This is a long guideline. It is mainly going to be useful if a patient asks specifically about air travel, but it may be something that should be raised with some patients at their annual reviews. It covers most respiratory and cardiac problems.
From our point of view, if in doubt, seek advice from a respiratory physician. They can do a ‘hypoxic challenge’ (which involves checking sats whilst at airline O2 levels) to decide whether a patient may need oxygen in flight. Conditions which may require further assessment include:
- Severe COPD (FEV1 < 30%) or asthma
- Conditions worsened by hypoxaemia (eg IHD / CVD / pulmonary hypertension)
- CPAP (eg sleep apnoea)
- Within 6./52 of discharge for an acute respiratory illness
Less common to us: Fibrosing Alveolitis, Neuromuscular disease, Kyphoscoliosis. Bullous lung disease, Severe restrictive disease (VC < 1L), Cystic Fibrosis, Pulmonary TB or recent pneumothorax
When advising a patient, ask about previous flight experience, recent exacerbations, destination (is it at altitude which could exacerbate illness?) and flight duration.
Advice to Patients
- There is a good leaflet for patients.
- Important bits of advice are to avoid alcohol and sedatives, which could further lower O2 levels, to move around frequently, to ensure they have their medication in flight and also to ensure that their insurance is adequate.