Flashcards in Air travel and children's health issues Deck (22):
What measures are present to prevent spread of infection on planes?
1. High-efficiency particulate filters remove 99.9% of bacteria and virus from cabin air
2. Air exchange 15-20 times per hour
3. Air flow occurs from top to bottom with little front to back flow
Which patients are recommended for evaluation of potential hypoxemia before air travel?
1. known or suspected hypoxemia
2. known or suspected hypercapnia
3. known chronic obstructive or restrictive lung disease
4. who already use supplemental oxygen
5. with a history of previous difficulty during air travel
6. patients with recent exacerbation of chronic lung disease
7. with other chronic conditions that may be exacerbated by hypoxemia
What is the oxygen content in a commercial flight?
Which children are at risk for developing DVT aboard planes?
2. Previous thromboembolism
4. major surgery w/in 6 weeks of the flight
What should be available for children with sickle cell anemia?
Oxygen therapy available on aircraft at altitudes over 2135m especially if they have splenomegaly and relatively higher blood viscosity
What is barotitis media?
Inflammatory change (acute or chronic) of the middle ear secondary to barotrauma characterized by sudden ear pain, impaired hearing, and occasionally vertigo and ruptured TM
How do you prevent barotitis?
Teach children to perform a valsalva manoeuvre, by T-tubes, or by treating nasal congestion or a sinus infection before a flight
What is true of children with recurrent otitis media and adenoidal hypertrophy?
They have a harder time equilibrating the pressure of the middle ear
What can be helpful for otalagia if used at least 30 min before takeoff and landing?
When are children safe to fly post AOM diagnosis?
Two weeks usually, but try to clinically evaluate prior to air travel. If diagnosis is within 48h of flight that cannot be postponed then provide analgesia
What should parents of children with food allergies do?
Inform flight crew and the airline of the allergy
Carry epipen and antihistamines on the flight
What precautions should be taken for air travel?
If a day is shortened by more than 2h decrease insulin and if it is lengthened by more than 2h than increase insulin as needed
What should parents with epileptic children do?
Inform flight attendant and airline
Anti-epiletic medication should be readily available
What are measures to combat air sickness?
2. directing cool ventilate air to the face
3. gazing at the horizon
4. selecting seat away from the rear of the cabin
What should be used for behavioral control?
1. Show books about air travel
2. Explain steps needed for travel
3. Take practice trips to the airport
4. Practice relaxation techniques
5. Do not use dimenhydrinate, chloral hydrate or promethazine as risk of oversedation and paradoxical irritation
What is jet lag?
Daytime fatigue, sleeping difficulties, irritability, and decreased mental efficiency that occur when there is an imbalance between the body's internal clock and the external environment
What are risk factors for jet lag?
1. Crossing multiple time zones, especially eastward
2. Poor sleep
Is melatonin recommended for use in children with jet lag?
No as side effect profile is not well studied and recent meta-analysis did not show any benefit
What should be done to all feeding and infusion tubes during takeoff and landing?
Capp them off
What should be done for children with recent fractures (48h)?
1. Plaster or fibreglass cast should be bivalved
2. Provide adequate analgesia
3. Engage in proper limb elevation
4. Pneumatic splints are usually not allowed
What is recommended regarding child restraints in aircrafts?
Recommended by the US but inconclusive safety and economic data
Holding an infant or child on a caregiver's lap is improper restraint and has the potential to contribute to injury on an aircraft