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.
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.
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 :
o Keep hydrated by drinking throughout the flight
o Use nasal decongestant spray, normal saline spray or other decongestants 30 minutes before departure to prevent nasal swelling
o To prevent blockage, practice frequent swallowing, chewing or gentle Vasalva maneuver (holding nose and generating pressure with closed mouth until ears pop)
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:
o Avoid drinking alcohol and caffeinated drinks
o Melatonin or short action hypnotics can be used (melatonin is contra-indicated in children, people taking warfarin or those who have epilepsy)
o Going to bed one hour earlier and awakening one hour earlier three days before traveling eastward and later if traveling westward
o Natural light exposure during day at the new destination will help resynchronization
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.
o People over 40
o Past history of venous thrombosis
o Recent surgery especially abdominal, pelvic or leg surgery
o Prolonged immobilization
o Coagulation problems or increased blood viscosity
o Pregnancy or recent delivery
o Cardiovascular diseases
o Estrogen hormone therapy or oral contraception
o Cigarettes smokers
o Varicose veins
o Wear loose fitting and comfortable clothing
o Wear graduated compression stockings
o Keep hydrated by drinking lots of water throughout the flight
o Leave the underside of the seat in front of you free to be able to move the legs
o Walk often in the cabin
o Exercise as recommended in the aircraft
o High risk passengers should consult their doctor before travelling for prevention (such as with low molecular weight heparin or aspirin)
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)
While en route our flight attendants will provide hot beverage service to passengers. In order to prevent burn injuries from hot liquid spills, we would like the passengers to:
-When a coffee/tea cup is placed on a carry tray, please wait until the flight attendant finishes pouring the hot liquid and then pick up the coffee/tea cup with caution.
-In case of no carry tray in use, the flight attendant will pour the hot liquid into a coffee/tea cup that the passenger holds with a handle. Please wait until he/she finishes pouring before taking it back; otherwise hot liquid may spill out and possibly cause injury.
Passenger seats on board all THAI aircraft have been designed, in line with standard aviation regulations, to be properly fitted, convenient and secure. In particular on long haul flights, some passengers may prefer to change their position by lying on the cabin floor around seating areas, but this can pose a threat to their own safety. Despite a clean and tidy floor, tiny dust particles in the carpet may cause allergic symptoms, and even affect the respiratory system. Moreover, the on-board oxygen may not be circulated fully and sufficiently down on the floor, causing difficult to breathe, and, upon getting up, the passenger may feel light-headed and dizzy. Most importantly, when lying on the cabin floor contact with the metal parts of the seat and floor can cause severe injury, especially during turbulence.
Sick passengers are sensitive to minor changes, therefore medical consultation before travelling is necessary to minimize health risks. Medications must be kept in the hand luggage. Travelers with metallic prosthesis, cardiac pacemaker, internal defibrillator or those who have to carry medical equipment on board must travel with a medical certificate.
Disabled passengers who need assistance during flight must be accompanied and notify in advance for special arrangements by cabin crew.
Passengers with medical conditions not treated and stabilized, or passengers which conditions that can be aggravated during flight, must have medical clearance before flight reservation. A MEDIF (medical information form) must be filled by treating doctor to inform the details of the medical conditions, and if special equipment such as oxygen, a wheelchair or stretcher is needed. The company has the right to refuse, delay or ask for changing travel conditions. Travelling by plane is permitted only for treated and stabilized patients.
The following conditions are contra-indicated for air travel :
• Infant less than 7 days of age, the cabin atmosphere can cause problem for newborns. MEDIF is needed for premature babies.
• Pregnant women : non complicated pregnancy is accepted on board; the conditions depend on the airlines to prevent premature labor on board; caution should be exercised about frequent flying during early weeks because of hypoxia. The conditions for pregnant women are as follows :
1. Pregnancy more than 28 weeks must have a medical certificate confirming the date of delivery and conditions of pregnancy
2. Single pregnancy can travel until 36th week for the flight less than 4 hours and 34th weeks for the flight more than 4 hours. The medical certificate with estimate date of delivery and confirmation of a normal pregnancy is needed. 3. Multiple or complicated pregnancy (placenta previa, past history of premature delivery etc.) are relatively contra-indicated for travelling long distance by air, the medical approval from the company is absolutely needed. 4. Pregnancy more than 36 weeks is an absolute contra-indication for travelling by air.
