Travel by Air, Land & Sea Flashcards

(41 cards)

1
Q

if you need to carry oxygen supply onboard flights for traveling by air, is it allowed?

A

no - need to notify the airline 3 days or more before departure to request in-flight supllemental oxygen

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2
Q

what is the max aircraft cabin air pressure?

A

max 8000 ft (2440 m) above sea level;
typically 6000-8000 ft

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3
Q

who is at risk of experiencing an exacerbation of their underlying medical condition due to high air craft pressure?

A

anemia (including sickle cell disease), cardiopulmonary disease, cerebrovascular disease

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4
Q

how does barotrauma occur in aircraft cabin?

A

pressure difference between enclosed body space (abdomen, middle ear, sinuses) and outside

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5
Q

what are the risk factor of thromboembolic disease while flying?

A

clotting disorders, estrogen use, severe obesity, pregnancy, recent surgery or trauma, previous thrombosis

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6
Q

how does the cabin air environment keep less conducive to the spread of most infectious diseases?

A

0.3 micro meter or bigger HEPA filter;
laminar airflow

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7
Q

what are the most common in-flight medical events?

A

syncope/presyncope
respiratory symptoms
nausea or vomiting
cardiac symptoms
seizures

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8
Q

what are the 2/3 of death in airplanes?

A

cardiac conditions

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9
Q

how many first aid kids in airplane?

A

1 kit for 0-50 seats;
2 kits for 51-150;
3 kits for 151-250;
4 for >250;

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10
Q

what is included in emergency medical kit in airplane?

A

antihistamine tab/injection; aspirin; atropine
bronchodilator,
dextrose (50%) and saline for infusion;
epinephrine (1:1000 and 1:10000);
lidocaine;
nitroglycerin tablets (0.4mg);
non-narcotic analgesic (325mg)

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11
Q

what medical devices are available in airplane?

A

blood pressure cuff, stethoscope, cardiopulmonary resuscitation mask,
oropharyngeal airways
manual resuscitation device

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12
Q

what is pulmonary embolism?

A

when a part of the DVT clot breaks off and travels to the lungs

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13
Q

what is venous thromboembolism refer to?

A

deep vein thrombosis and pulmonary embolism

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14
Q

is venous thromboembolism recurrent?
what is the long-term complications?

A

yes
post-thrombotic syndrome after a DVT
chronic thromboemblic pulmonary hypertension after a PE

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15
Q

what is Virchow’s classic triad for thrombus formation?

A
  1. venous stasis
  2. vessel wall damage
  3. hypercoagulable state
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16
Q

what are the risk factors of venous thromboembolism?

A

cancer (active);
estrogen use;
hospitalization, surgery, trauma (recent);
limited mobility;
obesity BMI 30 or more;
older age (after 40);
pregnancy and postpartum period;
previous VTE;
serious medical illness;
thrombophilia (inherited or acquired) or a family history of VTE;
air travel risk - height smaller than 1.6m and taller than 1.9m

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17
Q

after air travel, the risk of thrombosis returns to baseline by .. weeks?

18
Q

what are the symptoms of DVT/PE?

A

DVT - pain or tenderness, swelling, warmth in the affected area, redness or discoloration of the overlying skin

PE - unexplained shortness of breath, pleuritic chest pain, cough or hemoptysis, syncope

19
Q

how to diagnose DVT?

A

duplex ultrasonographyho

20
Q

how to diagnose PE?

A

CT pulmonary angiography;
ventilation-perfusion scan (2nd line)

21
Q

how to treat DVT or PE?

A

anticoagulant medications -
injection:
unfractionated heparin;
low molecular weight heparin;
fondaparinux

oral:
apixaban, betrixaban, dabigatran, edoxaban, rivaroxaban, warfarin

22
Q

is graduated compression stocking recommended for long-distance travelers not at increased risk of VTE?

23
Q

is there an evidence for an association between dehydration and travel-related VTE?

24
Q

what are the recommendations to prevent VTE for long-distance travelers?

A
  1. calf muscle exercises
  2. frequent ambulation
  3. aisle seating when possible
  4. graduated compression stocking (ONLY if at increased risk of VTE)
25
where is the melatonin secreated from the body?
pineal gland
26
what is the risk of melatonin?
may increase the frequency of seizures in people with epilepsy; potentially induce proinflammatory cytokine production, thus, should not be taken by those with autoimmune diseases
27
what are other alternatives of melatonin for jet-lag?
ramelteon - melatonin-receptor agonist; tasimelteon - dual melatonin-receptor agonist
28
what is the leading cause of nonnatural death among US citizens who die in a foreign country?
motor vehicle crashes
29
which country has the highest crash death rate for US travelers?
dominican republic
30
a good-quality helmet can reduce the risk for death by ... % and for severe injury by ... %
40% 70%
31
what are risk factors for crashes?
alcohol-impaired driving; bus travel; mobile telephones; country-specific driving hazards; general driving hazards; pedestrian hazards; taxis or hired drivers
32
most cruise lines do not permit pregnant people from ... week?
24th week
33
what is the most common medical complaints on cruise ships?
respiratory illness
34
how is Legionnaires' disease contracted?
by inhaling warm, aerosolized water containing the bacteria, Legionella; through aspiration of Legionella-containing water; typicaly human-to-human does not occur; contaminated hot tubs are commonly implicated as a source of shipboard Legionella outbreaks
35
what is the most common cause of GI illness on cruise ships?
norovirus
36
GI outbreaks on cruise ships also have been caused by contaminated food or water; most outbreaks were associated with ....?
Campylobacter; Clostridium perfringens; enterotoxigenic E. coli
37
what are the risk factors for motion sickness?
age, sex, preexisting medical conditions, concurrent meds -2-12 yrs esp susceptible; ->50 years are less susceptible; pregnancy, menstruation, taking hormone replacement therapy or oral contraceptives ppl with hx of migraines, vertigo, vestibular disorders
38
what are motion sickness symptoms?
Anorexia Apathy Cold sweats Drowsiness Generalized discomfort Headache Hyperventilation Increased sensitivity to odors Loss of appetite Nausea Salivation, excessive Sweating Vomiting or retching Warm sensation
39
what are medications for motion sickness?
antihistamines (cyclizine, dimenhydrinate, meclizine, promethazine); anticholinergics (scopolamine); benzodiazepines; dopamine receiptor antagonists (metoclopramide, prochlorperazine); sympathomimetics (often with antihistamines)
40
what is kids meds for motions sickness 2-12 years old?
dimenhydrinate - 1-1.5mg/kg per dose; diphenhydramine 0.5-1mg/kg per dose up to 25mg; oversedating young children with antihistamines can be life-threatening! no scopolamine!
41