PubMed · 14826515
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W GRAHAM. 1951. Flight nursing.. https://pubmed.ncbi.nlm.nih.gov/14826515/
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BACKGROUND: Air travel might increase the risk of deep vein thrombosis (DVT). It has been suggested that wearing compression stockings might reduce this risk. OBJECTIVES: To assess the effects of wearing compression stockings versus not wearing them among people travelling on flights lasting at least four hours. SEARCH STRATEGY: We searched the Cochrane Peripheral Vascular Diseases Group's Specialized Register (January 2006), the Cochrane Central Register of Controlled Trials (CENTRAL) (in The Cochrane Library, Issue 4, 2005), MEDLINE (January 1966 to November 2005), EMBASE (January 1980 to December 2005) and several other electronic or grey literature sources, detailed in full in the review. The most recent searches were done in January 2006. SELECTION CRITERIA: Randomized trials of compression stockings versus no stockings in passengers on flights lasting at least four hours. Trials in which passengers wore a stocking on one leg but not the other, or those comparing stockings and another intervention were also eligible. DATA COLLECTION AND ANALYSIS: At least two authors independently assessed the quality of each study and extracted data. We sought additional information from trialists. MAIN RESULTS: Ten randomized trials (n = 2856) were included; nine (n = 2821) compared wearing stockings on both legs versus not wearing them, and one (n = 35) compared wearing a stocking on one leg for the outbound flight and on the other leg on the return flight. Of the nine trials, seven included people judged to be at low or medium risk (n = 1548) and two included high risk participants (n = 1273). All flights lasted at least seven hours. Fifty of 2637 participants with follow-up data available in the trials of wearing stockings on both legs had a symptomless DVT; three wore stockings, 47 did not (odds ratio 0.10, 95% confidence interval 0.04 to 0.25, P < 0.00001). There were no symptomless DVTs in three trials. No deaths, pulmonary emboli or symptomatic DVTs were reported. Wearing stockings had a significant impact in reducing oedema (based on six trials). No significant adverse effects were reported. AUTHORS' CONCLUSIONS: Airline passengers similar to those in this review can expect a substantial reduction in the incidence of symptomless DVT and leg oedema if they wear compression stockings. We cannot assess the effect of wearing stockings on death, pulmonary embolus or symptomatic DVT because no such events occurred in these trials. Randomized trials to assess these outcomes would need to include a very large number of people.
In May 2000, the chairman of the European Radiation Dosimetry Group (EURADOS) invited a number of experts with experience of cosmic radiation dosimetry to form a working group (WG 5) on aircraft crew dosimetry. Three observers from the Article 31 Group of Experts as well as one observer from the Joint Aviation Authorities (JAA) were also appointed. The European Commission funded the meetings. Full meetings were organised in January 2001 and in November 2001. An editorial group, who are the authors of this publication, started late in 2002 to finalise a draft report, which was submitted to the Article 31 Group of Experts in June 2003. The methods and data reported are the product of the work of 26 research institutes from the EU, USA and Canada. Some of the work was supported by contracts with the European Commission, Directorate General XII, Science, Research and Development. A first overview of the EC report was published late in 2004. In this publication we focus on a comparison of measured and calculated ambient dose rate data using the EURADOS In-Flight Data Base. The evaluation of results obtained by different methods and groups, and comparison of measurement results and the results of calculations were performed in terms of the operational quantity ambient dose equivalent, H*(10). Aspects of measurement uncertainty are reported also. The paper discusses the estimation of annual doses for given flight hours and gives an outline of further research needed in the field of aircraft crew dosimetry, such as the influence of solar particle events.
Medical assistance by doctors on board an aircraft The number of in-flight medical emergencies continues to increase due to the rise in the number of (older) passengers, the greater capacity of new airplanes and the constant increases in the distances flown. The most common medical problems on board an aircraft are vasovagal collapse, dizziness, and gastro-intestinal and cardiac complaints. According to Dutch law, a physician on board an aircraft is obliged to deliver medical assistance in case of a medical emergency involving a passenger if requested by the cabin crew. The chances of being involved in a lawsuit afterwards are, however, very small because the usual medical standards do not apply and because the patient usually does not know the doctor that has assisted him. Even if it should come to a legal procedure, the chance that a physician will be found guilty of malpractice is very small because of the special circumstances and limitations in an airplane.