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Every year, over one billion people travel by air and that figure is predicted to double in the
next two decades.
Air travel is a comfortable and safe means of transport and is accessible to all sectors of the
population. The global increase in travel, as well as an increasingly aged population, means that
there may be a significant increase in older passengers and those with an illness who wish to
Health professionals may increasingly be asked to assess a patient’s fitness to fly, including
both UK nationals planning to travel abroad and visitors from overseas who need to be repatriated
following an accident or illness while in the UK. Most patients will be able to fly safely, but
some may require additional measures such as in-flight supplementary oxygen. Where necessary, even
passengers who require specialist in-flight medical care up to intensive care level can usually be
transported by air ambulance, although the cost of this can be prohibitive unless covered by the
patient’s medical insurance.
These guidelines address the most common issues that may affect a passenger’s fitness to fly.
Further advice and guidance is available in the IATA passenger medical clearance guidelines, the Aerospace Medical Association and, if the
passenger has made a booking, from the airline medical department (where there is one).
The Aviation Health Unit can be contacted for advice by emailing firstname.lastname@example.org.
It is important to note that although Cabin Crew are trained to render advanced first aid, they
are not trained to administer medication. In addition, most airlines will assist passengers to
reach the toilet accommodation on the aircraft but cannot render more personal hygiene or nursing
The majority of in-flight emergencies occur in situations when an individual's medical condition
is unknown to the airline and it is therefore essential that the passenger’s physician sends
adequate details well in advance of the flight to the carrier. Most airlines have medical advisors
who provide advice and “clear” passengers as fit to fly.
The key information that they require is:
The clearance can be done by telephone or by formal communication using the MEDIF form,
available through travel agents or from the internet, which allows the medical information to be
structured in a manner that can be processed by the majority of airlines.
The final decision whether or not to carry a passenger is that of the airline, but the more
information that is provided in advance, the more likely it is that a reasonable, evidence based
decision can be made.
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