How to avoid an in-flight medical incident

Travel Dale Yeager Blog
Travel Dale Yeager Blog

In recent months we’ve seen news about a range of medical and health issues occurring aboard commercial airline flights. The baby born in the skies between Philadelphia and Orlando on Southwest Airlines. The airborne medical emergency and subsequent death of Carrie Fisher. And the ongoing saga of American Airlines’ new flight attendant uniforms, with up to 2,000 employees claiming they cause rashes, headaches and other health hazards when worn in pressurized cabins.

Because 39,000 feet is a terrible location for a serious or life-threatening medical event, regulators and airline organizations have sought improvements. But challenges remain: MedAire, a company offering medical and travel safety services, published a 2011 white paper noting annual numbers of such events keep steadily increasing, due in part to longer life expectancies. Neurological events are by far the most common.

Many passengers might be surprised to learn in-flight deaths due to medical causes occur more frequently than accident-related deaths, this despite MedAire’s estimate that medical professionals are onboard 50%-60% of commercial flights. The best solution — when possible — is to avoid the likelihood of such occurrences, by consulting with your doctor in advance of flying. Here are some of the conditions for which fliers should pay special attention.

Chronic conditions

After Carrie Fisher’s in-flight emergency, some health and travel blogs demanded domestic airlines carry defibrillators for heart patients. In fact, they do. In 2001 the FAA regulated all U.S. commercial aircraft weighing more than 7,500 pounds and having at least one flight attendant must carry automated external defibrillators (AEDs) and enhanced emergency medical kits (EMKs); this rule was later updated in 2006.

An FAA spokesperson confirmed these rules still apply for all U.S. domestic and international flights, with no exemptions in place. Regulations dictate this equipment should only be accessed by trained crewmembers, or other qualified and trained professionals. The FAA states: “It would be preferable for flight attendants to check the credentials of passengers holding themselves out as medical specialists.”

The International Air Transport Association (IATA) advises certain post-op patients should not fly, particularly after gastro-intestinal surgery; abdominal trauma; and certain facial, eye and brain operations.

Disabilities

For those who require constant medication or assistance in-flight, it’s important to learn about a specific airline’s policies, which are available on their sites. The U.S. Department of Transportation provides details about the Air Carrier Access Act online, including provisions explaining the rights of passengers needing assistance and/or using Portable Oxygen Concentrators, mobility aids and assistive devices. The Transportation Security Administration’s site also details policies on devices and medications.

Flying while pregnant

For many years, researchers have attempted to determine if flight attendants suffer higher-than-average miscarriage rates. In 2015 the Centers for Disease Control and other government agencies undertook a comprehensive analysis of 840 pregnancies among flight attendants and found chronic sleep disturbance is a key factor for pregnant women who fly during “normal sleep hours” and across time zones. Those who flew more than 15 hours during normal sleep hours in the first trimester were at increased risk for miscarriage.

The report also addressed pregnancy risks for women whose flights travel through solar particle events, an occurrence that may seem rare for even frequent fliers. Yet a 2001 report from the American College of Obstetricians and Gynecologists noted: “For most air travelers, exposure to cosmic radiation are negligible. For pregnant aircrew members and other frequent flyers, this exposure may be higher.” For those worried about such risks, the Federal Aviation Administration offers an interactive tool that lets you estimate potential galactic radiation for a specific flight on a specific date.

Infants

When is it safe for newborns to fly? The answer: It depends, and in ALL cases you should consult your doctor first. In addition, airline policies vary, with some carriers requiring a physician’s letter during the first few weeks, so check the airline’s site.

MedAire recently issued guidelines for traveling with babies and noted: “The most common in-flight ailments for infants and children were gastrointestinal and respiratory related.” Parents and caregivers are advised to keep TSA-approved doses of “common medications” such as analgesics, antihistamines and anti-emetics in their carry-ons; ask if you’re unsure.

As for specific issues such as ear pain and infant pain relievers, the American Academy of Pediatrics offers a “Flying with Baby” page. KidsTravelDoc.com, created by pediatric travel expert Dr. Karl Neumann, likewise offers detailed advice on such issues. Also, it’s critical to remember what I’ve written about so frequently here: The SAFEST way for children under 2 to fly is in an approved child restraint.

Special risks for flight attendants

The AA uniform complaint is not the only acute health issue raised by flight attendants; in fact, labor unions such as the Association of Flight Attendants-CWA have detailed a range of hazards experienced by cabin staff.  These include aircraft air quality, contaminated water, disease transmission and many others. Some concerns I’ve written about here, such as deep vein thrombosis and the spraying of pesticides in cabins.

The question arises, if spending so much time in pressurized tubes at high altitudes affects the health of crewmembers, what effects are felt by passengers, particularly frequent fliers?

Who shouldn’t fly?

IATA, the industry’s global trade organization, offers health tips for passengers and advises that — in addition to newborn infants, some pregnant women and certain post-op patients — those who may not be safe for flying could include anyone with the following conditions:

  • contagious diseases
    • recent myocardial infarction or stroke
    • uncontrolled extreme hypertension
    • angina pectoris
    • certain severe chronic respiratory conditions
    • infections of the ear, nose or sinuses
    • recent psychiatric illness

As always, a medical profession should make the final determination — PRIOR TO BOOKING.

Bill McGee, Special for USA TODAY

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