Page 54 - GALENIKA MEDICAL JOURNAL

Knowing the influence of the specific ambient conditions in the plane on physiological processes in the body is of great
importance for determining the absolute and relative contraindications for flying by plane. Doctor-passengers have an
important role in the treatment of IMEs.

This work aims to introduce us to the specific ambient conditions in the aircraft cabin and their influence on the physiology
of the human body, the most common IMEs that occur under the influence of those conditions, the role of the doctor-
passenger as well as the absolute and relative contraindications for flying by plane.

Keywords: in-flight medical emergencies, doctor on board, aircraft medical kit

Literatura 19. Jacobson BF, Münster M, Smith A, Burnand KG, Carter A, Abdool-Carrim
AT, et al. The BEST study--a prospective study to compare business class
versus economy class air travel as a cause of thrombosis. S Afr Med J.
1. Borges do Nascimento IJ, Jerončić A, Arantes AJR, Brady WJ, Guimarães 2003 Jul;93(7):522-8.
NS, Antunes NS, et al. The global incidence of in-flight medical 20. Bettes TN, McKenas DK. Medical advice for commercial air travelers. Am
emergencies: A systematic review and meta-analysis of approximately Fam Physician. 1999 Sep 1;60(3):801-8, 810.
1.5 billion airline passengers. Am J Emerg Med. 2021 Oct;48:156-64.
21. Sane T, Koivisto VA, Nikkanen P, Pelkonen R. Adjustment of insulin
2. Kodama D, Yanagawa B, Chung J, Fryatt K, Ackery AD. "Is there a doctor doses of diabetic patients during long distance flights. BMJ. 1990 Sep
on board?": Practical recommendations for managing in-flight medical 1;301(6749):421-2.
emergencies. CMAJ. 2018 Feb 26;190(8):E217-E222.
22. Jones DR. Fear of flying-no longer a symptom without a disease. Aviat
3. Peterson DC, Martin-Gill C, Guyette FX, Tobias AZ, McCarthy CE, Space Environ Med. 2000 Apr;71(4):438-40.
Harrington ST, et al. Outcomes of medical emergencies on commercial
airline flights. N Engl J Med. 2013 May 30;368(22):2075-83. 23. Van Gerwen LJ, Diekstra RF. Fear of flying treatment programs for
passengers: an international review. Aviat Space Environ Med. 2000
4. Kesapli M, Akyol C, Gungor F, Akyol AJ, Guven DF, Kaya G. Inflight Apr;71(4):430-7.
Emergencies During Eurasian Flights. J Travel Med. 2015 Nov-
Dec;22(6):361-7. 24. Polk JD, Rugaber C, Kohn G, Arenstein R, Fallon WF Jr. Central retinal
5. Sand M, Bechara FG, Sand D, Mann B. Surgical and medical artery occlusion by proxy: a cause for sudden blindness in an airline
passenger. Aviat Space Environ Med. 2002 Apr;73(4):385-7.
emergencies on board European aircraft: a retrospective study of 10189
cases. Crit Care. 2009;13(1):R3. 25. Daniell WE, Vaughan TL, Millies BA. Pregnancy outcomes among female
6. Martin-Gill C, Doyle TJ, Yealy DM. In-Flight Medical Emergencies: A flight attendants. Aviat Space Environ Med. 1990 Sep;61(9):840-4.
Review. JAMA. 2018 Dec 25;320(24):2580-90. 26. Gendreau MA, DeJohn C. Responding to medical events during
commercial airline flights. N Engl J Med. 2002 Apr 4;346(14):1067-73.
7. Kim JH, Choi-Kwon S, Park YH. Comparison of inflight first aid