• Patient with cardiovascular and pulmonary diseases
Assure sufficient quantities of cardiac medications for the entire trip, including sublingual nitroglycerin, and keep in carry-on luggage. Keep a separate list of medications including dosing intervals and tablet size in the event that medications are lost. Limit unnecessary ambulation, particularly inflight. The following conditions are not safe for air travel :
1. Unstable chest pain - Recent myocardial infarction (MI) and congestive heart failure should not fly until at least 6 weeks have passed and they are back to usual daily activities no more chest pain
2. Coronary artery bypass grafting (CABG) and other chest surgeries should wait until the air is resorbed 2 weeks before air travel because air is transiently introduced into the chest cavity, there is a risk for barotrauma at decreased atmospheric pressure
3. Uncontrolled heart failure
4. Untreated hypertension with systolic blood pressure higher than 160 mmHg. No contra-indication to air travel for patients with hypertension as long as it is under reasonable control. Such patients should be reminded to carry their medications onboard
5. Untreated arrhythmia (heart rhythm must be controlled and on anti coagulant for travelling)
6. Decompensated valvular diseases
7. Scuba diving less than 24 hours or decompression sickness
8. Untreated or unstable pneumothorax
9. Undrainaged pleural effusion
10. Asthma, air travel is contra-indicated for those with asthma that is labile, severe, or that has required recent hospitalization. For asthmatics of less severity who are fit to fly, it is imperative that they are reminded to hand-carry on board any vital medication, particularly inhalers for rapid relief of symptoms
11. Chronic obstructive pulmonary disease (COPD). Patients with chronic bronchitis, interstitial lung disease and emphysema are susceptible to significant inflight hypoxemia, depending on their baseline PaO2. Preflight evaluation of these patients is ability to walk 50 meters or climb stairs without dyspnea and shortness of breath
12. Uncontrolled respiratory failure
13. Patient under mechanical ventilation or with the unstable condition for the trip
14. Active pulmonary infection
15. Neuromuscular diseases with hypoventilation and require a mechanical ventilation
16. Pulmonary tuberculosis especially in immunodeficients treated less than 2 weeks
17. Thoracic surgery less than 3 weeks
18. Special precaution for the patients with tracheostomy because of low humidity in the cabin
• Central Nervous System Disorders
1. Uncontrolled epilepsy or the patients undergone for brain surgery with no complications less than 2 weeks. Normally, the passengers with stable epilepsy or after brain surgery may be more prone to seizures during a long flight, mild hypoxia and hyperventilation are known precipitating factors, in addition to the aggravation of fatigue, anxiety and irregular medication. Whilst it would not be appropriate to change medication immediately prior to a trip, consideration should be given to providing extra anti-convulsive medication. If nothing else, the passengers with epilepsy must ensure that they have sufficient medication in their hand baggage for the duration of the flight and also for any unexpected delays
2. Following a stroke or cerebrovascular accident passengers usually have to wait at least 2 weeks before travel if stable or recovering. For those with cerebral artery insufficiency, hypoxia may lead to problems and supplementary oxygen may be advisable
3. Patients with accident and brain injury less than 15 days
4. Untreated brain edema or lumbar puncture less than 1 week
5. Patients who have recent brain scan with use of contrast media less than 3 days
6. Psychiatric patients need medical clearance in advance of intended travel. Patients with psychotic disorders who are stabilized on medication and are accompanied by a knowledgeable companion plus suitable sedation may be able to fly
• Gastro-Intestinal Disease :
Passengers may experience abdominal discomfort because of gas expansion in fight.
1. Patients who have abdominal surgery in which hollow viscus has been sutured are at risk of perforation or hemorrhage as a result of gas expansion at altitude. Air travel should be discouraged for 2 weeks following any abdominal surgical procedure
2. Travelers with colostomies are not at increased risk during air travel although intestinal distension may increase fecal output. The use of a large colostomy bag is recommended. More frequent changes may be necessary for smaller bags and extra supplies should be carried in the cabin hand baggage
3. Patients with intestinal occlusion or with hemorrhage from ulcer sites or rupture of esophageal varices. For hemorrhage, travel may be permitted if there is clear endoscopic evidence of healing or wait for 3 weeks and hemoglobin level more than 10 g/dl
4. Severe gastroenteritis with dehydration
5. Patients who have gastric or intestinal surgery in the past 7 days
6. Patients who have a colonoscopy in the past 24 hours
• Deep Vein Thrombosis (DVT):
Passengers are at risk of developing economic class syndrome from cramped seating, inactivity, prolonged immobilization, depletion of body fluids causing increased blood viscosity, poor blood circulation and swelling of feet and legs then a thrombus develops in the deep veins. To reduce the risk while traveling it is recommended to wear comfortable shoes or take shoes off, exercise the calves, mobilize, stretch arms and legs every couple of hours, walk around the cabin, avoid sleeping pills, remain adequately hydrated and avoid excess alcohol.
