Problems that may be encountered during air travel:
(1) These patients may have severely impaired respiratory function and may require mechanical ventilation during the trip.
(2) Dry cabin air can result in thick secretions, which can result in mucus plugging of the airways.
(3) Secretions may accumulate, requiring suctioning.
(4) Suctioning can result in bradycardia.
(5) Oxygen content of the air is reduced, even in a pressurized cabin.
Recommendations:
(1) The patient's pulmonary function should be tested prior to the trip. The trip by air should only be allowed if the patient has stable and sufficient lung function.
(2) Supplemental oxygen should be available. The supply should be sufficient to cover the planned duration of the trip and any delays.
(3) There should be a mechanism to humidify the air that the patient breathes.
(4) Suctioning equipment should be readily available.
(5) The patient should be accompanied by someone knowledgable in the care of such patients.
(6) Medications such as intravenous atropine should be available to treat significant bradycardia.
Additional recommendations:
(1) A pulse oximeter can help monitor the patient's pulse and oxygen saturation during the trip.
(2) Resuscitation equipment including an Ambu bag should be available in the event of an emergency.