performed by cabin crew members and medical volunteers. J Travel 27. International Air Transport Association. IATA Medical Manual. 11th ed.
Med. 2017 Mar 1;24(2). June 2018. https://www.iata.org/publications/Documents/medical-
manual.pdf. Accessed June 20, 2018.
8. Aerospace Medical Association Medical Guidelines Task Force. Medical
Guidelines for Airline Travel, 2nd ed. Aviat Space Environ Med. 2003 28. Pavlović A. Kardiopulmonalno cerebralna reanimacija. Medicinski
May;74(5 Suppl):A1-19. fakultet Priština-K. Mitrovica, 2022; p.291-8.
9. Silverman D, Gendreau M. Medical issues associated with commercial 29. AlShamlan NA, AlOmar RS, Alrayes MM, Alkhaldi SK, Alomar AH,
flights. Lancet. 2009 Jun 13;373(9680):2067-77. Alghamdi AA, et al. "Is there a doctor on board?": willingness and
confidence of physicians in the Kingdom of Saudi Arabia in assisting
10. Seccombe LM, Peters MJ. Oxygen supplementation for chronic with in-flight medical emergencies. BMC Emerg Med. 2021 Apr
obstructive pulmonary disease patients during air travel. Curr Opin 30;21(1):54.
Pulm Med. 2006 Mar;12(2):140-4.
30. Nable JV, Tupe CL, Gehle BD, Brady WJ. In-Flight Medical Emergencies
11. Ruskin KJ, Hernandez KA, Barash PG. Management of in-flight medical during Commercial Travel. N Engl J Med. 2015 Sep 3;373(10):939-45.
emergencies. Anesthesiology. 2008 Apr;108(4):749-55.
31. Wong, M. (2017). Doctor in the sky: Medico-legal issues during in-flight
12. Aerospace Medical Association; Aviation Safety Committee; Civil emergencies. Medical Law International, 17(1-2), 65-98. https://doi.
Aviation Subcommittee. Cabin cruising altitudes for regular transport org/10.1177/0968533217705693
aircraft. Aviat Space Environ Med. 2008 Apr;79(4):433-9.
32. Adwani SH, Jhorar P, Grant-Kels JM. Is there a doctor onboard?: The
13. Campbell CD, Smyth MW, Brown L, Kelly E. Air Travel for Subjects ethical conundrum of a specialist asked to provide in-flight medical
Receiving Long-Term Oxygen Therapy. Respir Care. 2018 Mar;63(3):326- assistance. J Am Acad Dermatol. 2018 Aug;79(2):387-9.
31.
33. Baltsezak S. Clinic in the air? A retrospective study of medical
14. Hampson NB, Kregenow DA, Mahoney AM, Kirtland SH, Horan KL, Holm emergency calls from a major international airline. J Travel Med. 2008
JR, et al. Altitude exposures during commercial flight: a reappraisal. Nov-Dec;15(6):391-4.
Aviat Space Environ Med. 2013 Jan;84(1):27-31.
15. Kelly PT, Seccombe LM, Rogers PG, Peters MJ. Directly measured cabin
pressure conditions during Boeing 747-400 commercial aircraft flights.
Respirology. 2007 Jul;12(4):511-5. Konflikt interesa: Nema
16. Zitter JN, Mazonson PD, Miller DP, Hulley SB, Balmes JR. Aircraft cabin Primljeno: 23. 10. 2023.
air recirculation and symptoms of the common cold. JAMA. 2002 Jul
24-31;288(4):483-6. Prihvaćeno: 07. 11. 2023.
Onlajn: 01. 12. 2023.
17. Srinivasan V, Spence DW, Pandi-Perumal SR, Trakht I, Cardinali DP. Jet
lag: therapeutic use of melatonin and possible application of melatonin
analogs. Travel Med Infect Dis. 2008 Jan-Mar;6(1-2):17-28.
18. Waterhouse J, Reilly T, Atkinson G, Edwards B. Jet lag: trends and coping
strategies. Lancet. 2007 Mar 31;369(9567):1117-29.

52 DOI: 10.5937/Galmed2308044P