Fit To Fly

No flying with:

  • Unstable angina
  • Decompensated cardiac failure
  • Uncontrolled hypertension
  • Uncontrolled arrhythmia
  • Severe symptomatic valve disease
  • If patient with respiratory problem can not walk 50m
  • Hypoxic challange test:
    • person breaths 15% Oxygen for 20mins
    • Sats are monitored throughout and ABG or SpO2 measured beforehand and on completion if PaO2 less than 55mm Hg – will need Oxygen in flight
  • Someone with active exacerbation of respiratory disease should wait until better to fly
  • Untreated pneumothorax
  • If pneumothorax has been treated they can fly at 2weeks


  • colonoscopy
  • laparoscopy

3 days

  • CVA

5 days

PCI – and needs assessment

7 days

  • Uncomplicated MI
  • Neurosurgery
  • Eye surgery (not retianal detachment) / penetrating eye trauma (

10 days

  • CABG
  • Abdo surgery

2-6 weeks

  • retinal detachment surgery

4-6 weeks

complicated MI

In flight oxygen required for:

  • Need for oxygen at baseline
  • NYHA III or IV

  • PaO2 <70
  • Angina iii or VI
  • Cyanotic congenital heart disease
  • Primary pulmonary hypertension
  • other known problems with baseline hypoxia


  • Not after 36 weeks for uncomplicated singletons
  • Not after 32 weeks for multiple pregnancy
  • Most airlines need confirmation from doctor after 28 weeks – including estimated delivery date and whether the pregnancy is progressing normally



  • If baby was born after 37weeks – wait til one week after baby would have been 40 weeks to fly
  • If babies were born premature they should have inflight O2 available
  • Infants with neonatal respiratory problems and chronic lung disease should have hypoxic challenge test pre-flight


  • If the Hb<7.5 need assessment and will probably require in flight O2
  • Patients with sickle cell should have Oxygen avaiable and shouldn’t fly within 10 days of a crisis



  • Flying is contraindicated if: middle ear infection, effusion, recent ear surgery – unless deemed fit by ENT doc
  • Large polyps, acute sinusitis and recent nasal surgery are relative contraindications

Post Op:

  • Abdo surgery – 10 days
  • Colonoscopy – 24hours
  • Laparoscopy – 24hours
  • Neurosurgery – 7 days
  • Retinal detachment surgery – 2-6 weeks depending on gas
  • Eye surgery / eye trauma – 7 days
  • If stoma may need bigger bag


  • Wait 24hours after cast application if flight less than 2 hours
  • Wait 48hours after cast application if flight more than 2 hours


  • assess on individual basis
  • epilepsy – be aware of changes in cicadian rhthym can upset them / delayed meal times etc

Contagious Disease

  • relative contraindication but depends on disease
  • Tuberculosis – patient should have proper treatment first and have two sputum smears negative



  • No restrictions for well controlled diabetics
  • Insulin usually needs  a letter to carry on board
  • Insulin shouldn’t be stored in the hold

Flying West to East – if more than two hours are lost – need to take a little less insulin

Flying East to west – if day is extended by more than two hours more short acting or medium acting insulin may be required