Special Assistance

Pre-travel medical examinations

It is recommended that international passengers seek a pre-travel medical examination and advice on vaccinations, safety precautions and information on the current situation at the destination, before and for the duration of the trip.

 

 

Whilst traveling

Air travel may have physical or psychological effects: stress, abdominal distension, ear pain, sinus congestion, leg swelling, body ache, airsickness, jet lag and, in rare cases, deep vein thrombosis.

 

Some recommendations to keep in good form during your flight:

• Avoid heavy meals before and during flight
• Breath deeply, be relaxed, as stress increases gastric acidity and abdominal discomfort
• Keep hydrated by drinking water or fruit juice throughout the flight; avoid alcohol and caffeinated drinks because of their diuretic effect
• Use moisturizer to prevent skin dryness
• Wear loose fitting cloths, take off shoes and move around in the cabin
• Stretch and move your body as recommended for in-flight exercises<
• Consult your doctor for appropriate treatment to prevent airsickness; keep eyes fixed on a non-moving object during turbulence
• For personnel hygiene, wash hands regularly

 

Well controlled, diabetics can travel by adjusting their treatment and meal times to specific time zones. Patients with insulin should inform the airline before departure and carry with them a medical certificate (in English) for bringing syringes and needles on board.

 

Some health hazards from pressure changes during flight : 

• Otitis and sinusitis

• Passengers with nasal allergies or chronic sinusitis are more prone to have ear and sinus problems because of low humidity in the cabin, changes in cabin pressure during ascent and descent aggravated nasal congestion. Especially during descent, the Eustachian tube tends to collapse in the middle ear, resulting in the characteristic “pop” sensation, difficulty hearing and pain. To avoid ear blockage :
• Keep hydrated by drinking throughout the flight
• Use nasal decongestant spray, normal saline spray or other decongestants 30 minutes before departure to prevent nasal swelling
• To prevent blockage, practice frequent swallowing, chewing or gentle Vasalva maneuver (holding nose and generating pressure with closed mouth until ears pop)

• Jet lag

Trans-meridian flights through multiple time zones on long-haul routes can cause sleeping difficulties stemming from biological clock and circadian rhythm disorder. The main symptoms are sleeping difficulty, tiredness, dizziness, constipation and a decrease in mental and/or physical performance. Elderly passengers, passengers traveling on night flights and eastward tend to be more sensitive to jet lag. To re-synchronize the internal biological clock more easily, some tricks can be used:

• Avoid drinking alcohol and caffeinated drinks
• Melatonin or short action hypnotics can be used (melatonin is contra-indicated in children, people taking warfarin or those who have epilepsy)
• Going to bed one hour earlier and awakening one hour earlier three days before traveling eastward and later if traveling westward
• Natural light exposure during day at the new destination will help resynchronization

• Deep vein thrombosis (DVT)

So-called “economy class syndrome” is a condition in which the thrombus develops in deep veins due to long distance flights, variation of cabin atmosphere (decrease in humidity and hypoxia, for example), immobility and dehydration. A dangerous consequence is that DVT can result in a pulmonary embolism. Symptoms of DVT can come late, after flights, indicated by aching or soreness in the calf, swelling in the calf or ankles, slight fever or feeling unwell.

 

People with the following risk factors should be aware of DVT :

• People over 40 
• Past history of venous thrombosis
• Recent surgery especially abdominal, pelvic or leg surgery 
• Prolonged immobilization
• Coagulation problems or increased blood viscosity
• Pregnancy or recent delivery
• Cancer
• Cardiovascular diseases
• Estrogen hormone therapy or oral contraception
• Cigarettes smokers
Varicose veins
• Obesity

Safety precaution to avoid DVT :

• Wear loose fitting and comfortable clothing
• Wear graduated compression stockings
• Keep hydrated by drinking lots of water throughout the flight
• Leave the underside of the seat in front of you free to be able to move the legs
• Walk often in the cabin
• Exercise as recommended in the aircraft
• High risk passengers should consult their doctor before travelling for prevention (such as with low molecular weight heparin or aspirin)

On board Medical Assistance

TG like every airline has some capability to render medical care inflight. Cabin crews are well and regularly trained for first aid and cardiopulmonary resuscitation, and they also may ask for assistance from an on-board medical doctor. Medical equipment available includes:

• First- aid kits (to used by cabin crew)
• Medical kits (one white and one black) are available for on-board medical doctors or with use of defibrillator
• Automatic external defibrillator (AED)
• Wheelchair (for long distance flight)