What is it about ?
In an airplane, the atmospheric conditions are not like those we experience on the ground. Oxygen pressure decreases with altitude, which means that the higher you climb, the more oxygen in the blood decreases. In the cabin of an airplane, the air is constantly recirculated, 6 to 12 times per hour. At sea level, 98% of hemoglobin (a protein found in red blood cells, capable of fixing oxygen) is saturated with oxygen. This percentage drops to 92% at 2,100 meters above sea level, and barely 87% at 3,000 meters. In addition, the air is very dry. The humidity level varies between 10 and 20%.
These elements have an influence on our body. Conditions characterized by low oxygen concentration (eg asthma or anemia) and circulation problems (eg heart attack) may worsen during high altitude flight.
Moreover, the air pressure in the cabin is constantly changing, which also causes pressure variations in closed body cavities, such as the sinuses and the middle ear. We all know that feeling of pressure in the ears when taking off and landing.
Finally, certain disorders or traumas may require special care. Think of a person with diabetes whose blood sugar (glucose) level changes or a skier who has had surgery after a fracture and has a completely cast in his leg.
Take this into account when planning a flight. There are things that need to be brought to the notice of the tour operator in advance so that they can arrange for the appropriate assistance if needed, such as oxygen supply or horizontal transport.
What can you do ?
Pain caused by the change in pressure in the middle ear can be prevented by opening the eustachian tube (the junction between the pharynx and the middle ear), for example by swallowing and / or yawning. To reduce the pressure in the ears, you can chew gum and / or drink something during takeoff and descent. Breastfeed or bottle-feed infants during take-off and landing and possibly a pacifier.
Certain conditions should always be reported in advance to the tour operator or airline. You will then need to complete a medical questionnaire, the MEDIF form (Medical Information Sheet), to be requested from the tour operator or to be printed from the airline’s website. The ailments to be reported mainly concern cardiovascular or pulmonary diseases, certain contagious diseases, recent surgeries and psychiatric disorders. Discuss this with your doctor beforehand.
The following conditions should always be reported in advance:
- Recent heart attack and narrowing of the coronary arteries, for example accompanied by chest pain;
- Recent stroke (cerebral hemorrhage, blood clot in the brain);
- Anemia (hemoglobin less than 7.5 g / dl);
- Serious injuries and recent operations;
- Chronic lung diseases requiring treatment with oxygen (oxygen therapy), such as asthma, chronic bronchitis (chronic obstructive pulmonary disease (COPD)), lung cancer, …;
- Contagious diseases such as tuberculosis, diphtheria and chickenpox in its vesicular phase (the phase of pimples containing liquid, before the appearance of dry scabs);
- Psychoses with possibility of acute crisis.
You can fly if you have these conditions, but you should talk to your doctor before you go and ask if there are any special precautions.
- To be able to travel without problems, people with cardiovascular disease must be able to walk at least 100 meters or climb stairs.
- People with lung disease should have an oxygen saturation greater than 95%. Otherwise, an oxygen supply must be provided during the flight.
- People suffering from psychosis with possible acute attacks must be accompanied.
- For diabetics, appropriate meals and necessary snacks should be ordered in advance. They are allowed to carry their insulin and injection equipment in their hand luggage. Diabetics who travel by plane with significant time differences should discuss the insulin administration schedule with their doctor beforehand.
- People who have been in an accident are sometimes unable to sit normally and fasten their seat belts. Horizontal transport may be necessary. The need for an anticoagulant during the flight should also be discussed with the doctor beforehand, for example after an operation or in the event of a plaster limb.
- After middle ear surgery, it is recommended that you do not fly for 2 to 4 weeks after the operation.
- Pregnant women are advised to discuss their air travel with their doctor or midwife. In the case of a normal pregnancy, it is in principle safe for a pregnant woman to fly. However, flying may be discouraged when there is an increased risk of bleeding, early onset of contractions, etc. For an airplane flight between the 28e and the 36e week of pregnancy, the woman must have a certificate stating that everything is going normally. Flights by plane are strictly discouraged from the 37e week of pregnancy. However, not all airlines apply the same rules. So check your airline’s website before booking your flight.
What can your doctor do?
The doctor will discuss your medical condition and the planned trip with you. A certificate may be required to certify that the flight can proceed safely. The doctor will also talk to you about the medications you need during the flight and provide you with the required medical certificate, if necessary. A person with diabetes, for example, needs a glucose meter and insulin on the plane.
What equipment is available on an airplane?
In addition to medical oxygen and a First Aid Kit (FAK), there is always an Emergency Medical Kit (EMK) on board. This contains equipment intended for use by a doctor, such as a stethoscope, blood pressure monitor, syringes and needles, as well as medicines for emergency first aid. The crew is not authorized to provide this type of treatment. Large airplanes are also equipped with an external defibrillator for the treatment of cardiac arrhythmias (DSA or semi-automatic defibrillator) and the cabin crew are trained in its use.
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