From shahsdestiny42 at gmail.com  Tue Nov 11 17:47:47 2008
From: shahsdestiny42 at gmail.com (jaspal singh)
Date: Tue, 11 Nov 2008 16:47:47 -0600
Subject: question?
Message-ID: <d61051ea0811111447q3270881i8393cab0e35c7c8d@mail.gmail.com>

how can we attempt to decrease the blood stasis problem on long flight?


From drdr0682 at aol.com  Wed Nov 12 10:10:14 2008
From: drdr0682 at aol.com (drdr0682 at aol.com)
Date: Wed, 12 Nov 2008 10:10:14 -0500
Subject: question?
In-Reply-To: <d61051ea0811111447q3270881i8393cab0e35c7c8d@mail.gmail.com>
References: <d61051ea0811111447q3270881i8393cab0e35c7c8d@mail.gmail.com>
Message-ID: <8CB12EFE6625C64-1498-3E9@WEBMAIL-DZ07.sysops.aol.com>


 I gave a talk at the recent AMTC in Minneapolis on PE/DVT. This included a discussion of PE/DVT in both the general patient population as well as the risks of PE/DVT in aircrew. In particular, I cited the case of a flight nurse on a long distance air ambulance service who had intemittent PEs for a year before diagnosis. 

I talked about what the literature says about risks in patients/crew who fly often - and there is some mild to moderate increased risk. 

The main thing that patients or aircrew that are relatively limited in mobility because of their jobs can do, is to keep the muscles moving in their lower extremities. Ideally, this means walking around. If that is not possible exercising the muscles in the feet, ankles and legs, while in the seat, is an alternative. 

Coincidentally, last night I was flying home from New Orleans on American Airlines and thumbing through their in-flight magazine. They devoted a whole page in the back of the magazine towards educating passengers about DVT risk and flying. They suggested staying well hydrated as there is some literature suggesting that the dehydration of higher altitude flight contributes to PE/DVT development. They also offered suggestions on exercises in the seat. They were fairly common sense like:

Dorsiflex the toes (point the toes and feet toward the head while seated) of both feet repetitively 10-15 times. Then plantar flex the feet (point the toes at the ground) a similar amount of time. 
Swing your feet in circles at ankle joint 10 -15 times. 
Flex your knees hips and bring your legs up to the chest 5-6 times. (Good luck finding room in a standard coach airline seat).Repeat as desired (and as tolerated by nearby passengers).

You get the general idea. 

The other regarding PE/DVT risk for aircrew that is not talked about is risk assessment at the time of hire and/or flight physical exam. I don't think there is any evidence - yet - that prospective crew need Factor V Leieden assessments or Protein C or S evaluation; but certainly historical risks should be sought. 

Prior history of PE/DVT
Family history
Smoking
Birth control pill use
Active Cancer
Recent Surgery or immobilization of a lower extremity.
Recent trauma to an extremity
Other recent long trips unrelated to work - car or other airplane flight.

These all should be screened for. Whether or not a crew member can fly with any of these risks is up to the program and/or the Occupational Health physician. In most of the above scenarios, I think they can, but they should be warned to take any potential symptoms very seriously and seek care. 

Symptoms of PE can be very, very subtle and are often ignored. Even when DVTs are present, there may be no symptoms. So an assessment of the crew's risk for PE/DVT should preceed flight and symptoms should be respected if they occur. 

Hope this helps. 

David Ross, DO FACEP
Colorado Springs CO



 


 

-----Original Message-----
From: jaspal singh <shahsdestiny42 at gmail.com>
To: flightmed at flightweb.com
Sent: Tue, 11 Nov 2008 3:47 pm
Subject: question?










how can we attempt to decrease the blood stasis problem on long flight?
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From Pedsrusscott at cs.com  Sun Nov 30 09:07:22 2008
From: Pedsrusscott at cs.com (Pedsrusscott at cs.com)
Date: Sun, 30 Nov 2008 09:07:22 -0500
Subject: baby pod
Message-ID: <0E2607F7.28D4B815.329B1E73@cs.com>

Greetings - As I recently saw the product again at a recent conference, I'm searching for contacts @ programs using the Baby Pod for neo/infant transport - any help/summaries of experiences with the product welcomed
thanx!
Scott DeBoer RN,MSN,CFRN
UCAN Flight RN




From BRUST at email.chop.edu  Sun Nov 30 09:28:39 2008
From: BRUST at email.chop.edu (Peter Brust)
Date: Sun, 30 Nov 2008 09:28:39 -0500
Subject: baby pod
Message-ID: <s9325cd3.042@email.chop.edu>

Scott we have baan using the baby pod for 4 years and. Would be happy to
talk with you about it. Give ma some times during the week that are
convenient for you.  Peter 
Peter Brust RN MSN 
Nurse Manager 
Emergency Transport Services 
Children's Hospital of Philadelphia 
215.590.2268 office  
-----Original Message----- 
From: Pedsrusscott at cs.com 
To:  <"flightmed at flightweb.com".GWIA1.MERCURY> 
To:  <"Pedsrusscott at cs.com".GWIA1.MERCURY> 
 
Sent: 11/30/2008 9:07:22 AM 
Subject: baby pod 
 
Greetings - As I recently saw the product again at a recent conference,
I'm searching for contacts @ programs using the Baby Pod for neo/infant
transport - any help/summaries of experiences with the product welcomed 
thanx! 
Scott DeBoer RN,MSN,CFRN 
UCAN Flight RN 
 
 
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From dean at spectrum-aeromed.com  Sun Nov 30 10:17:11 2008
From: dean at spectrum-aeromed.com (Dean Atchison)
Date: Sun, 30 Nov 2008 10:17:11 -0500
Subject: baby pod
Message-ID: <34B550D679366A49A1436B100AE9637A08F349@be40.exg3.exghost.com>

Scott: 
We have worked with many Air Medical programs to develop excellent solutions for pediatric transport.  Our Director of Special Missions, Jon Ness is always willing to discuss needs, options & solutions & we can put you in touch with a number of clients.  Let's try to touch base on Monday.
Respectfully,
Dean Atchison
Spectrum Aeromed
www. Spectrum-aeromed.com

Dean Atchison

Sent from my Blackberry Curve.

----- Original Message -----
From: flightmed-bounces at flightweb.com <flightmed-bounces at flightweb.com>
To: flightmed at flightweb.com <flightmed at flightweb.com>
Sent: Sun Nov 30 09:07:22 2008
Subject: baby pod

Greetings - As I recently saw the product again at a recent conference, I'm searching for contacts @ programs using the Baby Pod for neo/infant transport - any help/summaries of experiences with the product welcomed
thanx!
Scott DeBoer RN,MSN,CFRN
UCAN Flight RN


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