air travel safe for those with lung disease? Eur Respir J 2008; 32:1423.
- Christensen CC, Ryg MS, Refvem OK, Skjønsberg OH. Effect of hypobaric hypoxia on blood gases in patients with restrictive lung disease. Eur Respir J 2002; 20:300.
- Edvardsen A, Akerø A, Hardie JA, et al. High prevalence of respiratory symptoms during air travel in patients with COPD. Respir Med 2011; 105:50.
- http://www.altitude.org/air_pressure.php (Accessed on May 05, 2017).
- Ahmedzai S, Balfour-Lynn IM, Bewick T, et al. Managing passengers with stable respiratory disease planning air travel: British Thoracic Society recommendations. Thorax 2011; 66 Suppl 1:i1.
- Walker J, Kelly PT, Beckert L. Airline policies for passengers with obstructive sleep apnoea who require in-flight continuous positive airways pressure. Respirology 2010; 15:556.
- Johnston RV, Hudson MF, Aerospace Medical Association Air Transport Medicine Committe. Travelers' thrombosis. Aviat Space Environ Med 2014; 85:191.
- Centers for Disease Control and Prevention (CDC). Federal air travel restrictions for public health purposes--United States, June 2007-May 2008. MMWR Morb Mortal Wkly Rep 2008; 57:1009.
- Centers for Disease Control and Prevention. Criteria for requesting federal travel restrictions for public health purposes, including for viral hemorrhagic fevers. Fed Regist 2015; 80:16400.
- Tuberculosis and air travel: Guidelines for prevention and control. World Health Organization. 3rd ed. 2008. Available at: http://www.who.int/tb/publications/2008/WHO_HTM_TB_2008.399_eng.pdf (Accessed on March 13, 2012).
- Mirza S, Richardson H. Otic barotrauma from air travel. J Laryngol Otol 2005; 119:366.
- Jones JS, Sheffield W, White LJ, Bloom MA. A double-blind comparison between oral pseudoephedrine and topical oxymetazoline in the prevention of barotrauma during air travel. Am J Emerg Med 1998; 16:262.
- Vacanti JJ. Post-spinal headache and air travel. Anesthesiology 1972; 37:358.
- Bettes TN, McKenas DK. Medical advice for commercial air travelers. Am Fam Physician 1999; 60:801.
- GENERAL SCREENING AND HEALTH COUNSELING
- General considerations
- - Timing of medications
- - Keep medications within reach while on-board
- SPECIFIC PREEXISTING CONDITIONS
- Deep vein thrombosis
- - Infections that prohibit travel
- - Tuberculosis
- - Upper respiratory infection and ear barotrauma
- Nasal and sinus disease
- Surgery and procedures
- Ophthalmological conditions
- SCUBA diving and decompression sickness
- Mental illness
- RESOURCES FOR CLINICIANS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS