Almost all travellers have encountered someone with an in-flight medical emergency. When we think about in-flight emergencies, the most dramatic episodes come to mind. These include heart attack, trauma from falling objects and deep vein thrombosis (blood clots in the legs) leading to a pulmonary embolism (clot traveling to your lungs). However, the most common things are somewhat more mundane. A general understanding and approach to them will make flying a bit smoother and less daunting for the hypochondriac in us all.
So, what are the common concerns?
Most studies and data show that “syncope” or fainting is by far the leader among presentations on a flight. The issue with syncope is that it can be caused by visual or emotional stimuli which trigger nerve pathways which can cause a person to faint. So, if you are a nervous flyer, or encountered a rather surprising and powerful stimulus, it may cause you to faint. Most of these episodes are self-limiting and cause no long-term issues. The second most common are gastrointestinal symptoms, and by far the common complaint is nausea and vomiting caused by air sickness. While air sickness is mediated by your nervous system, the usual combination is nausea, vomiting and spatial disorientation. Third, and potentially more serious, are heart / lung issues. These include mostly hyperventilation and chest pain, keeping in mind some cases of chest pain may be related to anxiety rather than a problem with the heart.
The issue is that altitude has an effect on the partial pressure of oxygen. While the oxygen in the atmosphere is 21% everywhere, the partial pressure is 160mm Hg at sea level and 118mm Hg at 8000 feet. Why is 8000 feet an important number? Because the Aviation authorities require the cabin to be pressurised to somewhere below 8000 feet. The decreased partial pressure leads to a decrease in the proportion of oxygen you breathe in and the ease with which the body can take the oxygen in. Most of us can handle this level of oxygen, with popular tourist destinations such as Aspen sitting at about 7800 feet above sea level and Machu Picchu at about 8000 above sea level. However, those with significant heart or lung disease are more susceptible to these changes and should seek medical advice before travelling.
Our travel advice
Think about if you are a settled flyer or if you are a nervous flyer, what makes you that way? If there are certain symptoms that bother you, appropriate medications may help. Sensible precautions are still relevant, such as calf exercises and adequate hydration, alerting crew members early and providing support if you are able. You also might want to think about learning basic life support if you haven’t already – it can be really useful wherever you are. And rest assured that there are well trained people traveling with you (be it crew members, doctors or nurses) and the emergency kit on flights have now evolved to become quite sophisticated. A little insight goes a long way. Think about your existing medical conditions. If you are concerned you can use our doctor app and speak with a Specialist Emergency Doctor via video based chat directly from your smartphone. Download the app from our website or talk to your GP before flying.
In summary, illness can occur when we are away on holidays or even while we are travelling to our holiday. If you are concerned prior to your flight, the My Emergency Doctor App will allow you to have a review with a Specialist Emergency Doctor before you fly. In the event sickness after your flight, our medical app can provide you with the reassuring comfort of an Australian Specialist in Emergency Medicine to assess whether you can stay and be treated in your holiday home or need to attend the local emergency department. Please note that the My Emergency Dr service is unavailable during flight.