In message <00af01c13a49$14f35700$10af7dc2@pcwhj>, John Ryan
<[log in to unmask]> writes
>Back in Dublin I find I am having to re-learn all about treating rugby
>players ! Recent chap with a small traumatic right sided pneumothorax (10%)
>following a knee in the back wants to fly on day 10 to Europe, about a 2
>hour
>flight.
>
>How long do list members advise a patient should wait before flying ?
>Bearing in mind Angus Wallace's moment of glory with the famous coathanger,
>urinary catheter and bottle of water, certainly not the next day but 1 week
>post re-expansion ? 2 weeks ? 6 weeks ?
>
>And when would you let him play contact sport again ?
>
>There is one very thin paper with a series of 12 people which is hardly woth
>quoting but I can find little else based on sound evidence.
>
>
>Dr John Ryan
The figure of six weeks refers to the general advice that is given for
spontaneous pneumothorax. I would not be surprised if the airlines gave
the same advice for traumatic pneumothorax.
Having said that, the advice in my aviation medicine text book reads as
follows:
"once it has resolved, the risk of recurrence is extremely small and so
no further treatment is required. Once the initial episode is over,
aicrew can return to unrestricted flying duty"
and errr... thats it!
(Hopkirk J.A.C in Aviation Medicine 2nd Ed 1988, Ch 45 P600)
With a bit of luck, the advice in the next edition will have changed.
Straight after resolution and into a performance jet for some high
altitude frolics seems a bit short to me.
In a civil airliner, the aviation docs like to consider not only the
likelihood of recurrence at a cabin altitude of say 8000ft, but also the
effects of an emergency cabin decompression.
I agree there is there is no evidence for the advice given
I have to say that six weeks is a safe length of time and can be
defended.
--
Stephen Hughes Cert Av Med, SpR Royal London Hospital
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