Chest
Volume 104, Issue 3, September 1993, Pages 788-794
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Clinical Investigations
Preflight Medical Screenings of Patients: Analysis of Health and Flight Characteristics

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We evaluated the demographic, medical, and flight characteristics of 1,115 passengers who were routinely referred for preflight medical screening by a major domestic air carrier. The largest category consisted of 892 patients who requested in-flight oxygen therapy for cardiopulmonary conditions, of which COPD and cardiac disorders were the most frequent indications; 561 of these patients were 60 years or older. Overall, 386 passengers were recently hospitalized, 911 were using medications, 657 were receiving oxygen therapy, and 761 had flown previously. In the group using in-flight oxygen therapy, the average flight duration was 236 min and layover time, 87 min. These findings indicate that large numbers of patients undergoing preflight screening are receiving medication and have a wide range of medical diagnoses and variable health status. We conclude that preflight medical screening and counseling can be important and helpful in assuring safe and comfortable air travel in this patient population.

Section snippets

Materials and Methods

The medical screening policies and practices of commercial air carriers in the United States vary greatly. One major domestic carrier in the United States, Delta Air Lines, routinely refers passengers with known medical conditions, needs, or uncertain health status to a 24-h airline medical advisory service (Air Ambulance, Inc., San Carlos, Calif) for preflight screening and clearance. The advisory staff consists of registered nurses with experience in emergency department medicine, critical

Results

The medical advisory service evaluated 1,115 patients during the 12-month period, with 93 ± 13.3 (SD) screenings per month (Fig 1). These patients represented 0.003 percent of the 42,770,468 passengers flown on the carriers domestic flights during 1991 (S. Whitehead, oral communication, August, 1992). The advisory service also screened 784 patients referred from Delta in 1989 and 968 patients in 1990. Thus, the annual number of screened patients constituted a very low proportion of total

Discussion

The findings in this report indicate that large numbers of patients referred for preflight medical screening are receiving medication, have a wide range of medical diagnoses, and were recently discharged from an acute care hospital. The largest group consisted of patients requesting in-flight oxygen therapy. The oxygen group consisted primarily of elderly patients with COPD who used supplemental oxygen prior to flight. Many were “frequent fliers” who generally had not used in-flight oxygen

ACKNOWLEDGEMENTS

The authors are grateful for the expertise of the following members of the Flight Advisory Staff, Air Ambulance, Inc., San Carlos, Calif; Dorothy Dennin, Susan Ferez, Karen Lemelin, Ann Haley, Connie Pickett, and Catherine Anderson. Stan Whitehead, Stations Analyst, Delta Air Lines, provided airline data.

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Manuscript received October 2; revision accepted December 16.

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