Last week, I told us a story on how I allowed my Nephew, who had pneumothorax(air in the lungs), to travel back to London with the associated hazards. I also started the discussion of air travel and medical problems.
Today we shall look at the hazards of ii) Reduced Oxygen iii) Turbulence iv) Jet lag and iv) General precautions during air travel.
ii) Reduced Oxygen during air travel.
• The relatively low air pressure inside an airplane also causes problems because of its effect on oxygen levels.
• Low oxygen levels are particularly troublesome for people who have a severe lung disease such as emphysema or cystic fibrosis, heart failure, severe anaemia, severe angina, sickle cell disorder or certain congenital heart diseases.
• Usually such people above can fly safely if oxygen is provided on standby in case of an emergency. Airlines can handle a request for oxygen if notified 72 hours in advance of a flight.
• During flight people who have breathing problems should not smoke or drink alcohol before take-off – they aggravate the effects of reduced oxygen when airborne.
• In general anyone who can walk 100 yards or climb one flight of stairs, should be able to tolerate normal cabin conditions without additional oxygen.
iii) Turbulence during air travel.
• Turbulence can cause air sickness or an injury. People who are prone to air sickness may benefit from “dimenhydrinate” taken as a tablet or “scopolamine” applied to the skin as a patch.
• However, these drugs must be prescribed by your doctor after evaluation, especially in the elderly.
• The surface drugs with patches cause fewer side effects, therefore they are recommended.
• To prevent injuries, passengers should keep their seat belts fastened while seated.
iv) Jet lag
• Rapid travelling across several time zones, produces many physical and psychological stresses known as jet lag – circadian dysrhythmias.
• A gradual shift in eating and sleeping patterns before departure may alleviate the problem.
• Some medication schedules may have to be adjusted; for example, the intervals between drugs normally taken at precise times, through out the day should be based on elapsed time – such as every 8-hours, rather than on the local time.
• People who have diabetes and who use long-acting insulin, may switch to regular insulin, until they have adjusted to the new-time-zone, food, and activity level, or they may make up the difference in time zone changes over several days.
• People should work out a medication and eating schedule with their doctors before departure, and take with them a device to monitor blood sugar(glucose) levels.
• Melatonine a hormone that regulates sleep-wake cycle, is reported to help with sleep disturbances caused by jet lag. It’s effectiveness depends on taking the doses on a precise schedule.
• Because melatonine products are nutritional supplements, rather than prescription drugs, the claims made by the manufacturers have not undergone rigorous scrutiny, and the quality of each formulation may vary.
v) Psychological Stress.
• Fear of flying and claustrophobia (extreme or irrational fear of confined space), can cause distress.
• Hypnosis and behavioural modification help some people. Taking sedative may relieve fears before and during a flight.
vi) Physical Stress.
• Because the behaviour of some mentally ill people worsens during airplane flights, those with violent or unpredictable tendencies must be accompanied by an attendant, and they may need to take a sedative before flight.
General Precautions of Air Travel.
1) Cardiac pacemakers, metal artificial limbs, plates or pins are affected by airport metal detectors, used to scan concealed weapons. However, newer models of pacemakers can withstand potential interference from such detectors.
• To avoid health and security problems, people who wear such devices must carry a doctor’s report explaining their situations, to protect their health.
2) The risk of developing blood clots in the legs(thrombosis) is increased in anyone who sits in one place for a long time, with reduced atmospheric pressure, like in airplane cabins.
• Pregnant women and people who have poor circulation are at a particular risk. Walking around the airplane – cabin every hour or two and contracting and relaxing the leg muscles in a mild exercise, while sitting down will help to keep the blood flowing.
3) Dehydration resulting from low humidity – about 5% in the cabin, can be prevented by drinking enough liquids and avoiding excess alcohol, which makes dehydration worse.
4) People who wear contact lenses, should apply re-wetting solutions to their lenses frequently to combat the effects of dry air.
5) Travellers should pack drugs in a carry-on bag, rather than a suitcase that is checked-in, in case their luggage is lost, delayed or stolen. Drugs should be kept in their original containers.
6) Travellers may wish to carry a summary of their medical records, including electrocardiogram results, in case they become ill while away from home.
7) Those who have potentially disabling condition, such as epilepsy, should wear a Medic-Alert-Identification-Bracelet or Necklace (MAIB or MAIN. Always be medically guided.
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