Fitness to fly in the paediatric population, how to assess and advice

Abstract

The number of children on commercial aircrafts is rising steeply and poses a need for their treating physicians to be aware of the physiologic effects and risks of air travel. The most important risk factors while flying are a decrease in partial oxygen pressure, expansion of trapped air volume, low cabin humidity, immobility, recirculation of air and limited options for medical emergencies. Because on-board medical emergencies mostly concern exacerbations of chronic disease, the medical history, stability of current disease and previous flight experience should be assessed before flight. If necessary, hypoxia altitude simulation testing can be performed to simulate the effects of in-flight hypoxia. Although the literature on paediatric safety of air travel is sparse, recommendations for many different situations can be given.Conclusion: We present an overview of the most up to date recommendations to ensure the safety of children during flight. What is Known: • Around 65% of on-board medical emergencies are complications of underlying disease.• In children, the three most common emergencies during flight concern respiratory, neurological and infectious disease. What is New: • Although studies are scarce, some advices to ensure safe air travel can be given for most underlying medical conditions in children, based on physiology, studies in adults and expert opinions.• In former preterm infants without chronic lung disease, hypoxia altitude simulation testing to rule out in-flight desaturation is not recommended.Electronic supplementary materialThe online version of this article (10.1007/s00431-018-3119-9) contains supplementary material, which is available to authorized users.

Global commercial passenger airlines and travel health information regarding infection control and the prevention of infectious disease: What's in a website?

“…Yet, more than 20 years later, the results of this study suggest that airlines have appeared to not take advantage of the opportunity to provide passengers with tailored and comprehensive advice regarding how they can protect themselves from infectious diseases. Such advice should be included among the other health and wellbeing advice provided to passengers in the pre-flight [62,63], inflight [45,64] and post-flight [65,66] periods of their journey. It may be argued that such advice can be found in official government websites, such as Australia's SmartTraveller™, and that the travelling public should consult those sources of information.…”

Reisen mit Kindern und Jugendlichen mit rheumatischen Erkrankungen

“…Hinzu kommen je nach Art der Reise weitere Voraussetzungen, z. B. Feststellen der Flug- [ 11 ] oder Tauchfähigkeit [ 29 ]. Die Bedingungen vor Ort (Hitze, Kälte, Höhe, Hygiene, medizinische Versorgung), die geplanten Aktivitäten (Anstrengung) und das Alter des Kindes (erhöhtes Dehydratationsrisiko bei Säuglingen und Kleinkindern) müssen in die Beurteilung der Reisefähigkeit mit einbezogen werden.…”

Gesundheitliche Aspekte an Bord von Luftfahrzeugen

“…Circa 65 % aller medizinischen Notfälle an Bord von Flug zeugen entstehen durch (bereits bekannte) Vorerkrankun gen. In der pädiatrischen Population sind respiratorische, neurologische sowie infektiöse Ursachen der Hauptgrund für ein IFME [21].…”

“…Der große Anteil an respiratorisch-bedingten IFME in der pädiatrischen Population bedingt, vor allem bei bestehen der pulmonaler Erkrankung, ein ausführliches Assessment vor Antritt des Fluges. Hier stehen unter Umständen Hö hensimulationen innerhalb einer Druckkammer zur Verfü gung, um die Auswirkungen der geänderten Physiologie abschätzen zu können [21].…”