Preflight Medical Screenings of Patients: Materials and Methods
The medical screening policies and practices of commercial air carriers in the United States vary greatly. One major domestic carrier in the United States, Delta Air Lines, routinely refers passengers with known medical conditions, needs, or uncertain health status to a 24-h airline medical advisory service (Air Ambulance, Inc., San Carlos, Calif) for preflight screening and clearance. The advisory staff consists of registered nurses with experience in emergency department medicine, critical care units, and patient transport by fixed-wing aircraft. The nurses are trained in communication skills and conflict resolution, as well as Advanced Cardiac Life Support (American Heart Association), aviation physiology, and regulations of the Department of Transport and Federal Aviation Administration. The staff is supervised by a medical director who is an emergency department physician.
All preflight assessments were conducted by telephone and, when appropriate, facsimile. Agents from Deltas Customer Service Department throughout the United States referred to the medical advisory service those passengers who booked flights and who had known or possible medical issues. The advisory nurse then contacted the passenger or the passengers relative or friend, or both the passenger and a relative or friend, as well as the primary physician or nurse or both. The screening nurses utilized a standard evaluation form which requested information about the patients age, primary and associated medical conditions, a brief medical history, allergies, medications, oxygen use, recent laboratory data («eg, arterial blood gas levels or oximetry, hemoglobin value), history of previous flights, ambulatory status, accompanying individuals, special needs (eg, wheelchair, seating, oxygen, equipment, diet), complete flight itinerary, and physicians name and telephone number. The medical information was routinely confirmed with the patients physician or nursing staff, or both. The patient and physician were advised about any special arrangements and informed that a release letter and, if necessary, oxygen prescription, were needed for final clearance. The patients flight status was followed by the screening nurse until the individuals screening process was completed. The average time for completing a screening evaluation was generally 50 min, although there was great variability. The Customer Service Department agent was then notified about the screening status of the referred patient. Preflight screenings performed between Jan 1, 1991, and Dec 31, 1991, constituted the data for this report. The forms were collected quarterly, reviewed, and analyzed with a file management program (Professional File Version 2.0, Software Publishing Corp., Mountain View, Calif). Gate and in-flight emergencies and informational questions by airline personnel were excluded from analysis for the purpose of this study.
Category: Preflight Medical Screenings
Tags: antiseizure medications, cardiac disorders, cardiac medications, oxygen therapy