Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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Effect on people wih contact lenses
- ALok Dhawan (29 November 2000)
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Hyperventilation
- Richard Gunstone (5 December 2000)
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Clarification on Statistics
- Steven Holstein (27 January 2001)
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Re: Effect on people wih contact lenses
- Helena Nik (11 May 2001)
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The Fall of Commercial Supersonic Aviation – medical implications.
- Hutan Ashrafian (2 December 2003)
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Question for Tony Goodwin
- John E. Menditto (11 July 2004)
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ALok Dhawan, BOYSCAST Fellow, TNO-BIBRA International, Carshalton, Surrey, SM5 4DS
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This is an excellent overview on the in-flight medical emergencies. One of them, which has not been discussed and also has not been debated is the effect of contact lenses on the eyes while travelling on long distance flights. My wife travelled from India to the UK and faced a terrible irritation of the eyes which lasted for 2-3 days and the eyes were abolutely red. When a GP was contacted, the first thing he asked was does she wear contact lenses, and he then explained us that due to the dryness in the air inside the aircraft, the liquid in between the contact lens and the eye, dries out after a while and then it attaches tightly to the retina of the eye and if left uncared for, may even damage the retina. I think this is a very common thing and can be avoided if the airlines announce this before you board the flight or just before take off, so that those will, can change their contact lenses and wear spectacles instead. |
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Richard Gunstone
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Editor - I enjoyed Dr.Goodwin's paper on in-flight medical emergencies (1) but disagree when he implies that re-breathing from a paper bad will help the dyspnoea of hyperventilation. As we demonstrated on ourselves in physiology practicals at medical school, rebreathing in this way increases the arterial carbon dioxide, thus stimulating the rate and depth of breathing, but lowering the pH and so helping to relieve the tingling of the alkalotic tetany sometimes induced by hyperventilation. I have seen asthmatic patients distressed and hyperventilating enough to become alkalotic but at the same time hypoxaemic. The hypoxaemia could be dangerously aggravated by rebreathing. Dr Richard Gunstone, BSc,MB,FRCP
Conflicting interests: none except a tendency to fly more following retirement. 1 BMJ 2000 321:1338-41 |
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Steven Holstein, Vice President, Marketing MedAire, Inc.
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Portions of the article: In-flight Medical Emergencies: An Overview, relied on statistics that were presented at the Southern California Safety Institute 1999 Symposium by MedAire (Garrett, J.S. Experience with 1132 in -flight medical emergencies: what have we learned?) In that paper it was stated that some of the statistics were based on an October 1996 to September 1997 study of data from five airlines collected and analyzed by MedAire and the Civil Aeromedical Institute, University of Oklahoma. However, the statistics on common reasons for diversions were based on MedAire’s data of six airlines that spanned the time from January 1997 to December 1997, inclusive. This differs from the statistics published by the FAA Civil Aeromedical Institute in the Flight Safety Foundation Cabin Crew Safety Journal (DeJohn, C.,Véronneau, S., Wolbrink, A., Larcher, J., Smith, D., and Garrett, J. Evaluation of in-flight care aboard selected U.S. air carriers: 1996 to 1997. Flight Safety Foundation, Cabin Crew Safety. (35) 2. March - April 2000). The Flight Safety Foundation report extensively explored in-flight medical events and medical kit usage and made recommendations for changes to the U.S. airline medical kit. For the record, the Civil Aeromedical Institute’s statistics showed that the most common reasons for diversion for the 1132 cases in its study were cardiac (46%), neurological (18%), and vasovagal (7%). Our sincere apologies for any confusion this reference may have presented. Kind Regards Steve Holstein
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Helena Nik, Medical Student Liverpool University
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Dr Dhawan states in his response that contact lenses adhere to the retina and causes retinal damage because of the dryness of air in the aircraft cabin. Surely he means the cornea, not the retina. |
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Hutan Ashrafian, Senior House Officer in Cardiothoracic Surgery St Mary's Hospital, London W2 1NY
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Since it’s first commercial flight in 1976 until it’s recent grounding on the 24th October 2003, Concorde has flown over 4.5 million passengers. Having represented the most advanced commercial aerospace engineering of its time, it achieved a speed twice that of sound (March 2), which was never surpassed by other passenger carrying aircraft. Its final downfall arrived in heed of socio-economic disruptions sparked by 09/11 and an uncharacteristic crash in 2000. From the beginning supersonic flight has aroused concerns regarding its occupational hazards that included a high altitude of travel with reduced atmospheric shielding and a resultant exposure to large doses of in-flight cosmic radiation(1). Although this has been continually monitored, it has not yet yielded any definitive conclusions regarding an increased potential for disease induction such as tumourigenesis(2) when compared to normal air travel. Furthermore the perceived detriment of noise pollution on the environmental health of people under the flight path have also shown no significant increase when compared to normal air travel(3). In its favour, Concorde’s faster travel times permitted speedier voyages for medical specialists and patients. Had supersonic travel been developed further, there would undoubtedly have been an improved international healthcare mobility with shorter journey durations, less time for in-flight medical catastrophes(4) and even the possibility of reduced thromboembolic risk(5). 1 Living it up with Concorde. Br Med J 1970;3:661. 2 Heimers A. Chromosome aberration analysis in Concorde pilots. Mutat Res 2000;467:169-76. 3 Allen JA. Effect of increased noise levels by supersonic aircraft on annoyance levels and time estimations. Percept Mot Skills 1980;50:563- 9. 4 Goodwin T. In-flight medical emergencies: an overview. BMJ 2000;321:1338-41. 5 Geroulakos G. The risk of venous thromboembolism from air travel. BMJ 2001;322:188. Competing interests: None declared |
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John E. Menditto, General Counsel ECMHSP (USA)
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Mr. Goodwin - Do you have knowledge of Virgin Atlantic's policy concerning the care of passengers who suffer DVT episodes while on a Virgin Atlantic flight. My mother suffered a stroke while disembarking from a British Airways flight from Heathrow and British Airways's representatives failed to accompany my mother to the hospital. As a result, the medical personnel were unable to administer tPA, a clot-busting drug that would have greatly improved my mother's prognosis. I know that Virgin Atlantic does much more than BA in training flight attendants to care for passengers, but does that additional care go as far as to accompany a stricken passenger in a medical emergency (my mother was travelling alone and had no one else who could assist her) Your prompt response would be greatly appreciated. John Menditto Competing interests: None declared |
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