• Others medical problems
1. Ophtalmological conditions such as retinal detachment less than 3 weeks, acute glaucoma or recently operations (in the past 1 month), recent cataract surgery, unhealed keratitis, ocular surgery in the past 3 months
2. Acute sinusitis or acute otitis
3. Ear surgery in the past 3 months
4. Severe anemia with hemoglobin less than 10 g/dl. At low oxygen levels in cabin, passengers may experience lightheadedness or even lose consciousness during flight and hemoglobin less than 8.5 g/dl is contra-indicated for air travel
5. Diseases that need medical equipments forbidden by airline regulation
6. Transmitted infections : chicken pox, measles, mumps, pertussis, herpes zoster etc.
7. Immunodeficient patients with severe complications
8. Unstable diabetes must not travel by air. For well controlled diabetes, the first step is to order from the airline, in advance, the appropriate diabetic meal. Diabetic travelers should carry all medications (as well as needles, syringes, blood glucose monitors, sugared snacks, and a device to store needles/lances) in carry-on luggage and not in checked luggage. Journeys may across several time zones. It is recommended to remain on departure time during the flight and attempt to readjust to local time on arrival at destinations
9. All recent surgery or recent injury, gas trapped within the body will cause problems at altitude
10. Recent fracture under plaster cast (cast must be split for traveling to avoid compartment syndrome or harmful swelling on long flight)
11. Severe burn or infected large wounds
12. Terminal stage of illness which can deteriorate during trip
13. Precaution for the patients with urinary catheter, balloon must be filled with water, the catheter changed before departure with no sign of urinary tract infection by direct examination and by urine culture
Due to the number of passengers on THAI flights, the company cannot guarantee a 100% nut-free environment in its lounges nor aircraft cabins. Nevertheless, if THAI is informed well in advance of a passenger’s medical condition, the company will strive to ensure that each touch point is aware of passenger requirements.
We also highly recommend that you carry your medication and/or medical ID bracelets at all times, as well as alert THAI staff in cases of allergic reaction.
1. Avoid traveling in remote areas.
2. Consult your family doctor regarding appropriate medications, vaccinations, etc.
3. For any existing, chronic illness, to ensure that health conditions are safe for the trip, keep any necessary medication in your hand luggage.
4. Pack appropriate clothing for the destination.
5. Confirm your health insurance before flying
1. Exercise and try to move around in the aircraft to prevent blood clots.
2. Keep hydrated by drinking a lot of water; avoid alcohol and coffee.
1. Elderly passengers ¬– like small children – are more prone to severe dehydration, therefore they should avoid long term sun exposure.
2. Prevent constipation by increasing water intake or using laxatives if necessary.
3. Be mindful of food and water hygiene.
4.Take adequate rest to adjust to the local time zone.
5. Keep skin clean to avoid infections.
- Inform the local reservation & ticketing officers about children’s information for appropriate seating and preparation of facilities on the aircraft
o The Bassinet for babies less than 6 months of age, weighing less than 10 kg and not exceeding 62 67 cm in length.
o For babies less than 2 years old, an FAA-approved car-seat can be used on the normal paid seat for a child fare.
- Babies and toddlers must be held in the arms during taking off and landing
- Prepare adequate clothing to keep the baby warm in the plane
- Air travel is not recommended for infants during the first week of life, when a newborn’s body is still adjusting to life outside the uterus and to assure that the child is healthy and free of congenital defects. Healthy infants 7 days of age are acceptable to travel with an adult passenger.
- Children with chronic disease may be at risk for hypoxia during flight, and a physician should be consulted before air travel.
- Changing cabin pressure cause temporary changes in middle ear pressure, which can result in pain. To minimize this, it is helpful to have a baby nurse a bottle, breast or suck on a pacifier (older children may drink from a cup or chewing gum) particularly during descent. This will help equalize the air pressure in the middle ear.
- For children who suffer from motion sickness, medication can be used 30 minutes before departure
For more information, please contact your local THAI office
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